Short implants promise to sidestep bone grafting in the atrophic jaw. The open question has always been time: do they hold at ten years? This systematic review and meta-analysis gathered randomized controlled trials (RCTs) and prospective studies on implants of 6 mm or less with a full decade of follow-up, searching four databases and registered on PROSPERO. Eight studies qualified, four of them RCTs.

The pooled 10-year survival was 91.2% at the patient level and 93.7% at the implant level; sensitivity analysis, handling missing data by interpolation, returned the slightly more conservative 89.7% and 92.8%. Marginal bone loss (MBL) over ten years was modest, about 0.28 mm. Biological complications were dominated by peri-implant mucositis at 33.6%, while frank peri-implantitis stayed at 0.4%; technical complications ran at 23.5%, and screw-retained restorations survived less well than cemented ones. The head-to-head RCT comparison delivered the nuance: short implants survived significantly less than long implants (relative risk around 0.92-0.94), yet showed no significant difference in complications or bone loss.

So short implants are a viable long-term option for the atrophic ridge, sparing the patient augmentation, but their survival sits slightly below standard implants and the authors flag the small evidence base. A reasonable reading: a sound choice when grafting is best avoided, chosen with eyes open rather than as a free lunch.