Short versus Long Dental Implants: A Narrative Review of Clinical Performance, Biomechanics, and Contemporary Implant Concepts

Abstract

The use of dental implant therapy has now become part and parcel of modern prosthodontic rehabilitation with predictable results in replacement of missing teeth. Traditionally, the longer implants are desirable as they are likely to have more bone-to-implant contact and be biomechanically superior. Anatomical limitations like lower vertical bone height in the posterior maxilla and mandible have however resulted into the creation and subsequent adoption of short implants as an alternative to augmentation procedures. This narrative review is the critical assessment of the existing evidence on the comparison of short and long dental implants in terms of survival rates, biomechanical behaviour, marginal bone loss, prosthetic considerations, and clinical indications. New results indicate that short implants may be used to obtain survival rates similar to long ones in case the implants are placed in a sufficient environment and with a well-designed prosthetic. Although in some high-load scenarios the use of long implants can still be beneficial, short implants are a less invasive, less expensive option that causes less morbidity in patients. The review concludes that the length of the implants does not constitute the major determinant of success but a combination of biomechanical planning, accuracy during surgery, and prosthetic factors is the factors that influence long-term outcomes.