Clinical Study Of Tilted Implants In Atrophic Posterior Maxilla

Objective: To investigate clinical application of titled implants in atrophic posterior maxilla as an alternative to bone grafting,and summarize the advantages and disadvantages of this technique.Methods: A total of 24 consecutive patients with atrophic posterior maxilla were included in this study.the volumes of maxillary bone were not sufficient to maintain conventional placement of implants to support a fixed prosthesis.As an alternative to bone transplantation,a surgical method by implant placement in a titled manner along the posterior maxillary sinus wall was undergone,2 to 3 implants(titled implants and axial implants)with optimal length could be installed in each atrophic posterior maxilla.24 patients were included in this follow-up study.All the patients with the treatment of titled implants were followed up at 6 to 24 months after second-stage surgery.Almost each patient was evaluated by radiography and clinical examination.Results: All 24 patients with a total 68 implants were satisfied with tilted implants.Only two cases had the problems that their adhesive retention fixed bridge crown loosened,but radiography demonstrated the implants were well combined with bone.The other patients had all implants intact with fixed prostheses after second-stage surgery.The success rate is 100%.Five cases with poor oral hygiene had peri-implant inflammation,and two of them had the brush bleeding symptoms,their teeth were suffered from periodontitis.However,the implants themselves are healthy.Conclusion: This study demonstrates that the patients with insufficient bone volume in atrophic posterior maxilla can be treated with titled implants,this surgical technique is an alternative to bone grafting,sinus lifting which will cost more time and money.However,the surgeon must be similar to local anatomy and a perfect surgical skill is necessary.