Bone regeneration using an ultra-short implant in a periodontal patient: 15 years of follow-up

Abstract

Introduction: Managing implants in patients with chronic periodontitis and severe post-extraction bone atrophy presents a major clinical challenge. Using ultra-short (≤6 mm) implants coupled with bone regeneration techniques offers a minimally invasive alternative to sinus lift procedures, but necessitates strict protocols to ensure long-term stability.

Case report: We present the case of a 45-year-old patient with chronic generalized periodontitis, 2.7 element loss, and advanced periodontal compromise. After causal and surgical periodontal treatment, an extraction was performed, followed by socket preservation with heterologous biomaterial and resorbable membrane. After 6 months, an ultra-short endosseous implant (3.8 x 6 mm, MRS surface) was placed in site 2.7. Prosthetic rehabilitation was managed in two stages: a temporary resin crown and a subsequent zirconia definitive crown. The patient was enrolled in a structured periodontal maintenance protocol.

Results: After 15 years of follow-up, the implant appears to be fully osseointegrated, with stable peri-implant probing (1.5 mm), no radiographic bone loss, and no clinical signs of peri-implantitis. Biomechanical management, occlusal control, and periodontal monitoring were essential for the favorable prognosis.

Conclusion: This case report shows that even in patients with previous periodontal disease and severe posterior maxillary atrophy, using ultra-short implants combined with pre-implant bone regeneration can result in predictable and stable long-term outcomes. This is especially true when strict periodontal management and prosthetic customization are maintained. Therefore, ultra-short implants offer a viable treatment option in cases where more invasive surgical procedures are contraindicated.