title: Tilted implants for the restoration of posterior mandibles with horizontal atrophy: an alternative treatment.
abstract: OBJECTIVE
  Horizontal atrophy in the posterior mandible presents serious limitations on conventional implant placement. The purpose of this study was to evaluate the use of tilted implants angled in a buccolingual direction for restoring atrophic posterior mandibular sectors.
  
  
  METHODS
  A cohort study was performed of 25 patients who had partial prostheses supported by more than 1 implant (≥ 1 tilted and 1 axial implant) to restore molar areas in the mandible. When the bone thickness was at least 5 mm, axial implants were placed; when the alveolar ridge was narrower, the implant was placed with tilted angulation. The beds for these tilted implants were prepared using a lingual approach, tipping the implant apex toward the vestibule. Twelve months after loading, bone loss was evaluated and the success rates of the tilted and axial implants were calculated.
  
  
  RESULTS
  The study included 20 women and 5 men (mean age, 54.8 yr) who received 67 implants in the posterior mandibular sectors. Thirty-nine implants were placed with a buccal angulation and 28 implants were placed vertically. Mean bone losses of 0.59 ± 0.26 mm among the tilted implants and 0.48 ± 0.34 mm among the axial implants were observed 1 year after loading. The success rate of the tilted implants was 94.9%, and that of the axial implants was 100%. No significant differences in success rates or in bone loss between the tilted and axial implants were found at 12 months after loading.
  
  
  CONCLUSIONS
  Twelve months after loading, tilted implants provided good results for the restoration of posterior mandibles with horizontal atrophy and no significant differences in success rates or marginal bone loss between tilted and axial implants were observed.
authors: Faculty of Medicine and Dentistry, University of Valencia, Spain.
authors: María
authors: M
authors: Peñarrocha Diago
authors: Laura
authors: L
authors: Maestre Ferrín
authors: David
authors: D
authors: Peñarrocha Oltra
authors: Luigi
authors: L
authors: Canullo
authors: Jose Luis
authors: JL
authors: Calvo Guirado
authors: Miguel
authors: M
authors: Peñarrocha Diago
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology; D001284:Atrophy; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods; D015331:Cohort Studies; D003442:Crowns; D003724:Dental Arch / Q000473:pathology / Q000601:surgery; D059605:Dental Implant-Abutment Design; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003830:Denture, Partial, Fixed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; D015921:Dental Implants