title: Upper full arch rehabilitation with sinus by-pass with tilted implants via tapered-threaded expanders in low density bone: a clinical trial.
abstract: In the present paper the use of tapered-screw bone expanders (TSBEs) is proposed, in combination with the placement of tilted implants, in close proximity to the anterior sinus wall, solving the problem of the reduced height of the alveolar bone in the sub-antral area. The Authors present a case series of full-arch rehabilitations performed with this procedure named: Tilted Implant Expansion Osteotomy (TIEO).
  
  
  
  12 patients (5 males and 7 females, average age 58.5 ± 8.1 years) with totally or partially edentulous maxilla were enrolled in this study. For each patient 4 implants were placed, the anterior implants in the area of lateral incisors or canines while, the posterior implants, immediately in front of the maxillary sinus, with an inclined position. Adopting the aforesaid procedure, 48 cylindrical two-piece implants were placed, 24 of which were placed in tilted position, in order to by-pass the maxillary sinus. After a healing period of 6 months, the second stage surgery was performed. The cases were finalized by means of a hybrid metal-acrylic prosthesis. The post finalization follow-up was at 12 months.
  
  
  
  Survival rate was 100% since none fixtures were lost. At the one-year follow up the clinical and radiological appearance of the soft and hard tissues was optimal and no pathological signs were recorded.
  
  
  
  TIEO is a promising surgical procedure for full-arch rehabilitation of maxillary edentulous sites and represents a therapeutic alternative to sinus lift techniques.
authors.affiliation: Private Practice in Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Andreasi Bassi
authors.affiliation: Private Practice in Matera, Matera, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Andrisani
authors.affiliation: Private Practice in Olevano Romano (RM), Italy.
authors.forename: S
authors.initials: S
authors.lastname: Lico
authors.affiliation: Department of Oral Rehabilitation, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Ormanier
authors.affiliation: Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Arcuri
keywords: bone expansion; low density bone; sinus lift; tapered-screw bone expanders; tilted implants