Clinical investigation on axial versus tilted implants for immediate fixed rehabilitation of edentulous arches: preliminary results of a single cohort study.

PURPOSE: The purpose of this clinical investigation was to evaluate full-arch fixed-dental restorations supported by immediate loaded axial and tilted implants in a single-cohort study. Survival rate of axial and tilted implants was compared. MATERIALS AND METHODS: From 2006 to 2010, 30 patients were recruited and treated with dental implants. Provisional fixed-dental prostheses were screw-retained over axial or axial and tilted implants within 24 hours after surgery. Follow-ups at 6, 12, and 24 months and annually up to 5 years were scheduled, and radiographic evaluation of peri-implant bone level changes was conducted. RESULTS: Thirty patients (20 females and 10 males) were followed up for an average of 44 months (range 18-67 months). Six patients received both upper and lower implant rehabilitations, resulting in 36 restorations. A total of two hundred two implants were placed (maxilla = 118; mandible = 84) and 46% of the fixtures were evaluated at the 4-year recall. Four axial implants were lost in three patients, leading to 98.02% implant (97.56% axial implants and 100% tilted implants) and 100% prosthetic cumulative survival rate, respectively. No significant difference in marginal bone loss was found between tilted and axial implants in both jaws at 1-year evaluation. CONCLUSIONS: Midterm results confirmed that immediate loading of axial and tilted implants provides a viable treatment modality for the rehabilitation of edentulous arches.

Comparison between graft and no-graft in an immediate placed and immediate nonfunctional loaded implant.

PURPOSE: This study compares success rates and hard and periimplant soft tissue responses, between placement and nonplacement of the following five different types of grafts: autogenous bone (A); deproteinized bovine bone mineral (H); demineralized freeze-dried bone allograft (D); A + H; A + D in horizontal gaps between implant surfaces and the buccal bone wall, in immediate placed and immediate nonfunctional loaded implants in maxillary arch. MATERIAL AND METHODS: Forty-one patients with a mean age of 42.5 years were enrolled in this retrospective comparative study. Outcome assessments included clinical and radiographic evaluation. RESULTS: Patients were followed up on average for 32 months with a 100% implant survival rate. No significant difference was found between the two groups. CONCLUSION: Results of this study suggest that immediate placed and immediate restored single implants are valuable therapeutic options in the maxillary arch. The types of grafts placement: A, H, D, A + H, and A + D in horizontal gaps have no additional benefit in promoting better clinical outcomes given that a thick gingival biotype is present.