Treatment of the Complete Edentulous Atrophic Maxilla: The Tall Tilted Pin Hole Placement Immediate Loading (TTPHIL)-ALL TILT™ Implant Option

Abstract

Aim:A severely atrophied maxilla presents serious limitations for conventional implant placement and the reconstruction of which requires extensive surgical treatments. This original article presents an overview of this evidence-based technique used for maxillary rehabilitation. Background: Growing patients' needs to regain proper oral function with limited surgical effort presents a challenge to the surgeon for implant placement in harmony with the planned prosthesis. Different techniques and protocols have been put forward through the ages to improve implant survival, osseointegration, and quality of life. A new technique-Tall Tilted Pin Hole Immediate Loading (TTPHIL-ALL TILT™ technique)utilizes angulated long bicortical tapered implants placed in a flapless way in immediate loading with screw-retained prosthetic solutions. Technique: TTPHIL-ALL TILT™ technique involves flapless subcrestal bicortical placement of a total of six tall threaded tilted implants engaging the nasal cortex and the pterygoid pillars, rigidly splinted maintaining adequate anteroposterior spread, achieving proper primary stability, fit for immediate loading. Screw-retained prosthetic solutions are provided with the elimination of distal cantilever. Conclusion: The TTPHIL-ALL TILT™ technique can facilitate surgical rehabilitation of patients with maxillary resorption, as an alternative to other graft less and grafting procedures. Clinical significance: TTPHIL-ALL TILT™ technique provides a graftless solution for the challenging resorbed maxillary edentulous ridges. By following this protocol, primary stability is achieved which gives way for immediate loading satisfying the patient's functional and aesthetic needs.

Evaluation of Marginal Fit and Fracture Resistance of Zirconia Implant Abutment Supporting Two Types of Metal Free CAD/ CAM Restorations

“…However, dummies are non-sterile, that's why they are used in scientific researches on casts and models. To simulate the situation of an osseointegrated implant, selected dummy implants were embedded in epoxy resin blocks as the young's modulus of epoxy resin is similar to that of jaw spongy bone (24) . Moreover, to control thickness during the manufacture process and allow standardization of the mechanical possessions of the restorative materials, CAD/CAM technology was selected (3) .…”

Evaluation of Static and Dynamic Load of Two Metal Free Implant Supported Fixed Dental Prostheses

“…In the present study methodology, the selected implants analogues were fixed in epoxy resin blocks as its young's modulus is close to that of jaw bone. (15,36) The implant analogues were fixed with special centralized device to ensure that all the specimens were placed concentrically with a standardized embedment depth. Furthermore, to standardize the frameworks thickness, the frameworks were processed by CAD/CAM technology.…”

Rehabilitation of atrophic posterior partial edentulous maxilla with TTPHIL ALL TILT® technique: 3 year follow-up case report

“…Therefore, the treatment modalities are shifting towards minimally invasive immediate function protocols. One such treatment modality is TTPHIL ALL TILT® technique that employs anatomic features of nasal cortical and pterygoid bone aiding in immediate function [19,20]. It also provides second molars without cantilever, unlike other techniques which eliminate second molars to minimise cantilevers.…”