Scientific Review

Date of issue: February 2013

Narrow implants
The possibility of placing implants can sometimes be limited due to physical conditions,
e.g. where the horizontal space is limited by adjacent teeth and roots, or in situations with
a narrow alveolar ridge. By using a narrow implant the need for bone augmentation or
orthodontic tooth movement can be avoided. In situations with limited horizontal space a
narrow diameter implant may be the only option to replace a missing tooth.
Several studies evaluating the clinical outcome of narrow implants (<3.5 mm in diameter)
in general, placed in different indications, are available. Narrow implants supporting
single tooth replacements have shown favourable clinical results19 in the long-term
perspective4, 5, 79. Moreover, studies evaluating fixed partial dentures have shown good
clinical results both after short-10 and long-term follow-up periods79, 11, 12. Narrow implants
have also been used to support full arch reconstructions, and satisfactory results have
been shown for fixed bridges9 and overdentures in the mandible9, 13, 14 and in the maxilla9, 15.
Ingeneral, no difference in the clinical outcome between standard diameter implants and
narrow implants has been observed1, 3, 7, 1619. In an extensive review, Renouard and Nisand
concluded that survival rates for narrow implants are comparable with that of standard
diameter implants when used in appropriate indications. They also reported that no
relationship was found between marginal bone loss and implant diameter20.
Several studies evaluating implants from ANKYLOS 21-25 and ASTRA TECH Implant
System 26-28 (both diameter 3.5 mm) and XiVE 29 (diameter 3.4 mm) show high survival rates
after up to 10 years in function29.
The narrowest implants from DENTSPLY Implants are OsseoSpeed TX 3.0 S and XiVE 3.0,
both with a diameter of 3.0 mm*. Published data indicates that treatment with OsseoSpeed
3.0 S3032 and XiVE 3.033, 34 implants is safe and predictable in sites with limited physical
space in anterior regions. Prospective clinical studies evaluating early and immediate
loading of these 3.0 mm implants report on maintained marginal bone levels and 100%
implant survival rate from loading to 1-year and 3-year follow-up30, 33, 34.

* The intended use for OsseoSpeed 3.0 S is limited to replacement of maxillary lateral incisors and mandibular
incisors. The XiVE 3.0 is indicated for single-tooth restoration of maxillary lateral incisors and mandibular incisors
and splinted single-tooth restoration for mandibular incisors.

1. Andersen E, Saxegaard E, Knutsen BM,

Haanaes HR. A prospective clinical study
evaluating the safety and effectiveness of
narrow-diameter threaded implants in the
anterior region of the maxilla. Int J Oral
Maxillofac Implants 2001;16(2):217-24.
Abstract in PubMed
2. Cordaro L, Torsello F, Mirisola Di TorresantoV,
Rossini C. Retrospective evaluation of
mandibular incisor replacement with narrow
neck implants. Clin Oral Implants Res
2006;17(6):730-5. Abstract in PubMed
3. Mericske-Stern R, Grutter L, Rosch R,
Mericske E. Clinical evaluation and prosthetic
complications of single tooth replacements by
non-submerged implants. Clin Oral Implants
Res 2001;12(4):309-18. Abstract in PubMed
4. Polizzi G, Fabbro S, Furri M, Herrmann I,
Squarzoni S. Clinical application of narrow
Branemark System implants for single-tooth
restorations. Int J Oral Maxillofac Implants
1999;14(4):496-503. Abstract in PubMed
5. Vigolo P, Givani A. Clinical evaluation
of single-tooth mini-implant restorations:
afive-year retrospective study. J Prosthet Dent
2000;84(1):50-4. Abstract in PubMed
6. Zarone F, Sorrentino R, Vaccaro F, RussoS.
Prosthetic treatment of maxillary lateral incisor
agenesis with osseointegrated implants:
a 24-39-month prospective clinical study.
Clin Oral Implants Res 2006;17(1):94-101.
Abstract in PubMed
7. Romeo E, Lops D, Amorfini L, et al. Clinical
and radiographic evaluation of small-diameter
(3.3-mm) implants followed for 1-7 years:
alongitudinal study. Clin Oral Implants Res
2006;17(2):139-48. Abstract in PubMed
8. Vigolo P, Givani A, Majzoub Z, Cordioli G.
Clinical evaluation of small-diameter implants in
single-tooth and multiple-implant restorations:
a7-year retrospective study. Int J Oral Maxillofac
Implants 2004;19(5):703-9. Abstract in PubMed
9. Zinsli B, Sagesser T, Mericske E, MericskeStern R. Clinical evaluation of small-diameter
ITI implants: a prospective study. Int J
Oral Maxillofac Implants 2004;19(1):92-9.
Abstract in PubMed
10. Hallman M. A prospective study of treatment
of severely resorbed maxillae with narrow
nonsubmerged implants: results after 1 year
of loading. Int J Oral Maxillofac Implants
2001;16(5):731-6. Abstract in PubMed
11. Comfort MB, Chu FC, Chai J, Wat PY,
Chow TW. A 5-year prospective study on small
diameter screw-shaped oral implants. J Oral
Rehabil 2005;32(5):341-5. Abstract in PubMed

12. Lee JS, Kim HM, Kim CS, et al. Long-term

retrospective study of narrow implants for
fixed dental prostheses. Clin Oral Implants
Res 2012;E-pub Apr 4, doi:10.1111/j.16000501.2012.02472.x. Abstract in PubMed

24. Morris HF, Ochi S, Crum P, OrensteinIH,

Winkler S. AICRG, Part I: A 6-year
multicentered, multidisciplinary clinical study
of a new and innovative implant design. J Oral
Implantol 2004;30(3):125-33. Abstract in PubMed

13. Cho SC, Froum S, Tai CH, et al. Immediate

loading of narrow-diameter implants with
overdentures in severely atrophic mandibles.
Pract Proced Aesthet Dent 2007;19(3):167-74.
Abstract in PubMed

25. Romanos GE, Gaertner K, Nentwig GH.

Long-Term Evaluation of Immediately Loaded
Implants in the Edentulous Mandible Using
Fixed Bridges and Platform Shifting. Clin Impl
Dent Rel Res 2013;E-pub Jan 12, doi:10.1111/
cid.12032. Abstract in PubMed

14. Spiekermann H, Jansen VK, Richter EJ. A 10year follow-up study of IMZ and TPS implants
in the edentulous mandible using bar-retained
overdentures. Int J Oral Maxillofac Implants
1995;10(2):231-43. Abstract in PubMed
15. Payne AG, Tawse-Smith A, Thomson WM,
Duncan WD, Kumara R. One-stage surgery and
early loading of three implants for maxillary
overdentures: a 1-year report. Clin Implant Dent
Relat Res 2004;6(2):61-74. Abstract in PubMed
16. Weng D, Jacobson Z, Tarnow D, et al.
Aprospective multicenter clinical trial of 3i
machined-surface implants: results after 6 years
of follow-up. Int J Oral Maxillofac Implants
2003;18(3):417-23. Abstract in PubMed
17. Davarpanah M, Martinez H, Tecucianu JF,
Celletti R, Lazzara R. Small-diameter implants:
indications and contraindications. J Esthet Dent
2000;12(4):186-94. Abstract in PubMed
18. Block MS, Kent JN. Cylindrical HA-coated
implants 8-year observations. Compend Suppl
1993(15):S526-32; quiz S65-6. Abstract in PubMed
19. Degidi M, Piattelli A, Carinci F. Clinical
outcome of narrow diameter implants: a
retrospective study of 510 implants. J Periodontol
2008;79(1):49-54. Abstract in PubMed
20. Renouard F, Nisand D. Impact of implant
length and diameter on survival rates.
ClinOral Implants Res 2006;17 Suppl 2:35-51.
Abstract in PubMed
21. Degidi M, Nardi D, Piattelli A. Immediate
rehabilitation of the edentulous mandible with a
definitive prosthesis supported by an intraorally
welded titanium bar. Int J Oral Maxillofac
Implants 2009;24(2):342-7. Abstract in PubMed
22. Donovan R, Fetner A, Koutouzis
T, LundgrenT. Crestal bone changes
around implants with reduced abutment
diameter placed non-submerged and at
subcrestal positions: a 1-year radiographic
evaluation. J Periodontol 2010;81(3):428-34.
Abstract in PubMed
23. Degidi M, Nardi D, Piattelli A. Prospective
study with a 2-year follow-up on immediate
implant loading in the edentulous mandible with
a definitive restoration using intra-oral welding.
Clin Oral Implants Res 2010;21(4):379-85.
Abstract in PubMed

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26. Veltri M, Ferrari M, Balleri P. One-year

outcome of narrow diameter blasted implants
for rehabilitation of maxillas with knifeedge resorption. Clin Oral Implants Res
2008;19(10):1069-73. Abstract in PubMed
27. Geckili O, Mumcu E, Bilhan H. Radiographic
evaluation of narrow diameter implants after
5years of clinical function: a retrospective study.
J Oral Implantol 2011;E-pub Feb 5, doi:10.1563/
AAID-JOI-D-10-00158.1 Abstract in PubMed
28. Vanlioglu BA, Ozkan Y, Evren B, Ozkan YK.
Experimental custom-made zirconia abutments
for narrow implants in esthetically demanding
regions: A 5-year follow-up. Int J Oral Maxillofac
Implants 2012;27(5):1239-42. Abstract in PubMed
29. Arisan V, Bolukbasi N, Ersanli S,
OzdemirT. Evaluation of 316 narrow diameter
implants followed for 5-10 years: aclinical
and radiographic retrospective study.
Clin Oral Implants Res 2010;21(3):296-307.
Abstract in PubMed
30. Galindo-Moreno P, Nilsson P, King P, et al.
Clinical and radiographic evaluation of early
loaded narrow diameter implants 1-year
follow-up. Clin Oral Implants Res 2012;23(5):60916. Abstract in PubMed
31. Caudry S, Landzberg M. Clinical
considerations for the use of a two-piece 3.0
mm implant for replacing a missing mandibular
incisor. Journal of Clinical & Practical Oral
Implantology 2010;1(2):25-29.
32. Martin R. Astra Tech OsseoSpeed 3.0S
implant. Inside Dentistry 2010;6(4):2-4.
33. Degidi M, Nardi D, Piattelli A. Immediate
versus one-stage restoration of smalldiameter implants for a single missing
maxillary lateral incisor: a 3-year randomized
clinical trial. J Periodontol 2009;80(9):1393-8.
Abstract in PubMed
34. Oyama K, Kan JY, Rungcharassaeng K,
Lozada J. Immediate provisionalization of
3.0-mm-diameter implants replacing single
missing maxillary and mandibular incisors:
1-year prospective study. Int J Oral Maxillofac
Implants 2012;27(1):173-80. Abstract in PubMed

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References