Clinical performance of short and extrashort dental implants with wide diameter: A systematic review with meta-analysis

Statement of problem. Rehabilitation with wide-diameter reduced-length implants has become popular for patients with minimal vertical bone. However, a consensus on the benefits of this approach is lacking. Purpose. The purpose of this systematic review with meta-analysis was to evaluate the influence of wide compared with regular diameter on the clinical performance of short (<10 mm) and extrashort (<6 mm) dental implants used for rehabilitations with single crowns, fixed partial dentures, or both, in the posterior region. Material and methods. A search in 6 databases was conducted to select randomized controlled trials (RCTs) and nonrandomized controlled trials (N-RCTs). Five meta-analyses were performed, where the risk ratio (RR) was evaluated. The certainty of evidence was evaluated, and the risk of bias was determined from the Joanna Briggs Institute checklist. Results. Fourteen articles were included, 272 wide- and 478 regular-diameter implants. One study presented a low, 3 an unclear, and 11 a high risk of bias. Meta-analyses showed no statistical difference: implant survival, short dental implants in N-RCTs (up to 1 year- RR 1.01 [0.98; 1.03], 1 to 5 years- RR 1.01 [0.94; 1.08], more than 5 years- RR 1.01 [0.97; 1.06]), extrashort dental implants in N-RCTs (RR 1.04 [0.90; 1.20]), RCTs (RR 1.05 [0.88; 1.25]); implant success in N-RCTs (RR 1.01 [0.97; 1.05]); prosthesis success in N-RCTs (RR 1.01 [0.97; 1.05]). Conclusions. Short and extrashort dental implants with a wide and regular diameter appear to be clinically appropriate options for implant-supported posterior restorations, with high survival, success, and prosthesis success rates.