Clinical Evaluation of Immediate Loading of Electroeroded Screw‐Retained Titanium Fixed Prostheses Supported by Tilted Implant: A Multicenter Retrospective Study

Abstract

Statement of problem: Immediate occlusal loading of dental implants in the edentulous mandible has proven to be an effective, reliable, and predictable treatment protocol. However, there is limited long-term data available in the literature, when an electroeroded definitive cast-titanium fixed prosthesis is used for this treatment protocol.Purpose: The aim of this study was to evaluate the clinical effectiveness of dental implants (Astra Tech Dental, Mölndal, Sweden) in the edentulous mandible immediately loaded with an electroeroded cast-titanium screw-retained fixed prosthesis.Materials and Methods: Forty-five patients received five implants each in the interforaminal area. All the implants were inserted with torque up to 40 Ncm and the distal implants were distally tilted approximately 20 to 30 degrees to minimize the length of posterior cantilevers. Implants were loaded within 48 hours of placement with an acrylic resin-titanium screw-retained prosthesis fabricated by electroerosion.Results: Two of the 225 inserted implants failed after 3 and 16 months of healing, respectively, with a cumulative survival rate of 99.1% and a prosthetic survival rate of 97.8%.Conclusion: Immediate loading of tilted dental implants inserted in the edentulous mandible with a screw-retained titanium definitive prosthesis fabricated with electrical discharge machining provide reliable and predictable results.

Tilted versus axially placed dental implants: A meta-analysis

“…Twenty-five prospective studies 8,13-36 and nineteen retrospective analyses 1,3,7,37-52 were included in the meta-analysis. Five studies 15,18,20,27,44 were multicenter. Four studies 24,31,39,40 had a relatively short follow-up time (up to 12 months).…”

“…Some patients in thirty-three studies 1, 3,7,8,14,15,17,18,[20][21][22][23][24][25][27][28][29][30][32][33][34]36,[40][41][42][44][45][46][47][48][49]51,52 were smokers. Five studies 16,42,44,46,49 reported the presence of bruxers among the patients, and six studies 1, 28,42,46,48,49 the presence of diabetic patients. In twelve studies [17][18][19]21,22,27,32,34,36,…”

“…Seventeen studies 3,7,14,17,19,20,23,29,32,33,36,37,39,45,47,49,51 exclusively evaluated implants inserted in maxillae, and exclusively evaluated implants inserted in mandibles in eleven studies. 1, 18,21,28,30,31,42,44,46,48,50 Implants were not immediately loaded in eight studies 7,13,37,38,43,47,48,51 In one study 36 some implants were immediately or delayed loaded, and another study 41 did not provide information about the healing/loading time. Twenty-three studies 8,13,[15][16][17]20,21,23,25,26,31,33,37,…”

“…Four studies 25,36,38,51 did not inform what kind of implants was used. Thirty studies 1, 3,8,[14][15][16][17][18][19][20][21][22]24,26,[28][29][30][31][32][33]35,[37][38][39][40]44,45,[49][50][51] provided information about the use of prophylactic antibiotics. Twenty studies 14,[17][18][19]21,22,[24][25][26][28][29][30][31][32][33][34]38,44,45,…”

“…Nine studies 3,21,25,32,40,[44][45][46]51 provided information about postoperative infection. However, in five studies 3,25,40,45,51 with ten of the thirteen occurrences, there was no information about which groups these patients belonged to.…”