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.
Highlights
The term tilted implants refers to implants placed at an angle of normally 30 degrees or more with respect to axially or vertically positioned implants (1)
In selecting the publications we reviewed the titles and abstracts to identify the relevant studies, which were retrieved in full format and assessed for the following inclusion criteria: the use of tilted implants, clinical series involving at least 10 patients, and a minimum follow-up of 12 months after prosthetic loading
Prosthetic rehabilitation of the edentulous maxilla includes the placement of tilted implants as a relatively recent option
Summary
The term tilted implants refers to implants placed at an angle of normally 30 degrees or more with respect to axially or vertically positioned implants (1). The use of tilted implants in the posterior maxillary sector offers advantages over axial implants (2-7). The combination of tilted and axial implants allows the use of longer implants, thereby increasing the osseointegration surface; improves primary stability by anchoring in more than one cortical layer; avoids cantilever extremities by placing the implants more distal and with better load distribution over the dental arch; and avoids the use of bone grafts and sinus lift procedures - with the resulting reduction in morbidity (1,8). The present metaanalysis compares the course of patients treated with tilted implants versus those treated conventionally with axial implants, analyzing the success rate and marginal bone loss
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