Mandibular Full‐Arch Fixed Prostheses Supported on 4 Implants with Either Axial Or Tilted Distal Implants: A 3‐Year Prospective Study

Krennmair, Stefan; Weinländer, Michael; Malek, Michael; Forstner, Thomas; Krennmair, Gerald; Stimmelmayr, Michael

doi:10.1111/cid.12419

Cited by 36 publications

(52 citation statements)

References 32 publications

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“…The plaque around posterior implants was significantly higher than anterior implants. A similar finding was noted by Krennmair et al 35 who compared axial and tilted implants supporting All-On-Four mandibular fixed prosthesis. They attributed this finding to the impaired cleaning process of posterior implants caused by prosthesis design (due to presence of cantilever) with excessively close gingival attachment due to the inaccessibility of posterior implant compared to anterior implants.…”

Section: Probing Depthsupporting

confidence: 85%

Clinical and radiographic outcomes of polyetheretherketone (PEEK) hybrid prosthesis used for “All on four” rehabilitation of edentulous maxilla. A short-term case series study

Ali

Talawy

2019

Egyptian Dental Journal

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Purpose: The aim of this study was to evaluate clinical and radiographic outcomes of polyetheretherketone (PEEK) hybrid prosthesis used for "All on four" rehabilitation of edentulous maxilla. Materials and methods: Six patients with atrophied edentulous maxillary ridges were managed by 4 implants according to the "All on four" protocol using computer guided surgery and flapless surgical approach. The existing maxillary dentures were placed immediately after modifications on the same day. After 6 months, the definite prosthesis consisted of screw retained milled BioHPP framework bonded to acrylic resin teeth and denture base. The prosthesis restored lost teeth, hard and soft tissues (hybrid fixed prosthesis). Plaque and gingival index, probing depth, implant mobility and bone loss (measured by standardized periapical radiographs) were evaluated after prosthesis delivery (T0), six months (T6) and 12 months (T12) after delivery. Results: Two implants failed in one patient resulting in 91.7% survival rate. Plaque index increased with time. No difference in gingival index, pocket depth, implant stability, and vertical bone loss between observation times was noted. Posterior implant showed higher plaque scores and pocket depth than anterior implants after 6 and 12 months and no significant difference in all other parameters between anterior and posterior implants was noted. Conclusion: Within the limitation of this study, PEEK hybrid prosthesis bonded to acrylic resin teeth and denture base can be used successfully to rehabilitate patients with atrophic maxilla according to "All on four" concept as it was associated with favourable clinical and radiographic outcomes after one year.

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Section: Probing Depthsupporting

confidence: 85%

Clinical and radiographic outcomes of polyetheretherketone (PEEK) hybrid prosthesis used for “All on four” rehabilitation of edentulous maxilla. A short-term case series study

Ali

Talawy

2019

Egyptian Dental Journal

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“…Most studies focused on the clinical performance of four implants placed in the edentulous maxilla or mandible. Only one level II study focused on the direct comparison between axially placed and tilted implants (Krennmair et al., ). In this particular 3‐year prospective clinical trial, 21 patients with four axially placed implants (axial group: two anterior and two posterior implants) and 20 patients with four implants (tilted group: two anterior axially placed and two distal tilted implants) were all restored with implant supported mandibular full‐arch fixed dental prostheses.…”

Section: Resultsmentioning

confidence: 99%

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review

Lin

Eckert

2018

Clinical Oral Implants Res

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Objectives:The aim of this review was to determine the clinical performance of dental implants that are intentionally tilted when compared with implants that are placed following the long axis of the residual alveolar ridge. Materials and methods:A systematic review of the scientific literature using a predefined research question (PICO) and search strategy was undertaken. This search included five electronic databases. Two independent reviewers examined electronic databases and performed a manual review following search strategy to accomplish the item generation and reduction. Included articles were evaluated to determine the level of evidence. Data were extracted only from level I and level II studies, based on the Oxford Centre for Evidence-based Medicine-Levels of Evidence (March 2009).If included studies were homogeneous in nature, data were to be accumulated.However, if included studies were heterogeneous in nature, only descriptive data would be reviewed and analyzed.Results: A total of 811 articles were identified through the PICO question and search strategy. Detailed review of the abstracts and articles resulted in further item reduction, and 46 articles were included for full-text review. A total of 42 articles were then selected for inclusion in the systematic review. The identified articles included two level I and 20 level II studies. In addition, 15 level IV, one gray literature, and four previous systematic reviews with meta-analyses were also used in the study. The extracted data from the included studies demonstrated heterogeneity that prevented quantitative assessment, and only one level II study directly compared tilted and axially placed implants. Assessment of the descriptive data demonstrated no differences in implant survival, marginal bone loss, prosthesis survival, or patient-reported outcome measures (PROMs) whether implants are placed axially or with intentional inclination of the coronal aspect of the implant toward the distal aspect of edentulous jaws.Conclusions: Based upon the systematic review of the literature, an analysis of the descriptive data suggested no differences in clinical performance between implants that are placed in an axial position relative to the residual alveolar ridge when compared with implants that are intentionally tilted toward the distal aspect of edentulous jaws. K E Y W O R D Sclinical assessment, clinical research, clinical trials, diagnosis, prosthodontics tilted, axialThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…Pocket depth increased significantly with time. Similarly, several authors reported an increase in pocket depth around implants supporting "All on four" prosthesis (22,23) . Premolar implants showed increased pocket depth than canine implants.…”

Section: Discussionmentioning

confidence: 80%

“…The increased plaque scores for premolar implants compared to canine implants may be due to the difficulty of cleaning the prosthesis due to presence of acrylic flanges and the inaccessibility of posterior implants compared to anterior ones. Similarly, Krennmair et al (22) found increase plaque scores around tilted posterior implants compared to axial anterior implants and attributed this finding to the impaired cleaning process of posterior implants caused by prosthesis design (due to presence of cantilever) with excessively close gingival attachment. However, the increased plaque accumulation did not cause an increase in gingival inflammation and gingival index over the time.…”

Section: Discussionmentioning

confidence: 94%

Computer guided flapless vestibular to lingual trans-alveolar implant insertion for All on four implant prosthesis in case of severely atrophied mandible: A short term clinical and radiographic study

Mourad

Awad

Shamaa

2020

Egyptian Dental Journal

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Aim: This short-term investigation aimed to study the outcomes of computer guided flapless vestibular to lingual implant insertion for All on four implant prosthesis in case of severely atrophied mandible.Material and methods: Six (3 men and 3 women) edentulous patients (mean age of 59 years) with atrophied mandibles received four implants using the computer guided flapless surgical protocol and a stereolithographic surgical guide. The posterior implant was installed in bicuspid region lingual to mental foramen and inclined in buccolingual trans-alveolar direction to engage the lingual cortical plate. Fixtures were loaded by the old denture the same day of implant placement. Plaque and bleeding scores, probing depth, fixture mobility and loss of bone around implants were measured at baseline (immediately after loading), 6 and 12 months thereafter. Results:There was a significant increase in plaque scores, probing depth and resorption of bone with passage of time. gingival scores and stability of the implants did not change with time. Premolar implants showed significant higher plaque scores, probing depth and marginal loss of bone compared to canine implants. Two posterior implants were lost resulting in survival rate of 91.6% after one year. Conclusion:Within the limits of this study, it could be concluded that computer guided flapless vestibular to lingual trans-alveolar posterior implant insertion for All on four implant prosthesis in case of severely atrophied mandible is a predictable and reliable method as it was associated with favourable clinical and radiographic peri-implant outcomes after one year.

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Mandibular Full‐Arch Fixed Prostheses Supported on 4 Implants with Either Axial Or Tilted Distal Implants: A 3‐Year Prospective Study

Abstract: For clinical implant and prosthesis outcome no statistical significant mean differences were noted for distally cantilevered 4-ISFMP supported by distal implants placed in tilted or axial direction.

Cited by 36 publications

References 32 publications

Clinical and radiographic outcomes of polyetheretherketone (PEEK) hybrid prosthesis used for “All on four” rehabilitation of edentulous maxilla. A short-term case series study

Clinical and radiographic outcomes of polyetheretherketone (PEEK) hybrid prosthesis used for “All on four” rehabilitation of edentulous maxilla. A short-term case series study

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review

Computer guided flapless vestibular to lingual trans-alveolar implant insertion for All on four implant prosthesis in case of severely atrophied mandible: A short term clinical and radiographic study

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