title: Immediate rehabilitation of the mandible with fixed full prosthesis supported by axial and tilted implants: interim results of a single cohort prospective study.
abstract: OBJECTIVE
  The aims of this prospective study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants for the rehabilitation of the mandible and to compare the outcome of axial versus tilted implants.
  
  
  METHODS
  Sixty-two patients (34 women and 28 men) were included in the study. Each patient received a full-arch fixed bridge supported by two axial implants and two distal tilted implants (All-on-Four, Nobel Biocare AB, Göteborg, Sweden). Loading was applied within 48 hours of surgery. Patients were scheduled for follow-up at 6, 12, 18, and 24 months, and annually up to 5 years. At each follow-up, plaque level and bleeding scores were assessed; moreover, patient's satisfaction for aesthetics and function was evaluated by a questionnaire. Radiographic evaluation of marginal bone level change was performed at 1 year.
  
  
  RESULTS
  The overall follow-up range was 6 to 43 months (mean 22.4 months). Forty-four patients were followed for a minimum of 1 year. No implant failures were recorded to date, leading to a cumulative implant survival and prosthesis success rate of 100%. Plaque level and bleeding scores showed progressive decrease over time, parallel to increase of satisfaction for both aesthetics and function. No significant difference in marginal bone loss was found between tilted and axial implants at 1-year evaluation.
  
  
  CONCLUSIONS
  The present preliminary data suggest that immediate loading associated with tilted implants could be considered a viable treatment modality for the mandible.
authors.affiliation: Department of Health Technologies, Centre for Research in Oral Implantology, Istituto Ortopedico Galeazzi IRCCS, University of Milan, Milan, Italy. luca.francetti@unimi.it
authors.forename: Luca
authors.initials: L
authors.lastname: Francetti
authors.forename: Enrico
authors.initials: E
authors.lastname: Agliardi
authors.forename: Tiziano
authors.initials: T
authors.lastname: Testori
authors.forename: Davide
authors.initials: D
authors.lastname: Romeo
authors.forename: Silvio
authors.initials: S
authors.lastname: Taschieri
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Fabbro
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003799:Dental Stress Analysis; D003825:Denture, Complete, Immediate; D003826:Denture, Complete, Lower; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D015993:Life Tables; D008297:Male; D008334:Mandible; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors; D019415:Torque; D016896:Treatment Outcome; D016474:Weight-Bearing
chemical_list: D015921:Dental Implants