Short implant vs. Sinus Lift?

Last Updated: Nov 01, 2019

63 y/o female patient wants implant to replace missing tooth #14. CBCT shows low bone height, but enough to place a 6mm implant. Pictures show the planning with a 4.8 x 6mm Dentsply Astra EV implant. Question is would you place the short implant or do a crestal sinus lift?

> (Note: See the Sinus Lift Kit for all the instruments you need for both the crestal and lateral approaches.)

38 Comments on Short implant vs. Sinus Lift?

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Peter Fairabirn

11/01/2019

With all the new tools and materials , Sinus augmentation is now so easy and predictable as well as safer , simply why not

RRO

11/01/2019

There are multiple techniques that allow up to 4 mm in height with a crestal approach. Less reliable techniques at times attain more. Why not place an 8 or 10 mm implant? If there is bone loss later in life a longer implant will last longer.

Richard Hughes DDS, HFAAI

11/01/2019

I agree with Peter! You can lift and place an 8 long or 11 long Bicon or a 6 or 9 long Quantum. Both will give the patient outstanding service.

AWA

11/01/2019

Thank you for the advice. I do agree longer implant would be better, I was just hoping to avoid a sinus lift since I have not done one yet. I am comfortable with surgery, but for some reason the sinus makes me nervous. I guess I was the same way about implants before I got trained and finally started doing them. Any recommendations on techniques, instruments, kits?

Mikey

11/04/2019

The latest trend in Versah. It is good and this case is perfect for it. But, summers osteotomes are fine, especially for this case. If you pierce the sinus and go in accidentally 2mm anyone with enough experience will tell you that is fine. 516-852-1386

Alejandro Berg

11/01/2019

This is a perfect indication for DIVA sinus lift and a 13mm long implant. And as Peter says, simply why not, a 13mm will last you a couple of lifetimes and it has 0 post op really.

01/23/2020

Any implant longer than 10mm is not indicated unless it is an immediate and the apical portion of the implant is secured in sound bone for initial stability.

Dok

11/01/2019

"Easy" surgeries sound so nice....until a complication occurs. There is no such thing as easy anything. I still occasional struggle with fillings that I have done a million times. Training and experience gets you through. Moral of the story is to get yourself trained to do sinus lifts. Then it all becomes a piece of cake......sort of.

JohnManuel, DDS

11/01/2019

Some short implants can provide as much or more loading surface area as the longer counterparts. From the limited documents and history provided, this case looks like an ideal situation for a Bicon Short Implant. I’d usually place a 6x6 mm x 3mm post implant in this situation with the Internal sinus lift procedure. Check online (Bicon.com) for demos and training opportunities.

Richard Rodriguez

11/01/2019

I totally agree with you Doctor. Is a safe, success and long term solution, thinking in our patients. Bicon ultra short implant has more evidence than any other implant system, and most important no bone loss. Bone loss is not a physiological process.

Jason Larkin

11/03/2019

I would do an 8mm long with a Versah drill lift. Very easy and you get better quality bone and cortical engagement at apex. I would have implant platform 1 to 1.5 mm subcrestal to give nice concave gingival abutment height 2 to 3 mm tall.

Raul Mena

11/04/2019

Short Implants are as successful and predictable as long implants. We have the option of placing Quantum's up to 14 mm implants, but my choice for many years has been Quantum's 6mm implants with a true Morse Taper Abutment. This implants are threaded to the bone and provide Immediate Fixation.

Dr. Gerald Rudick

11/01/2019

If the amount of bone available was in the mandible and very limited because of the inferior alveolar nerve , I would say you have no choice but to go with a very short implant, in bone that is much more dense....however, the density of the bone in the maxilla is less dense, and as stated above, a sinus lift these days is such an easy procedure, with very little effort....then for sure you must go longer...… consult with people in your area who are familiar with the techniques, your patient will thank you....

Tarek Abdelsamad

11/01/2019

I have a good experience with short implant Bicon 5*5. In posterior maxilla in a case similar to that. Follow up more than 4 years. Good luck

JIN KIM

11/01/2019

I will place 8.5 or 8.0 mm long implant with sinus bump. no need for sinus graft.

01/23/2020

Sensible approach.

Ash

11/01/2019

Evidence for survival rates of short implants is good . This is an option should the patient want a less invasive procedure

DrT

11/01/2019

The consensus of posts is that either option can be effective. I think it is important to offer BOTH options to the patient and not exclude one because you do not feel comfortable doing it...this is not fair to the patient

Hal Wilson, DDS, FICOI

11/01/2019

I’ve done a lot of crestal sinus lifts over the years with various techniques and found the Versah Burs to be by far the easiest and most predictable technique. I’d definitely do the sinus lift and place a longer implant.

01/23/2020

Why? If an 8 mm implant has been proven to service as well as longer ones why take risks and put the patient through more surgery?

Miguel Moura Gonçalves

11/01/2019

I agree with Hal Wilson ,is an excellent technique

AWA

11/01/2019

All great input, thanks. Both options will definitely be presented with full disclosure on my experience. I agree that longer implant in this situation would be preferable based on several of the comments. If I need to refer I will, but first I will research closed sinus augmentation and will look into the burs mentioned.

Admiral518

11/01/2019

I've been using the Versah system successfully last 3 years. Dr Huwais offers a good training program. Osseodensification integrates well even in guided cases ( I use Cerec guide 2).

Robert Cadalso DDS, MS

11/01/2019

I have been placing BICON implants for years without a single implant loss. In this particular case I would feel comfortable placing an 8 mm implant and "bump" the sinus predictable and effective. If on the other hand I had less than the 6 mm and for whatever reason I did not want to invade the sinus a BICON implant is quite effective.

Jason Larkin

11/03/2019

Goatgruff

12/02/2019

Then you haven’t placed enough, are you saving you have never experienced an implant failure?

Gumdoc7

11/02/2019

Every additional procedure comes with some additional risk factor. I’ve been using the EV short implants since they were brought out and find a similar success rate with the 6 mm long implant as I do with the 15 mm ones. I’ve been using short implants since 2002 with similar results. Just bury all threads, make sure there is adequate keratinized tissue on the buccal, and be sure there are no excessive occlusal forces on it. It will be fine.

01/23/2020

I completely agree. Over the past 18 years of placing implants I favor shorter ones over longer ones in my treatment plans.

Jason Larkin

11/03/2019

01/23/2020

I agree but submerging the implant only works with a platform switched conical connection. Sometimes a bone profiler is needed to give spave for the surrounding attachment and placement of a healing abutment.

Eduardo Dias

11/04/2019

Nowadays Short dental implants are as predictable as regular implants and represent less morbidty, costs and treatment time. So, in my opinions short dental implant would be the treatment choice for this case. We recently published a paper showing 97% success rate of short (<8,5mm) implants in 48 months (mean) follow up (1 to 9-year).

Greg Kammeyer, DDS, MS, D

11/05/2019

Also consider what will be the final diameter of the implant platform and hence how closed the gingival embrasures will be. I like 6mm wide plateform implants for molars.

Dr Saad

01/07/2020

I will do sinus lift and put 11 mm length and 4'5 mm diameter implant .its more stable and will have more success than short implant.

Mark Barr

01/07/2020

good advice above , take away is to always advance your knowledge and clinical training, there are many intracrestal sinus lift kits/techniques for sale in the market place but just because we have a hammer not everything is a nail..... Clinical training reduces the practitioners ‘ stress and the patients infections ... .

Marthenet

01/09/2020

Had a sinus lift in September 2010. Procedure planning after 4 months' healing . Continuing with 4 x implants with a a clip on denture protesis will finalise the process.

Marthenet

01/09/2020

Sorry 2019 was meant to type.

01/23/2020

Were the results satisfactory for you? I wonder why a fixed restoration was not provided.

Dick

01/12/2020

I dunno

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