Successful Management of Early Failure (One Month) of a Standard Maxillary First Molar Implant After Sinus Lifting Using a Short Implant: A Case Report.

The use of short implants (5 mm diameter × 6 mm length) has increased in recent years, and they have mostly been indicated in the posterior maxillary areas in cases of insufficient bone height, as an alternative to sinus lift procedures. Short implants have rarely been proposed in cases of early failure (less than one month) of maxillary first molar standard implants placed after sinus lifting. We are reporting a 64-year-old female smoker who was referred for consultation concerning the extraction and implantation of tooth #16. The periodontal preparation and smoking cessation were followed by a sinus lifting. After a 10-month post-graft period, a standard implant (4.7 × 11.5 mm; Zimmer Biomet®, Warsaw, IN, USA) was placed. One month postoperatively, early failure occurred due to failure in osseointegration, and the implant was removed; three months later, a short implant (5 mm diameter × 6 mm length) was placed. The second stage of surgery was carried out at six months postoperatively. After four weeks, a crown was set. The control at 13 months showed a bone-integrated implant without lateral bone loss. The main risk factors associated with implant failure are low bone density, sinus grafting, and chronic smoking. In this case report, the association of these three risk factors led to standard implant failure. A short implant was proposed in order to avoid a new bone graft. A 2:1 crown-to-implant ratio has no impact on marginal bone loss or implant survival. In conclusion, the short implant (5 mm diameter × 6 mm length) may be a minimally invasive alternative in cases of early loss (less than one month) of a standard implant placed after sinus lifting without any additional bone grafting procedure. This data must be confirmed with a cohort study.