Abstract
The purpose of this study was to evaluate the degree of vertical peri-implant resorption around implants inserted with an inclination increased more than 10° at a distance of at least 1 year from insertion. For the realization of the study, a sample consisting of 47 patients for a total of 115 implants was selected. We excluded all those subjects whose conditions could have compromised the outcome of the treatment. An orthopantomography of the dental arches was made using Orthophos XG 3D Sirona at time T0 (at the end of definitive insertion of prosthesis) and at time T1 (at least 1 year after T0) with the aim of an individualized positioner. In this study, all the implants with inclination equal to or greater than 10° were subdivided into three groups, and the implants with inclination between 0 and 10 were used as control sample. In group I, there is a statistically significant difference in at least one of the two sides (distal one) between T0 and T1. In groups II and III, there is a statistically significant difference in the degree of bone resorption on the mesial side with respect to distal side. In group IV, a statistically significant difference on both sides was evidenced. The implant survival at a distance of 1 year was equal to 100% of cases. Surgeons must take into account the possibility that an increase in inclination of implants may lead to a more rapid resorption of bone mesially or distally. The direction of the prosthetic load transmitted to the fixture is a variable that could influence the degree of reabsorption of both mesial and distal bone structures according to both laboratory and clinical data.
Highlights
Abstr ac tAim: The purpose of this study was to evaluate the degree of vertical peri-implant resorption around implants inserted with an inclination increased more than 10° at a distance of at least 1 year from insertion
In the same cohort of patients, we evaluated implant survival at a distance of at least 1 year from the insertion of the fixtures
Del Fabbro et al found no significant difference in failure rate between tilted and upright implants, both maxillary and mandibular implants
Summary
Aim: The purpose of this study was to evaluate the degree of vertical peri-implant resorption around implants inserted with an inclination increased more than 10° at a distance of at least 1 year from insertion. Conclusion: Surgeons must take into account the possibility that an increase in inclination of implants may lead to a more rapid resorption of bone mesially or distally. To obtain an optimal anchorage of the implant within the bone plate, the surgeon should take into account the anatomy of the maxillary and mandibular regions: in the maxillary arch, the presence of the maxillary sinuses can sometimes make implant placement difficult in the posterior sectors; in the mandibular arch, the presence of the alveolar neurovascular bundle can make distal implant placement impossible if the level of bone atrophy is high To overcome these problems, some procedures of regenerative dentistry have been described: maxillary sinus lift represents a solution that allow implant positioning in the maxillary arch; even in the mandibular arch, it is possible to carry out regenerative procedures, through the use of bone grafts.
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