Augmentation of the alveolar ridge compared with shorter implants in atrophic jaws: a meta-analysis based on randomised controlled trials

Our aim was to compare two therapeutic options - augmentation of the alveolar ridge and shorter implants - in the treatment of atrophic jaws. To fulfill the preset inclusion criteria, we searched the electronic databases PubMed, EMBASE through OVID, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two people were responsible for screening, extraction of data, and assessment of quality. The meta-analysis was made with the aid of Review Manager (RevMan) 5.1. The quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). The electronic database and manual search yielded 1426 studies. After screening the titles, abstract, and the full text, and cross-matched them with the inclusion criteria, only 6 studies were eligible. A total of 837 implants were investigated, which included 429 in the augmentation group and 408 in the shorter implants group. There were significantly more failed implants (p = 0.006), complications (p = 0.01), and marginal bone losses (p = 0.0004) in the augmentation group than in the shorter implants group. According to the GRADE, the levels of evidence were moderate (failed implants), high (complication rate), and high (loss of alveolar bone). In atrophic jaws with enough residual bone, shorter implants without augmentation might be the first choice as they seem to be associated with fewer failed implants and complications, and less peri-implant bone loss.