Survival rates of short dental implants (≤6 mm) compared with implants longer than 6 mm in posterior jaw areas: A meta-analysis

Purpose: To systematically review randomized controlled clinical trials (RCTs) reporting on the long-term survival and failure rates, as well as the complications of short implants (<= 6 mm) versus longer implants (>6 mm) in posterior jaw areas. Materials and Methods: Electronic and manual searches were conducted to identify studies, specifically RCTs, reporting on short dental implants (<= 6 mm) and their survival and complication rates compared with implants longer than 6 mm. Secondary outcomes analyzed were marginal bone loss and prosthesis survival rates. Results: Ten RCTs fulfilled the inclusion criteria and featured a total of 637 short (<= 6 mm) implants placed in 392 patients, while 653 standard implants (>6 mm) were inserted in 383 patients. The short implant survival rate ranged from 86.7% to 100%, whereas standard implant survival rate ranged from 95% to 100% with a follow-up from 1 to 5 years. The risk ratio (RR) for short implant failure compared to standard implants was 1.29 (95% CI: 0.67, 2.50, p=0.45), demonstrating that overall, short implants presented higher risk of failure compared to longer implants. The heterogeneity test did not reach statistical significance (p = 0.67), suggesting low between-study heterogeneity. The prosthesis survival rates from the short implant groups ranged from 90% to 100% and from 95% to 100% for longer implant groups, respectively. Conclusion: Short implants (<= 6 mm) were found to have higher variability and lower predictability in survival rates compared to longer implants (> 6 mm) after periods of 1-5 years in function. The mean survival rate was 96% (range: 86.7%-100%) for short implants, and 98% (range 95%-100%) for longer implants. Based on the quantity and quality of the evidence provided by 10 RCTs, short implants with <= 6 mm length should be carefully selected because they may present a greater risk for failure compared to implants longer than 6 mm.