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Der MKG-Chirurg

, Volume 6, Issue 3, pp 221–227 | Cite as

Kurze Implantate

Ersetzen sie die Rekonstruktion des Alveolarfortsatzes?
  • E. Nkenke
Leitthema

Zusammenfassung

Das Abwägen zwischen der Insertion eines kurzen Implantats in den ortständigen Knochen und der Rekonstruktion des Kieferkamms zur Herstellung einer implantierbaren Knochenhöhe von ≥ 10 mm ist eine alltägliche klinische Aufgabe. Die vorliegende Arbeit versucht, zur Klärung der Frage beizutragen, wann kurze Implantate gegenüber Implantaten mit Längen ≥ 10 mm und gleichzeitiger Augmentation bevorzugt werden sollten. Eine Vielzahl von Studien belegt, dass kurze Implantate in der Überlebensrate gegenüber ≥ 10 mm langen Implantaten, die zum Einbringen eine Augmentation des Alveolarfortsatzes erforderten, gleichwertig oder sogar besser sind. Für kurze Implantate werden nach Belastungsphasen von 10 Jahren Überlebensraten von >90 % beschrieben. Allerdings wurde gezeigt, dass bei kurzen Implantaten ein Zusammenhang zwischen zunehmender Länge und steigender Überlebensrate besteht. Unbeantwortet bleiben derzeit Fragen zum Ausmaß des periimplantären Knochenabbaus und der Prävalenz der Periimplantitis an kurzen Implantaten im Langzeitverlauf. Die Analyse der Datenlage vermittelt, dass die hohe Erfolgsrate kurzer Implantate durch die enge Indikationsstellung für dieses Therapiekonzept begründet erscheint. Der Zusammenhang zwischen zunehmender Länge und Steigerung des Überlebens kurzer Implantate deutet darauf hin, dass diese nicht grundsätzlich gegenüber längeren bevorzugt werden müssen. Sie stellen kein generelles Konzept dar, sondern müssen im Hinblick auf ihre Indikation streng geprüft werden. Die Rekonstruktion des Alveolarfortsatzes mit ihrem breiten Einsatzspektrum wird auch weiterhin die breite Indikation implantologischer Versorgungen sichern.

Schlüsselwörter

Implantation Periimplantitis Alveolarer Knochenverlust Augmentation Entscheidungsfindung 

Short implants

Do they replace reconstruction of the alveolar crest?

Abstract

Decision-making between placing a short implant and reconstructing the alveolar crest with subsequent installation of implants with lengths ≥ 10 mm has to be frequently performed in clinical practice. The present paper aims at contributing to the clarification of the question on which occasions short implants should be preferred to longer ones that necessitate prior or simultaneous alveolar ridge augmentation. Randomized controlled trials and systematic reviews including meta-analyses have shown that the survival rate of short implants is comparable or even better than that of implants with lengths ≥ 10 mm placed in combination with augmentation procedures. After loading intervals of 10 years survival rates above 90 % have been described; however, a correlation between increasing length of short implants and improved survival rate has been shown. To date it is not possible to find reliable long-term data in the current literature on marginal bone loss and the prevalence of peri-implant disease around short implants. So far it seems that the favorable success rates of short implants are the consequence of keeping the indications of placing these implants limited to a well-defined small number of occasions. Improved survival rates with increasing lengths of short implants indicate that short implants should not be preferred to longer ones. Short implants do not represent a general concept in implant dentistry. Instead, the indications to place these implants have to be thoroughly checked. The reconstruction of the alveolar crest with its wide spectrum of applications is still the intervention which ensures the broad indications for dental implants.

Keywords

Dental implantation Periimplantitis Alveolar bone loss Augmentation Decision making 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Mund-, Kiefer- und Gesichtschirurgische KlinikUniversitätsklinikum ErlangenErlangenDeutschland

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