title: Immediate fixed rehabilitation of the edentulous maxilla: a prospective clinical and radiological study after 3 years of loading.
abstract: OBJECTIVE
  The aim of this study was to prospectively evaluate the clinical and radiographic outcomes of immediate full-arch fixed maxillary prosthesis supported by two axial and four tilted implants after 3 years of loading.
  
  
  METHODS
  Thirty-two patients with atrophic maxilla were consecutively enrolled and treated. Each patient received a fixed full-arch maxillary rehabilitation supported by four tilted implants that engaged the posterior and the anterior sinus walls and two axial anterior implants. A total of 192 implants (30 Brånemark System MK IV and 162 NobelSpeedy Groovy, Nobel Biocare AB, Göteborg, Sweden) were inserted and immediately loaded. The definitive restorations were placed 6 months later, and follow-up visits were scheduled every 6 months. During follow-ups, marginal bone loss (MBL), plaque and bleeding scores, and patient's satisfaction were recorded.
  
  
  RESULTS
  All patients reached at least 3-year follow-up examination (range 36-78, average 55.53 months). Two tilted implants failed before delivering the definitive restoration, resulting in a cumulative survival rate of 98.96%. All final prostheses were stable and functional, resulting in a cumulative survival and success rate of 100%. At the 3-year follow-up there was no significant difference in MBL between axial (1.55 ± 0.31 mm) and tilted implants (1.46 ± 0.19 mm) (p = .05). Plaque and bleeding scores decreased over time, while patient's satisfaction in both aesthetics and function increased.
  
  
  CONCLUSIONS
  Implants placement with this configuration could be considered a predictable and cost- and time-effective alternative approach for the immediate restoration of the edentulous maxilla, avoiding bone grafting procedures, even with a medium-term follow-up.
authors.affiliation: Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy.
authors.forename: Enrico L
authors.initials: EL
authors.lastname: Agliardi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pozzi
authors.forename: Christian F J
authors.initials: CF
authors.lastname: Stappert
authors.forename: Riccardo
authors.initials: R
authors.lastname: Benzi
authors.forename: Davide
authors.initials: D
authors.lastname: Romeo
authors.forename: Enrico
authors.initials: E
authors.lastname: Gherlone
mesh_terms: D000328:Adult; D000368:Aged; D015921:Dental Implants; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011862:Radiography, Panoramic
chemical_list: D015921:Dental Implants