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Single-crown restorations in premolar-molar regions: short (<= 6.5) vs longer implants: retrospective cohort study

Abstract

Purpose To compare the survival, changes in marginal bone level and prosthetic complications rate of short (<= 6.5 mm) and longer implants (>= 7.5) supporting a single-crown restoration in the maxillary/mandibular premolar or molar region. Methods This cohort study was conducted following the STROBE statement recommendations for observational studies. Clinical outcomes of 88 short implants in 78 patients and 88 long implants in 88 patients were examined. All the implants had been placed by the same surgeon and restored following the same prosthetic concept; using a transepithelial abutment (intermediate abutment) and a screw retained restoration. Results All the implants were in function after the follow-up period since insertion (median: 31 months; range 11 to 84 for SiG vs median: 35 months; range: 6-117 for CG; p = 0.139). No statistical differences (p = 0.342) were observed related to prosthetic complications (screw loosening 2/88 vs 5/88 CG, ceramic chipping 1/88 vs 0/88, temporary crown resin chipping 1/88 vs 0/88 for SiG and CG, respectively) or related to marginal bone level (Mesial or Distal MBL >= 2 mm in 1/88 implants for SiG vs 3/88 for CG; p = 0.312). Conclusions Within the limitations of this study, no survival differences have been observed between short implants and longer implants in single-crown restorations in posterior maxilla/mandible.

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Single-crown restorations in premolar-molar regions: short (<= 6.5) vs longer implants: retrospective cohort study

Author: Anitua Aldekoa, Eduardo,Alkhraisat, Mohammad Hamdan,Eguía del Valle, Asier
Publisher: Springer
Year: 2022
DOI: 10.1186/s40729-022-00438-y
Source: https://addi.ehu.eus/bitstream/10810/58603/1/s40729-022-00438-y.pdf
Ani uae al.
In e na ional Jou nal o Implan Den is y (2022) 8:40
h ps://doi.o g/10.1186/s40729-022-00438-y
RESEARCH
Single-c own es o a ions inp emola –
mola egions: sho (≤ 6.5) s longe implan s:
e ospec i e coho s udy
Edua do Ani ua1,2*† , Mohammad Hamdan Alkh aisa 2 and Asie Eguia1,3†
Abs ac
Pu pose: To compa e he su i al, changes in ma ginal bone le el and p os he ic complica ions a e o sho
(≤ 6.5 mm) and longe implan s (≥ 7.5) suppo ing a single-c own es o a ion in he maxilla y/mandibula p emola
o mola egion.
Me hods: This coho s udy was conduc ed ollowing he STROBE s a emen ecommenda ions o obse a ional
s udies. Clinical ou comes o 88 sho implan s in 78 pa ien s and 88 long implan s in 88 pa ien s we e examined.
All he implan s had been placed by he same su geon and es o ed ollowing he same p os he ic concep ; using a
ansepi helial abu men (in e media e abu men ) and a sc ew e ained es o a ion.
Resul s: All he implan s we e in unc ion a e he ollow-up pe iod since inse ion (median: 31 mon hs; ange 11 o
84 o SiG s median: 35 mon hs; ange: 6–117 o CG; p = 0.139). No s a is ical di e ences (p = 0.342) we e obse ed
ela ed o p os he ic complica ions (sc ew loosening 2/88 s 5/88 CG, ce amic chipping 1/88 s 0/88, empo a y
c own esin chipping 1/88 s 0/88 o SiG and CG, espec i ely) o ela ed o ma ginal bone le el (Mesial o Dis al
MBL ≥ 2 mm in 1/88 implan s o SiG s 3/88 o CG; p = 0.312).
Conclusions: Wi hin he limi a ions o his s udy, no su i al di e ences ha e been obse ed be ween sho implan s
and longe implan s in single-c own es o a ions in pos e io maxilla/mandible.
Keywo ds: Den al implan s, Sho implan s, Ma ginal bone loss, C own- o-implan a io
© The Au ho (s) 2022. Open Access This a icle is licensed unde a C ea i e Commons A ibu ion 4.0 In e na ional License, which
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In oduc ion
Too h loss leads o changes in he in eg i y o he al eo-
la bone and so issues [1, 2]. The healing o ex ac ion
socke s leads o his ological and dimensional changes
in he emaining al eola idge [1–4]. P og essi e a o-
phy o he al eola p ocess begins a his momen bo h
ho izon ally and e ically. Reso p ion o he al eola
idge occu s due o a combina ion o di e en ac o s,
such as loss o he pe iodon al ligamen (and lack o he
ascula iza ion o he bundle bone), loss o unc ion (and
he s imulus on he bone), ac u es in he al eola wall
du ing ex ac ion o he subsequen occu ence o in ec-
ious p ocesses [1–4].
The physiological pos -ex ac ion eso p ion (RRR,
Residual Ridge Reduc ion) [5] can hinde he implan
ehabili a ion o missing ee h. I no only a ec s he
a ailable olume, bu also he densi y o he emaining
bone [5]. These changes could hampe he subsequen
placemen o an implan in an op imal posi ion o a ec
he es he ic esul s. [6]
Clinicians a e o en aced wi h he challenge o ea -
ing pa ien s wi h se e e e ical bone a ophy. Di e en
ea men op ions allow he use o s anda d implan s
in he pos e io egion whe e he ne e canal o he
Open Access
In e na ional Jou nal o
Implan Den is y
†Edua do Ani ua and Asie Eguia con ibu ed equally o he wo k
*Co espondence: edua do@ undacionedua doani ua.o g
1 Clínica Edua do Ani ua, Jose Ma ia Cagigal Kalea, 19, 01007, Vi o ia-Gaz eiz,
Ála a, Spain
Full lis o au ho in o ma ion is a ailable a he end o he a icle
Page 2 o 8
Ani uae al. In e na ional Jou nal o Implan Den is y (2022) 8:40
maxilla y sinus limi he esidual bone heigh , such as
guided bone egene a ion (GBR), maxilla y sinus g a -
ing, inlay o onlay bone g a , dis ac ion os eogenesis,
ne e la e aliza ion o o he s [7, 8]. These echniques
equi e g ea e knowledge and su gical skills on he pa
o he p o essional and po en ially inc ease he compli-
ca ion a e [9–12]. Recen ad ances in implan design
and sizing (sho , ex a-sho implan s) ha e p o ided
new solu ions and al e na i es o ha e allowed op imi-
za ion o exis ing ones [13–15]. In addi ion o acili a e
he p ocedu es, he use o sho implan s educes he isk
o eaching ana omical s uc u es a he ime o d illing,
minimizes he numbe o su ge ies, educes he ime and
cos o ea men , and sa es he need o bone augmen a-
ion. [7, 16–18]
In cases o e ical a ophy, he p os he ic space is
la ge hus inc easing he c own- o-implan a io. Fo -
me ecommenda ions abou he ideal p opo ions seem
ou da ed in sigh o he di e se clinical and biomechani-
cal s udies demons a ing he sa e y and good clinical
pe o mance o sho and ex a-sho implan s [19, 20].
C own- o-implan a ios anging om 0.9 o 2.2 did no
in luence he occu ence o echnical o biological com-
plica ions [21]. Indeed, i has been claimed ha wi hin
he ange o 0.6 o 2.36, he highe he c own- o-implan
a io, he less he pe i-implan ma ginal bone loss (MBL)
[20]. As he leng h o he implan is educed, i has been
sugges ed o inc ease he diame e o enhance he bone–
implan con ac and op imize he dis ibu ion o s ess in
he bone, pa icula ly in cases o low bone densi y. [22]
Sho implan s a e no limi ed o cases o limi ed a ail-
able bone. Cu en ly, sho implan s can be p e e ed o
main ain as much p is ine bone as possible, e en when
s anda d implan s could be housed. [23, 24]
Some au ho s epo ed ha sho implan s could ha e
lowe su i al a es han s anda d implan s [25, 26] bu
ecen sys ema ic e iews ha e shown ha sho implan s
had a be e o equal pe o mance compa ed wi h s and-
a d [27–29] and did no seem o ha e a signi ican in lu-
ence on ma ginal bone loss [30]. Se e al sys ema ic
e iews and me a-analysis ha e been conduc ed o cla i y
he con o e sies on he clinical pe o mance o sho
implan s [25, 31–34] bu hei esul s should be indi idu-
ally in e p e ed wi h cau ion o assess he e en ual p es-
ence o uncon olled con ounding ac o s in he included
s udies [31] (as s udies including bo h splin ed and non-
splin ed es o a ions, implan s placed in bo h g a ed o
p is ine bone, di e en implan designs and su aces o
di e en ypes o es o a i e design).
The e is also ano he con o e sy ega ding he clas-
si ica ion o sho implan s ha could esul in a mis-
in e p e a ion o he esul s. While some au ho s
conside ed sho implan s hose unde 10mm [35, 36],
o he s conside ed a leng h unde 8mm [37] and mo e
ecen ly, o he s unde 6.5mm [38] o 6mm. [39, 40]
Recen e idence om clinical ials has shown he need
o mo e s udies and longe pe iods o ollow-up be o e
he ecommenda ion o sho implan s o suppo single-
c own es o a ions [19, 40]. The objec i e o his s udy
has been he compa ison be ween sho implan s and
longe implan s in e ms o implan su i al, ma ginal
bone emodeling and p os he ic complica ions o single-
c own es o a ions.
Ma e ials andme hods
S udy design
The p esen unicen ic obse a ional e ospec i e s udy
was conduc ed ollowing he STROBE s a emen ecom-
menda ions o obse a ional s udies and in compliance
o he p inciples o he Decla a ion o Helsinki on clinical
esea ch in ol ing human subjec s. Be o e s a ing, he
pe mission o he e hics commi ee was ob ained om
he Basque d ug esea ch commi ee.
Sample size es ima ion
A s udy o a con inuous esponse a iable o ma ched
pai s o s udy subjec s was planned. The sample size was
es ima ed based on p e ious bone loss da a a 12-mon h
ollow-up indica ing ha he di e ence in esponse o
ma ched pai s was no mally dis ibu ed wi h a s anda d
de ia ion o 0.4320 [41]. I he ue di e ence in ma ginal
bone loss a 12mon hs o ma ched pai s was 0.13, 88
pai s o implan s should be necessa y o ejec he null
hypo hesis ha his di e ence in esponse is ze o wi h a
p obabili y (powe ) o 0.8. The p obabili y o ype I e o
associa ed wi h his es o he null hypo hesis was 0.05.
Pa ien s
Da a we e e ospec i ely collec ed om 88 sho
(≤ 6.5 mm; 78 pa ien s) and 88 longe implan s
(≥ 7.5mm; 88 pa ien s) andomly selec ed om a coho
o 16.780 implan s placed om 2012 o 2019 a he same
cen e (Edua do Ani ua Clinic, Vi o ia, Spain). A e
sample size es ima ion, his coho was di ided in wo
g oups (sho implan g oup; SIG and con ol g oup; CG)
and simple andom sampling was conduc ed using he
SPSS so wa e, (SPSS o Windows, Ve sion 15.0. Chi-
cago, SPSS Inc) o selec 88 implan s o m each g oup.
The inclusion c i e ia we e:
– Implan s placed bo h in maxilla o mandible
– Implan s suppo ing a single-c own sc ew- e ained,
es o ed using a ansepi helial (in e media e abu -
men ).
– Pa ien s o e 18yea s
Page 3 o 8
Ani uae al. In e na ional Jou nal o Implan Den is y (2022) 8:40
To add ess sou ces o bias, all pa ien s included in his
s udy had been p e iously ea ed by he same eam,
using he same implan sys em (UnicCa®, BTI Bio ech-
nology, Vi o ia, Spain) and he same su gical and p os-
he ic p o ocols. All he ea men s we e pe o med
ollowing he usual clinical p ac ice o he pa icipa ing
cen e o he inse ion and subsequen loading o sho
and s anda d implan s in he mandible and/o maxilla.
Da a collec ion me hods
The ou comes measu ed we e su i al (p esence o he
implan a he las isi ), MBL and p os he ic ( echnical)
complica ions. The bone le el assessmen was pe o med
e ically measu ing he dis ance om he bone c es
o he i s bone-implan con ac bo h mesially and dis-
ally. Measu emen s o es ima e MBL we e pe o med a
loading ime and a he ime o he las a ailable adio-
g aph using he Sidexis so wa e (Den sply Si ona; Yo k,
US) and he leng h o he implan was used as calib a o .
Among he echnical complica ions sc ew loosening/
b eak and ce amic/ esin chipping we e conside ed.
O he clinically ele an a iables eco ded we e
implan diame e , loca ion, inse ion o que, bone ype,
sex and age, esidual bone heigh , ype o an agonis ee h
and he need o addi ional su gical echniques. Follow-
up ime was calcula ed since implan inse ion (un il las
ecall) and implan loading (un il las ecall).
The c own- o-implan a io was de e mined by di id-
ing he leng h o he c own oge he wi h he ansepi he-
lial (in e media e) abu men by he leng h o he implan .
Residual bone heigh was measu ed om he bone idge
c es o he maxilla y sinus/ne e canal a he implan
posi ion, using he adiog aphy ob ained p e iously o
he su ge y.
In o ma ion abou smoking habi , alcohol in ake, dia-
be es o hype ension was also e ie ed om medical
eco ds. Bone ype quali y [42] was a ed wi h he aid o
compu e so wa e (BTI Scan, BTI Bio echnology, Vi o-
ia, Spain).
S a is ical analysis
A s a is ical analysis was pe o med using specialized
so wa e (SPSS o Windows, Ve sion 15.0. Chicago,
SPSS Inc). Ca ego ical a iables we e exp essed in abso-
lu e and ela i e equencies. Con inuous a iables we e
exp essed as median and ange. Be o e s a is ical analy-
sis, he no mal dis ibu ion o he con inuous a iables
was e alua ed using he Saphi o–Wilk no mali y es .
S a is ical di e ences be ween ca ego ical a iables we e
pe o med by he Chi-squa e es , and s a is ical di e -
ences be ween dicho omous and con inuous ca ego ical
a iables we e pe o med wi h he Mann–Whi ney es .
The e ec o he c own o implan a io on he ma ginal
bone loss was assessed by linea eg ession analysis. The
s a is ical signi icance was se a p < 0.05.
Resul s
The s udy included 176 den al implan s placed in 166
pa ien s ha complied wi h he inclusion/exclusion c i-
e ia. The Sho implan G oup (SiG) was composed by
88 sho implan s (≤ 6.5mm) placed in 78 pa ien s (53
emales; 35 males) and he Con ol G oup (CG) was com-
posed by 88 implan s (≥ 7.5mm) placed in 88 pa ien s
(52 emales; 36 males). Fu he demog aphic da a a e
p esen ed in Table1.
F om he SiG, 71 implan s we e 6.5mm-leng h and
17, 5.5mm-leng h. A ending o hei loca ion, 4 co e-
sponded o Uppe P emola s (UP), 3 o Lowe P emola s
(LP), 52 o Uppe Mola s (UM) and 29 o Lowe Mola s
(LM). Figu es1,2. F om he CG, 69 we e 7.5-leng h, 17
8.5 mm-leng h and 2 we e 10 mm-leng h, and co e-
sponded o 23 UP, 11 LP, 20 UM and 34 LM. Diame e o
he implan s is p esen ed in Fig.3. The diame e o SiG
implan s was highe (p < 0.001).
Residual bone heigh was highe (p < 0.001) in CG
(12.6 s 7.7mm) and c own- o-implan a io was highe
(p < 0.001) in SiG (1.7 s 1.3mm). Figu e4. Con e sely,
he e we e no s a is ical di e ences be ween bo h g oups
ega ding inse ion o que, bone ype o an agonis ype.
Fu he in o ma ion is a ailable in Table2.
A he ime o implan placemen , no di e ences could
be obse ed a ending o he numbe o implan s placed
equic es al (− 0.5 o 0.5 mm), subc es al > 0.5 mm o
sup ac es al < −0.5mm. in mesial, bu a highe p opo -
ion o sho implan s (p ≤ 0.001) we e placed equic es al.
A he ime o loading and las adiog aphy, no di e -
ences in bone le el we e obse ed be ween bo h g oups
in mesial. CG implan s we e mo e subc es al in dis al a
loading ime han SiG implan s (p ≤ 0.001). In addi ion,
du ing he las adiog aphy, a sligh di e ence (p < 0.05)
in dis al bone le el was obse ed in a o o CG implan s.
Mo eo e , he c own o implan a io did no signi ican ly
a ec he ma ginal bone loss (p = 0.781).
Table 1 Demog aphic da a
CG con ol g oup, SiG sho implan g oup
a Mann–Whi ney es
b Chi-squa e es
SiG CG p- alue
Numbe o pa ien s (n = 176) 78 88 NA
Numbe o implan s (n = 186) 88 88 NA
Age (yea s; median ( ange) 56 (20 o 78) 53 (18 o 76) 0.159a
Sex ( emales (males) 52 (36) 53 (35) 0.878b
Smoke s 7 8 0.787b
Page 4 o 8
Ani uae al. In e na ional Jou nal o Implan Den is y (2022) 8:40
Fig. 1 Le : 6.5 leng h implan placed in #3.7 posi ion. Cen e : 2 yea s la e ; single sc ew- e ained c own o e 4 mm. s aigh ansepi helial
(in e media e abu men ). Righ : 6 yea s a e implan placemen . No ma ginal bone loss obse ed a e 6-yea ollow-up
Fig. 2 Le : 8.5 leng h implan placed in #1.4 posi ion. Cen e : 2 yea s la e ; single sc ew- e ained c own o e 2 mm. S aigh ansepi helial
(in e media e abu men ). Righ : 6 yea s a e implan placemen . No ma ginal bone changes a e 6-yea ollow-up
3.30 3.50 3.75 4.00 4.25 4.50 5.00 5.50 6.00 6.25
SiG (≤6.5mm) 23285932 22 41
CG (≥7.5 mm) 319128 6419 16 10
0
5
10
15
20
25
30
35
SiG (≤6.5mm) CG (≥7.5 mm)
Fig. 3 Implan diame e . SiG (sho implan g oup), CG (con ol g oup)
Page 5 o 8
Ani uae al. In e na ional Jou nal o Implan Den is y (2022) 8:40
The ollow-up o den al implan s, since inse ion had
a median o 31 mon hs ( ange 11 o 84) o SiG and
35mon hs o CG ( ange 6–117).
All he implan s om bo h g oup we e in unc ion
a he las ecall (100% su i al) and he numbe o
p os he ic complica ion did no s a is ically di e (3
e en s o SiG s. 6 o CG). A ending o he Heal h
Scale o Den al Implan s [43], Success a e o SIG g oup
was 100% and 98.9% o CG. No s a is ical di e ences
in Ma ginal Bone Loss (MBL) we e obse ed ei he in
Fig. 4 Le : 5.5 mm leng h implan placed in he #2.7 posi ion. Sc ew- e ained single-c own o e a 3 mm ansepi helial (in e media e abu men ).
C own- o-implan a io: 1.84. Righ : 7.5 mm leng h implan placed in he same posi ion (#2.7). Sc ew- e ained single-c own o e a 3 mm
ansepi helial (in e media e abu men ). C own- o-implan a io: 1.80
Table 2 Su gical da a, c own- o-implan a io, and ollow-up da a
a Mann–Whi ney es
b Chi squa e es
G oup p- alue
Expe imen al Con ol
Residual bone heigh (mm; median ( ange)) 7.7 (4.2 o 17.6) 12.6 (7.7 o 20.4) 0.000a
Inse ion o que (Ncm; median ( ange)) 42.5 (5.0 o 70.0) 35.0 (5.0 o 70.0) 0.188a
Bone ype (numbe o implan s)
Type I 4 4 0.234b
Type II 44 49
Type III 33 22
Type IV 7 13
An agonis (numbe o implan s)
Too h 63 66 0.609b
Implan 25 22
C own o implan a io (median ( ange)) 1.7 (1.1 o 2.5) 1.3 (0.9 o 2.1) 0.000a
Immedia e loading (numbe o implan s) 49 49 1.000b
Follow-up since inse ion (mon hs; median ( ange)) 31 (11 o 84) 35 (6 o 117) 0.139a
Follow-up since loading (mon hs; median ( ange)) 27 (4 o 84) 31 (6 o 67) 0.249a
Follow-up o ma ginal bone le el (mon hs; median ( ange)) 24 (3 o 92) 30 (1 o 96) 0.095a

Page 6 o 8
Ani uae al. In e na ional Jou nal o Implan Den is y (2022) 8:40
mesial o dis al be ween bo h g oups a e he ollow-
up pe iod. The e we e no di e ences in he numbe o
implan a eas (mesial/dis al) showing MBL ≥ 2mm (SiG
1/166; 6/166 CG). Addi ional in o ma ion abou he clini-
cal pe o mance is a ailable in Table3.
Discussion
The esul s o he p esen e ospec i e coho s udy
showed no di e ences in su i al, changes in ma ginal
bone le els o p os he ic complica ions be ween SiG and
CG implan s suppo ing a single-c own es o a ion o e
a ansepi helial (in e media e abu men ) in pos e io
maxilla o mandible. These esul s a e in line wi h hose
o he sys ema ic e iew and me a-analysis published
by Tolen ino da Rosa de Souza e al. [7] Sho implan s
in pos e io single c own had simila su i al a es, low
MBL and low p os he ic and su gical complica ions
a e o a 1-yea ollow-up ime. On he con a y Xu
e al. [41] on hei me a-analysis s a ed ha he su i al
a e o sho implan s in he maxilla may be lowe han
ha o long implan s, while in he mandible bo h ype
o implan s showed simila su i al a e. Fu he mo e,
sho implan s ha e been associa ed wi h lowe MBL and
biological complica ions bu highe echnical complica-
ions. I Wo h men ioning ha sho and longe implan
de ini ion was di e en in hese s udies [7, 41]. Mo eo e ,
mos o au ho s selec ed a unique leng h in he SiG and a
unique leng h in he CG ins ead o de ining a limi leng h
be ween bo h g oups. The ype o included a icles (only
RCTs [41] o CCTs and RCTs [7]), he a io o maxilla y/
mandibula implan s, he p opo ion o implan s placed
wi h addi ional echniques, o he ollow-up pe iod could
also explain he di e ences be ween bo h me a-analysis.
Sys ema ic e iews compa ing Sho and S and-
a d implan s including bo h splin ed and non-splin ed
implan s [31, 44, 45] should be in e p e ed wi h cau ion
as he biomechanical pe o mance o splin ed implan s is
subs an ially di e en om non-splin ed ones. In mul i-
ple es o a ions splin ed implan s can dispe se he s ess
on each single implan he eby educing he implan
o e load and he possible incidence o mechanical com-
plica ions [7, 46, 47]. In ela ion o he biomechanical
pe o mance o sho implan s suppo ing single c owns,
simila ou comes ha e been epo ed when he implan is
placed in he mos dis al posi ion in he a ch o be ween
adjacen ee h o o he implan s. [48]
Many a icles ha e been published compa ing he
pe o mance o sho implan s in na i e bone s longe
implan s along wi h sinus g a ing in he maxilla. A
ecen umb ella e iew o me a-analysis om Ve omilla
e al. [28] concluded ha sho implan s showed ewe
biological complica ion a es, educed cos , and an o e -
all simila sa is ac ion a e o he pa ien s.
In he p esen s udy, he c own- o-implan a io o all
he implan s in he CG whe e wi hin he anges ha ha e
been s a ed no o nega i ely in luence he pe o mance
o implan s; om 0.9 o 2.2 [21] o 0.6 o 2.36 [20]. F om
he SiG, only 2/88 implan s sligh ly exceeded his second
Table 3 Resul s. Da a ela ed o implan su i al, MBL (ma ginal bone loss) and p os he ic complica ions
Ma ginal bone (MB) le el ((−): below he mos co onal pa o he implan shoulde ; ( +): abo e he mos co onal pa o he implan shoulde )
a Mann–Whi ney es
b Chi squa e es
G oup p alue
Sho Implan s S anda d
Technical complica ions (numbe o implan s) None 85 82 0.342b
Sc ew loosening 2 5
Resin chipping 1 0
Ce amic chipping 0 1
Mesial MB le el (mm; median ( ange)) Loading 0.7 (− 0.7 o 2.5) 0.7 (− 0.4 o 2.3) 0.173a
Las isi 0.8 (− 1.2 o 2.9) 0.6 (− 3.3 o 2.9) 0.262a
Dis al MB le el (mm; median ( ange)) Loading 0.3 (− 2.5 o 2.3) 0.6 (− 1.3 o 2.3) 0.001a
Las isi 0.4 (− 2.1 o 2.1) 0.5 (− 3.8 o 2.4) 0.018a
Change in MB le el (mm; median ( ange)) Mesial 0 (− 1.5 o 1.3) 0.1 (− 4.0 o 1.4) 0.322a
Dis al 0.1 (− 2.2 o 1.0) 0.1 (− 4.0 o 1.0) 0.758a
Change in MB le el ≥ 2 mm Mesial 0 1 0.316b
Dis al 1 3 0.312b
Change in MB le el ≥ 3 mm Mesial 0 1 0.316b
Dis al 0 1 0.316b
Su i al (numbe o implan s) 88 88 NA
Page 7 o 8
Ani uae al. In e na ional Jou nal o Implan Den is y (2022) 8:40
p e iously published ange and 5/88 he i s one. The
di e ences be ween SiG and CG in he c own- o implan
in he p esen s udy we e lowe han in o he s udies [20,
21] p obably because he leng h o he CG implan s was
lowe .
The use o ansepi helial abu men s in all he implan s
p obably con ibu ed o achie e a low numbe o echni-
cal complica ions in bo h g oups and helped o dissipa e
implan loads hus posi i ely in luencing in he biologi-
cal pe o mance oo [22, 49, 50]. This o al homogenei y
in he ype o p os he ic es o a ion and in he ype o
implan su ace oge he wi h a well-balanced sampling
in ela ion o pa ien s´ sex and age, numbe o smoke s,
bone ype, inse ion o que o ype o an agonis , a e
ele an s eng hs o he p esen s udy. The unicen ic
design o he s udy ensu ed ha all implan s we e placed
and p os he ically ehabili a ed by he same eam, ollow-
ing he same p o ocol. This could ha e helped o educe
bias bu a he same ime he lack o da a om o he
cen e s could be a he same ime conside ed a limi a-
ion o he s udy. O he limi a ions o he s udy we e he
limi ed ollow-up ime o he educed abili y o con ol
con ounding ac o s o he e ospec i e designs. New
long- e m p ospec i e s udies a e ecommended o con-
i m hese esul s.
Conclusions
Wi hin he limi a ions o his s udy, sho (≤ 6.5mm)
and s anda d (≥ 7.5mm) implan s suppo ing a single-
c own es o a ion o e a ansepi helial (in e medi-
a e abu men ) in he pos e io maxilla/mandible show
simila clinical pe o mance (su i al, MBL, p os he ic
complica ions).
Acknowledgemen s
No applicable.
Au ho con ibu ions
All au ho s ha e made subs an ial con ibu ions o he concep ion o design
o he wo k o he acquisi ion, analysis, o in e p e a ion o da a o he
wo k; AND d a ing he wo k o e ising i c i ically o impo an in ellec ual
con en ; AND ha e gi en inal app o al o he e sion o be published; AND
ag ee o be accoun able o all aspec s o he wo k in ensu ing ha ques ions
ela ed o he accu acy o in eg i y o any pa o he wo k a e app op ia ely
in es iga ed and esol ed. All au ho s ead and app o ed he inal manusc ip .
Funding
This esea ch did no ecei e any speci ic g an om unding agencies in he
public, comme cial, o no - o -p o i sec o s.
A ailabili y o da a and ma e ials
The da a se s used and/o analysed du ing he cu en s udy a e a ailable
om he co esponding au ho on easonable eques .
Decla a ions
E hics app o al and consen o pa icipa e
The s udy p o ocol was app o ed by he e hical commi ee o he Uni e si y
Hospi al o A aba (FIBEA-02-ER/22/Ex aco os).
Consen o publica ion
No applicable.
Compe ing in e es s
EA is he Scien i ic Di ec o and he p esiden o BTI Bio echnology Ins i u e,
a den al implan company ha in es iga es in he ields o o al implan ology
and PRGF-Endo e echnology, and he p esiden o Edua do Ani ua Founda-
ion. MHA is a esea che (employee) a BTI Bio echnology Ins i u e. AE is a
esea che a he Edua do Ani ua Founda ion.
Au ho de ails
1 Clínica Edua do Ani ua, Jose Ma ia Cagigal Kalea, 19, 01007, Vi o ia-Gaz eiz,
Ála a, Spain. 2 BTI-Bio echnology Ins i u e, Vi o ia-Gaz eiz, Ála a, Spain. 3 Uni-
e si y o he Basque Coun y UPV/EHU, Leioa, Vizcaya, Spain.
Recei ed: 7 June 2022 Accep ed: 8 Sep embe 2022
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Publishe ’s No e
Sp inge Na u e emains neu al wi h ega d o ju isdic ional claims in pub-
lished maps and ins i u ional a ilia ions.