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Influence of Implant Length and Associated Parameters Upon Biomechanical Forces in Finite Element Analyses: A Systematic Review.

PURPOSE
The aim of this systematic review is to provide an overview of finite element analyses comparing standard and short dental implants concerning biomechanical properties and to detect the most relevant parameters affecting periimplant stress concentrations.


MATERIAL AND METHODS
After screening the literature and assessment of studies, 36 studies were included in this review.


RESULTS
Eighty-three percent of the studies state that short dental implants have to bear higher stress concentrations compared with standard length implants. At the same time, 44% of articles note that implant diameter can be considered a more effective design parameter than implant length to reduce stress concentrations and to avoid an overload of periimplant bone. Regardless of implant dimension, in all studies, the highest stress concentrations are found in the cortical section around the upper part of the implant.


CONCLUSIONS
Unaffected of bone quality, implant diameter is found to play a key role to minimize periimplant stress concentrations. Concerning stress reduction implant length gains increasing relevance with decreasing bone density. Furthermore, splinting of short implants constitute an appropriate tool to avoid crestal overloading.