Abstract
Simple SummaryFollowing tooth loosening due to periodontal disease, caries, trauma, or tumoral processes, bone resorption and remodeling of the alveolar ridge makes the insertion of implants difficult. A number of bone augmentation techniques are available to treat atrophic jaws. However, when posterior bone is lacking and extensive bone augmentation surgeries are rejected by the patient, placing distally tilted posterior implants may offer a valid therapeutic option for implant-supported restorations. This treatment modality places the implants in preexisting bone, improving bone anchorage and prosthetic support. Nevertheless, some studies suggest that for tilted implants, bending moments are greater at the level of the angled abutment.The aim of this study was to assess the long-term clinical behavior of straight implants in comparison with intentionally tilted dental implants (ITDI) supporting fixed restorations in partial or total edentulous arches, analyzing implant survival and success rates, complications, and marginal bone loss (MBL) after >5 years of function. An electronic search was conducted in five electronic databases (MEDLINE/Pubmed, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials) supplemented by a manual search. The electronic and manual search identified 1853 articles, of which 8 articles were selected for analysis. Out of a total of 3987 dental implants, 2036 were axial dental implants and 1951 tilted. Similar results were found in implant survival or overall implant success rates. Moreover, no statistically significant differences were found in MBL (p = 0.369; MD 0.116 mm (−0.137; 0.369) 95% CI) The prosthodontic/biological complications reported in the articles were very diverse and irregularly distributed. This systematic review suggests that there is no difference between tilted compared with straight dental implants in the medium-long term (>5 years). However, further research is needed to generate long-term data and confirm the present review’s findings.
Highlights
The rehabilitation of totally or partially edentulous jaws by means of osseointegrated implants has proven to be a predictable treatment option over time [1], enjoying success rates of between 92.5% and 96.4% and a survival rate of 94.7–99.4% over at least5 years [2,3,4]
Forest plots were produced to compare marginal bone loss between axial and tilted implants supporting partial or full rehabilitations; the results found no statistically significant differences (p ≥ 0.05) between the two groups (p = 0.369; MD 0.116 mm (−0.137–0.369) 95% confidence interval (CI)) (Figure 2)
Within the limitations of this systematic review, it may be concluded that intentionally tilted dental implants (ITDI) would appear to be a reliable option for supporting fixed restorations
Summary
The rehabilitation of totally or partially edentulous jaws by means of osseointegrated implants has proven to be a predictable treatment option over time [1], enjoying success rates of between 92.5% and 96.4% and a survival rate of 94.7–99.4% over at least5 years [2,3,4]. In cases of atrophic maxillae and/or mandibles, several treatment options are available to make implant placement possible, including guided bone regeneration, split crest technique, sinus lift, osteogenic distraction, or bone blocking, among others [5,6]. When posterior bone is lacking and extensive bone augmentation surgeries are rejected by the patient, implant placement often results in a longer distal cantilever that produces high stress on both implants and bone. This can compromise implant survival [7]. Short implants or implant placement in the zygoma or the tuberosity offer an alternative to advanced bone-augmentation surgeries [8,9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
