title: The effect of offset implant configuration on bone stress distribution: a systematic review.
abstract: OBJECTIVE
  The aim of this systematic review was to compare straight-line and offset implant configurations for three-element implant-retained prostheses.
  
  
  METHODS
  Two independent reviewers conducted a review on PubMed/Medline, EMBASE, and Cochrane Library for studies published in English, from January 1, 1995 to January 17, 2014. A systematic review was conducted following the PRISMA statement. All relevant titles were selected according to inclusion/exclusion criteria. From this pool of titles, abstracts and full texts were reviewed.
  
  
  RESULTS
  A total of 6080 titles were identified with the initial search. Twenty-one were selected based on title and abstract. Of these, after discussion and complete reading, 12 studies were selected according to the inclusion and exclusion criteria, all of which were in vitro studies.
  
  
  CONCLUSIONS
  A systematic review of the current literature showed only in vitro evidence that there is no consensus on the advantage of using an offset configuration implant compared to those in straight-line configuration, even though some studies present a slight improvement of bone stress distribution when an offset implant is under oblique loading (PICO).
authors.affiliation: Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Campus of Araçatuba, São Paulo, Brazil.
authors.forename: Victor Eduardo de Souza
authors.initials: VE
authors.lastname: Batista
authors.forename: Joel Ferreira
authors.initials: JF
authors.lastname: Santiago Junior
authors.forename: Daniel Augusto de Faria
authors.initials: DA
authors.lastname: Almeida
authors.forename: Leonardo Ferreira de Toledo Piza
authors.initials: LF
authors.lastname: Lopes
authors.forename: Fellippo Ramos
authors.initials: FR
authors.lastname: Verri
authors.forename: Eduardo Piza
authors.initials: EP
authors.lastname: Pellizzer
mesh_terms: D015921:Dental Implants; D017267:Dental Prosthesis Design; D003799:Dental Stress Analysis; D004548:Elasticity; D020342:Finite Element Analysis; D006801:Humans; D008027:Light
chemical_list: D015921:Dental Implants
keywords: Dental implants; biomechanics; implant-retained dental prosthesis; prosthodontics