Short implants or sinus lift? What the evidence says
Updated: 6 days ago
60 Second Journal, Vol. 2. For colleagues.
When the posterior maxilla has lost height, the traditional answer has been a lateral sinus lift and a 10 mm implant. Several systematic reviews of randomised trials now compare that route with short implants (6 mm or less) placed without grafting.
What the trials show
Implant survival is similar between short implants and standard implants with sinus augmentation over 1 to 5 years of follow-up.
Marginal bone loss is slightly lower around short implants.
Short implants mean fewer post-operative reactions, fewer sinus complications, shorter treatment and lower cost.
Beyond 5 years the picture is less certain. One timewise meta-analysis found a trend in favour of grafting plus regular implants at 5 years that approached, but did not reach, significance.
How I apply it
With around 5 to 6 mm of residual bone and a patient who would rather avoid grafting, a short implant is a reasonable first choice, provided occlusion is controlled. In heavy bruxers, splinting and a night guard matter more than implant length. Patients who are fit for surgery should still hear the benefits and risks of both options before deciding.
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Related: Implant crowns and bridges
References
Grunau O, Terheyden H. Lateral augmentation of the sinus floor followed by regular implants versus short implants in the vertically deficient posterior maxilla: a systematic review and timewise meta-analysis of randomized studies. Int J Oral Maxillofac Surg. 2023;52(7):813-824. doi:10.1016/j.ijom.2022.11.015
Toledano M, et al. Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis. Clin Oral Investig. 2022;26(11):6681-6698. doi:10.1007/s00784-022-04628-1
Yan Q, et al. Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis. BMJ Open. 2019;9(10):e029826. doi:10.1136/bmjopen-2019-029826
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