Bone level changes around axial and tilted implants in full-arch fixed immediate restorations. Interim results of a prospective study.
OBJECTIVE
The aim of this prospective study was to assess clinical outcomes and peri-implant bone level changes around tilted and axial implants supporting full-arch fixed immediate rehabilitations up to 60 months of loading.


METHODS
Forty-seven patients (22 women and 25 men) were included in the study. Each patient received a full-arch fixed bridge supported by two axial and two distal tilted implants. Loading was applied within 48 hours of surgery. Patients were scheduled for follow-up at 6, 12, 18, 24 months, and annually up to 5 years. At each follow-up, plaque level and bleeding scores were assessed and radiographic evaluation of marginal bone level change was performed. Periapical radiographs were taken using a paralleling technique, and subsequently scanned at 600 dpi. An image analysis software was used to assess bone level.


RESULTS
A total of 33 mandibles and 16 maxillae were rehabilitated (two patients received a fixed prosthesis in both arches). One hundred ninety-six Nobel Biocare implants of 4 mm diameter were placed. The mean follow-up duration was 52.8 months (range 30-66 months) in the mandible, and 33.8 months (range 22-40 months) in the maxilla. All subjects attended the scheduled follow-up visits. No implant was lost. No significant difference in marginal bone loss was found between axial and tilted implants in both jaws, at each follow-up. No significant difference in bone loss was found between mandible and maxilla, for both axial and tilted implants at each comparable time frame, although slightly higher mean values were always found for the mandible.


CONCLUSIONS
The use of tilted implants in the immediate rehabilitation of fully edentulous jaws is safe and is not associated to a higher marginal bone loss as compared to axially placed implants.
Center of Research in Oral Implantology, Department of Health Technologies, University of Milano, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Luca
L
Francetti
Davide
D
Romeo
Stefano
S
Corbella
Silvio
S
Taschieri
Massimo
M
Del Fabbro
D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects; D017267:Dental Prosthesis Design / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading / Q000009:adverse effects; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography
D015921:Dental Implants