Immediate rehabilitation of the mandible with fixed full prosthesis supported by axial and tilted implants: interim results of a single cohort prospective study.
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.
Francetti
Luca
L
Department of Health Technologies, Centre for Research in Oral Implantology, Istituto Ortopedico Galeazzi IRCCS, University of Milan, Milan, Italy. luca.francetti@unimi.it
Agliardi
Enrico
E
Testori
Tiziano
T
Romeo
Davide
D
Taschieri
Silvio
S
Del Fabbro
Massimo
M
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
D015921:Dental Implants