Marginal bone loss in short implants vs long implants with sinus lift in atrophic maxilla, A systematic review and Meta-analysis.

Abstract

Objective: This systematic review and meta-analysis evaluated the differences in bone loss and implant survival rates between short implants and long implants placed with sinus lift procedures in the atrophic posterior maxilla. Materials and Methods: A comprehensive literature search was performed in Scopus, Cochrane Library, and PubMed databases up to January 25, 2025, using specific MeSH terms. The study adhered to PRISMA guidelines and applied the PICO framework to analyze implant survival and marginal bone loss. Initially, 246 studies were identified, of which 14 randomized controlled trials (RCTs) met the inclusion criteria. Statistical assessments, including meta-analysis and heterogeneity evaluation, were conducted using Review Manager 5.4. Results: The meta-analysis of 10 studies assessing marginal bone loss included 348 patients with short implants and 364 patients with long implants. The pooled mean difference was -1.23 (95% CI: -9.30 to 6.84, p = 0.77), indicating no statistically significant difference. However, heterogeneity was high (I² = 100%). In contrast, the meta-analysis of 7 studies evaluating implant survival included 289 patients with short implants and 310 with long implants. The results demonstrated a statistically significant higher survival rate for long implants (OR = 2.68, 95% CI: 1.50 to 4.80, p = 0.0009), with low heterogeneity (I² = 3%). Conclusion: Short implants appea.r to yield clinical outcomes like long implants regarding marginal bone loss. However, long implants showed a higher survival rate. Due to the substantial variability in bone loss findings, results should be interpreted with caution. Further large-scale studies with extended follow-up periods are necessary to strengthen the evidence.