Oral rehabilitation with tilted dental implants: A metaanalysis

Abstract

Objective: To compare the course of patients treated with tilted implants versus those treated conventionally with axial implants, analyzing the success rate and marginal bone loss. Material and Methods: A PubMed search was made using the key words “tilted implants”, “angled implants”, “angulated implants”, “inclined implants” and “maxillary atrophy.” A review was made of the articles published between 1999-2010. The inclusion criteria were the use of tilted implants, clinical series involving at least 10 patients, and a minimum follow-up of 12 months after prosthetic loading. The exclusion criteria were isolated clinical cases, studies with missing data, and publications in languages other than English or Spanish. The metaanalysis finally included 13 articles: 7 retrospective studies and 6 prospective studies. Results: On analyzing the success rate in the retrospective studies, two reported a higher success rate with tilted implants; one a higher success rate with axial implants; and two reported similar success rates with both implants. On analyzing the success rate in the prospective studies, two reported a higher success rate with tilted implants; two a higher success rate with axial implants; and two reported similar success rates with both implants. On examining marginal bone loss, three studies reported greater bone loss with axial implants and one with tilted implants. Conclusions: There was no evidence of differences in success rate between tilted and axial implants in either the prospective or retrospective studies subjected to review. The marginal bone loss observed with the tilted and axial implants likewise proved very similar. It thus can be deduced that tilted implants exhibit the same evolutive behavior as axial implants. Key words:Axial implants, tilted implants, maxillary atrophy, tilted implants.

Stress analysis in oral obturator prostheses over parallel and tilted implants: photoelastic imaging

“…Therefore, it may be considered a predictable technique with an excellent prognosis in short and medium term. [1][2][3] According to this study, when there is a need for installation of tilted implants in the posterior region of maxilla, success can be achieved for implant-retained obturators prosthesis.…”

“…Without this technique, these regions would receive shorter implants or would require bone graft, increasing the complexity, time and cost of the treatment. [1][2][3] Allied to implants, different types of attachment systems are usually indicated for improving the retention and stability of overdentures, [4][5][6][7][8] such as ball systems, magnet, and bars, and it is also possible to associate them with one another. 4,5,[7][8][9][10][11] The dental literature has shown many studies that approach the distribution of forces in order to collect better background information for planning of overdentures.…”

Angulated Implants: An Alternative to Bone Augmentation and Sinus Lift Procedure: Systematic Review

“…Some studies have advocated that we should not place single angulated implant to replace single missing tooth since prosthesis fabricated over it will be of fixed type creating more amount and duration of load and increased off axis loading [25]. In one meta analysis, author found no difference in success rate between tilted and axial implant [23]. This opens our thought process that tilted implants can be placed at high success rate as that of axial implant.…”

“…• Ata-Ali et al, [23] performed meta-analysis on oral rehabilitation with tilted implants and deduced that tilted implants exhibit same evaluative behaviour as axial implant. There was no evidence of differences in success rate between tilted and axial implants in either the prospective or retrospective studies subjected to review.…”

Implant angulation: 2-year retrospective analysis on the influence of dental implant angle insertion on marginal bone resorption in maxillary and mandibular osseous onlay grafts

“…Dental implants placed in bone from the chin or hip, and relative prosthetic restorations, were marked as follows: implants in grafts from: iliac crest (black), parasymphyseal area (red). Implants restored by: single crown cemented over a custom metal abutment (empty square), single crown screw retained via UCLA-type abutment (solid square), splinted fixed restoration cemented over custom metal abutments (empty circle), Toronto bridges (solid circle) Several recent systematic reviews which have focused on the immediate loading rehabilitation of the edentulous maxilla by means of tilted and upright implants have not shown significant results regarding a relationship between marginal bone remodelling and implant inclination: a non-significant mean difference between tilted and upright implants was found with regard to marginal bone loss, and thus tilted implants seem to show the same behaviour as axial implants [36,37]. All the above reviews considered mainly mesial or distal marginal bone loss found using bi-dimensional analysis, performed either on peri-apical film or on panoramic radiographic images, showing their measurements; moreover, tilted dental implants were placed in pristine bone.…”