الفهرس 
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Abstract
During this case series, an investigation of ultra-short 4mm implants in the posterior arches was conducted. 43 short implants were placed in 13 patients. These implants were loaded after 12 weeks and followed up after placement for 6 months.
All the patients had a cone beam computed tomography before surgery to check the bone level, bone quality and the distance from the inferior alveolar nerve. A crestal flap was performed during surgery. Drilling was done according to the companies’ recommendations and bone quality to achieve optimal primary stability.
The implants were left to heal for a minimum of 12 weeks, then a splinted fixed prosthesis with non-occlusal load temporary was placed for 6 weeks. Then, impressions were taken using pickup implant transfers for the final prosthesis. The fixed partial prostheses were designed with freedom in-centric and avoided steep cuspal inclinations and extreme lateral contacts. Further, the restorations were splinted and fixed with screw-retained prosthesis.
The marginal bone changes were compared using panoramic x-rays on the day of surgery and 6 months after surgery.
Forty three dental implants were inserted and loaded with 18 fixed dental prosthesis. 3 dental implants failed before loading. One patient did not show for follow-up and dropped out of the study. 38 implants were eligible for examination and were followed up at 6 month post insertion with a survival rate of 92.7%. No complications or side effects appeared after implant surgeries. The mean change in the marginal bone loss around implant after 6 months of surgery was found to be 0.22mm with a standard deviation of 0.43mm (p<0.01).
During surgery, the placement of ultra-short implants was similar to that of longer implants. No complications arose during surgeries. For fabrication of the screw-retained prosthesis, the implants had to be place with a degree of parallelism.
Ultra-short 4mm implants can be successfully used to support multiple splinted fixed prosthesis in the posterior atrophic jaws. The uses of these implants allow for the treatment of patients who have medical, anatomical or financial constraints that do not allow them to undergo complex surgeries. However, longer follow-up times are needed. Also, more clinical studies should be conducted to show the impact of crown to implant ratio on implant survival.