Immediate rehabilitation of the edentulous maxilla: preliminary results of a single-cohort prospective study.
OBJECTIVE
This article reports preliminary results of a single-cohort prospective study that sought to evaluate a new surgical protocol for the immediate rehabilitation of edentulous maxilla without using bone grafting.


METHODS
Twenty consecutive patients in need of a full-arch maxillary rehabilitation were included in the study. Each patient received four tilted implants that engaged the posterior and the anterior sinus wall and two axial implants in the anterior maxilla. A total of 120 implants (30 Branemark System MK IV and 90 NobelSpeedy Groovy) was inserted. Acrylic resin provisional prostheses were delivered within 4 hours of implant placement, and definitive restorations were placed 4 to 6 months later. Follow-up visits were scheduled every 6 months for the first 2 years and yearly thereafter. At each follow-up appointment, plaque and bleeding indexes were scored, periapical radiographs were obtained to assess marginal bone level changes, and patient satisfaction was recorded by means of a questionnaire.


RESULTS
The follow-up ranged between 18 and 42 months (average, 27.2 months). No implants failed. All prostheses were stable and functional. No adverse events occurred. At 1 year, mean marginal bone loss around axial and tilted implants was similar: 0.8 mm for axial implants (SD 0.4, n = 30) and 0.9 mm for tilted implants (SD 0.5 mm, n = 60) (P > .05). Plaque and bleeding scores decreased over time, and patient satisfaction with both esthetics and function increased.


CONCLUSIONS
This technique can be considered a viable treatment modality for the immediate rehabilitation of the edentulous maxilla, as it provides optimal support in the posterior region, minimizes distal cantilevers, and avoids bone grafting or sinus augmentation.
Department of Health Technologies, Milan University, Milan, Itally.
Enrico L
EL
Agliardi
Luca
L
Francetti
Davide
D
Romeo
Massimo
M
Del Fabbro
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification; D015331:Cohort Studies; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D003825:Denture, Complete, Immediate; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D010512:Periodontal Index; D011446:Prospective Studies; D011862:Radiography, Panoramic; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D015921:Dental Implants