ArticleClinical implant dentistry and related research2025
Clinical Outcomes of Bone-Level and Tissue-Level Short Implants Placed in Posterior Maxilla: A Case-Control Study.
Article in Clinical implant dentistry and related research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Resonance Frequency Analysis and Clinical Outcomes in Implant Dentistry: A Systematic Review and Meta-Analysis.Clinical implant dentistry and related research · 2026Pooled it
- Peri-Implantitis and Survival Outcomes of Tissue Level Versus Bone Level Dental Implants: A Systematic Review and Meta-Analysis.Clinical and experimental dental research · 2025Pooled it
- Tissue-level implants in the aesthetic zone: why and how?British dental journal · 2026Article
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- Observational
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Authors and funding
7 authors.
Funding
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Abstract
introductionShort implants are today a reliable, minimally invasive option for the rehabilitation of the posterior maxilla. However, maintaining marginal bone stability remains a crucial factor for long-term success, particularly in the case of short implants. The present multicenter prospective case-control study aimed to compare the clinical outcomes of bone-level and tissue-level short implants in the posterior maxilla, focusing on implant survival and peri-implant marginal bone stability over 1 year of function.
methodsFifty-nine patients who met specific inclusion criteria were enrolled and treated by three clinical centers with a total of 74 short implants, either bone-level (7 mm in length, placed 1 mm sub-crestally) or tissue-level (5 or 6.5 mm in length). The primary outcome was physiological bone remodeling (PBR) measured via radiographs at baseline (T0), prosthesis delivery (T1), and 12 months post-loading (T2). Statistical analysis was performed to evaluate differences in PBR between groups, with multivariate analysis assessing the influence of various patient and site-specific factors.
resultsThe final analysis included 58 patients who were treated with a total of 71 short implants, comprising 36 tissue-level and 35 bone-level implants (one patient dropped out as he did not attend follow-up visits on time). All implants were rehabilitated with fixed, screwed prosthetics after 5 months, with no recorded complications up to 1 year of loading. Stability was similar between the two implant types at T0 and T1, with no significant differences in insertion torque and implant stability quotient (ISQ). Multivariate analysis revealed a significant positive correlation between insertion torque and ISQ at T0, as well as with bicortical engagement of the implant apex with the sinus floor. Tissue-level implants demonstrated significantly lower peri-implant bone remodeling (PBR) compared to bone-level implants at both T1 (0.11 ± 0.27 mm vs. 0.34 ± 0.35 mm, p = 0.004) and T2 (0.30 ± 0.23 mm vs. 0.55 ± 0.42 mm, p = 0.003). Multivariate analysis showed a significant positive correlation between PBR (T0-T1) and thin vertical mucosal thickness (≤ 2 mm) at T0 in both tissue-level and bone-level implants. Additionally, PBR (T1-T2) in both groups significantly correlated with the use of short prosthetic abutments (≤ 2 mm) and, only in bone-level implants, with crown emergence angles > 30°.
conclusionBoth tissue-level and bone-level short implants are effective options for implant-supported rehabilitation in the posterior maxilla. Tissue-level short implants offer superior marginal bone stability compared to bone-level implants placed subcrestally, suggesting their favorable use in clinical practice.
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