The rehabilitation of posterior atrophic maxilla by using the graftless option of short implant versus conventional long implant with sinus graft: A systematic review and meta-analysis of randomized controlled clinical trial

AIM: The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla. SETTING AND DESIGN: Systematic review and meta analysis. MATERIALS AND METHODS: Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (<8.5 mm) and long implant (>8.5 mm) with sinus graft were included. (Prospero CRD42020186972). STATISTICAL ANALYSIS USED: Random-effect model, fixed-effect model, A funnel plot and the Egger's test. RESULTS: Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I(2) = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I(2) = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I(2) = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I(2) = 0%). CONCLUSION: There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.