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Conference by Dr Maryia KARABAN

Discover Dr Maryia KARABAN's retrospective study on the rehabilitation of atrophied posterior jaws with 4 mm implants.

You can’t miss the oral communication which will take place at the EAO congress highlighting our implant Twinkon 4:

“the long-term retrospective study on four-millimeters implant in the rehabilitation of posterior atrophic jaws” presented by Dr Maryia KARABAN from the Department of Biomedical and Neuromotor Sciences at the University of Bologna! Saturday, 30th September from 11.30am to 12.45pm– You can find it on site at CityCube Berlin in Germany under the name Oral communication Clinical Research- Surgery 2 session.


This study was carried out by Maryia Karaban*1, Carlo Barausse1,2, Lorenzo Bonifazi1,3, Gerardo Pellegrino1, Roberto Pistilli4, Andrea Ravidà5, Hom-Lay Wang6, Pietro Felice1


The primary aim is to evaluate the long-term survival of implant-prosthetic rehabilitations in patients affected by bone atrophy, treated with conical, transgingival implants, 4 mm long. Secondary aims include the evaluation of intra- and post-operative complications, prosthetic failures, correlations between implant survival and systemic and clinical factors, as well as the relationship between marginal bone loss and the technical, clinical and habitual characteristics of the patients.


Materials and Methods : The digital and medical paper records of the Oral Surgery department of the Dental Clinic of the University of Bologna were analyzed. Anamnestic data, treatment data and other useful information were collected for each patient,

selecting those included in the study criteria. The marginal bone loss of each implant was calculated at different time intervals, estimating the annual bone loss rate.

Descriptive and inferential statistical analyzes were conducted to examine the effects of history data on peri implant bone loss and implant failures.


Results: 212 patients with 496 implants were examined. The mean follow-up was 96.21 months ± 26.04.

The number of implants with radiographic documentation available at each time frame was: T0=496; T1=482; T3=480; T5=408; T8=309; T10=123. The mean marginal bone loss between T1 and T0 was 0.47 ± 0.24 mm, while between T10 and T0 it was 0.59 ± 0.25 mm. The annual rate of marginal bone loss was 0.10 ± 0.12 mm.


There was a significant inverse relationship between the duration of implant follow-up and marginal bone loss (p<0.001). Implants affected by peri-implantitis showed significantly more bone loss than unaffected implants (p<0.001). Additionally, greater bone loss was observed in implants placed in the maxilla compared to those in the mandible (p=0.002). A relevant element was the number of professional oral hygiene sessions performed annually, which played a crucial role in reducing bone loss: patients who underwent more frequent sessions reported less bone loss (p<0.001) The failure rate per implant was 4.64% (23/496). Of these, 14 failures occurred before prosthetic loading and 9 after. The survival rate with a mean follow-up of 96.21 months ± 26.04 was 95.36% (473/496). Patients older than 64 years showed a higher number of failures (p<0.001). A statistically significant correlation was highlighted between the failures that emerged in the mandible and in the upper jaw, having a greater predisposition for the latter (p<0.001). The same can be said of the implants positioned in the molar area, where a higher rate of failure was found when compared with those inserted in the premolar area. (p=0.0299). The correlation between the different implant diameters proved to be statistically in favor of the 4.0 mm diameter implants where the failure rate was lower (p<0.001). Finally, a lower number of failures was observed in patients undergoing more than three hygiene sessions per year (p<0.001).


Conclusions: Ultrashort implants appear to be a promising alternative to the bone regeneration. Survival and success rates remain high even 10 years after insertion. The use of these implants offers a fixed prosthetic solution to patients suffering from bone atrophy, reducing surgical invasiveness, shortening rehabilitation period, and reducing surgical costs.


1- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna;

2- Postgraduate School of Oral Surgery, University of Modena and Reggio Emilia, Modena;

3- Department of Interdisciplinary Medicine, University of Bari, Bari;

4- Oral and Maxillofacial Unit, San Camillo Hospital, Rome, Italy;

5- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh;

6- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann

Arbor, United States.