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Clin Implant Dent Relat Res. 2014 Apr;16(2):292-302. doi: 10.1111/j.1708-8208.2012.00482.x. Epub 2012 Aug 9.

Immediate fixed rehabilitation of the edentulous maxilla: a prospective clinical and radiological study after 3 years of loading.

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Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy.



The aim of this study was to prospectively evaluate the clinical and radiographic outcomes of immediate full-arch fixed maxillary prosthesis supported by two axial and four tilted implants after 3 years of loading.


Thirty-two patients with atrophic maxilla were consecutively enrolled and treated. Each patient received a fixed full-arch maxillary rehabilitation supported by four tilted implants that engaged the posterior and the anterior sinus walls and two axial anterior implants. A total of 192 implants (30 Brånemark System MK IV and 162 NobelSpeedy Groovy, Nobel Biocare AB, Göteborg, Sweden) were inserted and immediately loaded. The definitive restorations were placed 6 months later, and follow-up visits were scheduled every 6 months. During follow-ups, marginal bone loss (MBL), plaque and bleeding scores, and patient's satisfaction were recorded.


All patients reached at least 3-year follow-up examination (range 36-78, average 55.53 months). Two tilted implants failed before delivering the definitive restoration, resulting in a cumulative survival rate of 98.96%. All final prostheses were stable and functional, resulting in a cumulative survival and success rate of 100%. At the 3-year follow-up there was no significant difference in MBL between axial (1.55 ± 0.31 mm) and tilted implants (1.46 ± 0.19 mm) (p = .05). Plaque and bleeding scores decreased over time, while patient's satisfaction in both aesthetics and function increased.


Implants placement with this configuration could be considered a predictable and cost- and time-effective alternative approach for the immediate restoration of the edentulous maxilla, avoiding bone grafting procedures, even with a medium-term follow-up.


dental implants; edentulous maxilla; immediate loading; tilted implant

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