Prof. Waldemar Polido - "Long-Term Success of Short Implants"
Episode summary
Prof. Waldemar Polido, Clinical Professor of Oral and Maxillofacial Surgery at Indiana University School of Dentistry, previews his Edentulism 2025 Conference session on the long-term success of short implants. He explains that the definition of a short implant has shifted from under 10mm to under 7mm, and that survival rates rose primarily because of the move from smooth to micro-rough surfaces rather than macro shape. Short implants are best documented for partial, splinted restorations and work better in the mandible than the maxilla. Polido argues that crown-to-implant ratio is not a decisive factor when implants are splinted and occlusion is controlled, and that losing a short implant is far less consequential than complications from major grafting or remote anchorage. He positions short implants as a low-risk, less invasive alternative between regular implants and zygomatic or pterygoid solutions, while noting that immediate loading remains predictable mainly in the mandible.
Key takeaways
- The clinical definition of a short implant has shifted over the years from under 10mm to roughly 6-7mm or less, with 4-6mm implants now showing good survival rates.
- Improved survival of short implants is attributed mainly to the change from smooth to micro-rough implant surfaces, not to macro-design changes.
- The shortest implant on the market has about 4mm of surface area but reaches roughly 6mm total when the tissue-level neck (1.8 or 2.8mm) is included.
- Short implants are best documented for partial, splinted restorations and perform better in the mandible than in the maxilla.
- A crown-to-implant ratio around 3:1 is not a decisive risk factor for short implants as long as they are splinted and the occlusion is adjusted.
- Immediate loading of short implants is predictable in the mandible due to high torque values, but maxillary short implants should generally be left to integrate before loading.
- Polido estimates his practice uses short implants in about 20-30% of full-arch cases, longer/zygomatic implants in about 20-30%, and straightforward regular implants in roughly 50%.
- Understanding that load concentrates on the most coronal part of an integrated implant also justifies using regular 10mm implants rather than 14-18mm ones even when more bone is available.
What you'll learn
- Why short implant survival rates improved thanks to micro-rough surfaces rather than macro shape
- How to indicate short implants by bone height and width, and when to graft or use zygoma instead
- Why crown-to-implant ratio is not a decisive factor when implants are splinted and occlusion is adjusted
- Immediate loading limits: predictable in the mandible, but wait for integration in the maxilla
- Surgical pearls for primary stability: extra-short drills, patient positioning, and technique tweaks
About the guest
Prof. Waldemar Polido
Prof. Waldemar Polido is an oral and maxillofacial surgeon originally from Porto Alegre, Brazil, who completed an oral surgery residency at the University of Texas Southwestern Medical Center in Dallas. Since 1992 he has worked with dental implants in private practice and academics, training in zygomatic implants in Belgium in 1999. Since 2017 he has been a full-time Clinical Professor of Oral and Maxillofacial Surgery at Indiana University in Indianapolis, where he directs the pre-doctoral OMFS program and helps lead the Center for Implant, Esthetic and Innovative Dentistry. Indiana University is an academic partner of the ZAGA Centers, and he is a ZAGA Scientific Partner.
Credentials: Clinical Professor and Director, Pre-doctoral Oral and Maxillofacial Surgery Program, Indiana University School of Dentistry (Indianapolis); ITI Fellow and Speaker; ZAGA Scientific Partner
ZAGA profile · LinkedIn · dentistry.iu.edu
