Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study
Identifieur interne : 004258 ( Ncbi/Merge ); précédent : 004257; suivant : 004259Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study
Auteurs : Nicol Cavalli ; Bruno Barbaro ; Davide Spasari ; Francesco Azzola ; Alberto Ciatti ; Luca FrancettiSource :
- International Journal of Dentistry [ 1687-8728 ] ; 2012.
Abstract
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DOI: 10.1155/2012/180379
PubMed: 23133453
PubMed Central: 3486129
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study</title><author><name sortKey="Cavalli, Nicol" sort="Cavalli, Nicol" uniqKey="Cavalli N" first="Nicol" last="Cavalli">Nicol Cavalli</name></author><author><name sortKey="Barbaro, Bruno" sort="Barbaro, Bruno" uniqKey="Barbaro B" first="Bruno" last="Barbaro">Bruno Barbaro</name></author><author><name sortKey="Spasari, Davide" sort="Spasari, Davide" uniqKey="Spasari D" first="Davide" last="Spasari">Davide Spasari</name></author><author><name sortKey="Azzola, Francesco" sort="Azzola, Francesco" uniqKey="Azzola F" first="Francesco" last="Azzola">Francesco Azzola</name></author><author><name sortKey="Ciatti, Alberto" sort="Ciatti, Alberto" uniqKey="Ciatti A" first="Alberto" last="Ciatti">Alberto Ciatti</name></author><author><name sortKey="Francetti, Luca" sort="Francetti, Luca" uniqKey="Francetti L" first="Luca" last="Francetti">Luca Francetti</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23133453</idno><idno type="pmc">3486129</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3486129</idno><idno type="RBID">PMC:3486129</idno><idno type="doi">10.1155/2012/180379</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002D53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D53</idno><idno type="wicri:Area/Pmc/Curation">002D53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002D53</idno><idno type="wicri:Area/Pmc/Checkpoint">001C27</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001C27</idno><idno type="wicri:Area/Ncbi/Merge">004258</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study</title><author><name sortKey="Cavalli, Nicol" sort="Cavalli, Nicol" uniqKey="Cavalli N" first="Nicol" last="Cavalli">Nicol Cavalli</name></author><author><name sortKey="Barbaro, Bruno" sort="Barbaro, Bruno" uniqKey="Barbaro B" first="Bruno" last="Barbaro">Bruno Barbaro</name></author><author><name sortKey="Spasari, Davide" sort="Spasari, Davide" uniqKey="Spasari D" first="Davide" last="Spasari">Davide Spasari</name></author><author><name sortKey="Azzola, Francesco" sort="Azzola, Francesco" uniqKey="Azzola F" first="Francesco" last="Azzola">Francesco Azzola</name></author><author><name sortKey="Ciatti, Alberto" sort="Ciatti, Alberto" uniqKey="Ciatti A" first="Alberto" last="Ciatti">Alberto Ciatti</name></author><author><name sortKey="Francetti, Luca" sort="Francetti, Luca" uniqKey="Francetti L" first="Luca" last="Francetti">Luca Francetti</name></author></analytic><series><title level="j">International Journal of Dentistry</title><idno type="ISSN">1687-8728</idno><idno type="eISSN">1687-8736</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Purpose</italic>. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. <italic>Materials and Methods</italic>. Thirty-four patients (18 women and 16 men) were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. <italic>Results</italic>. The overall follow-up range was 12 to 73 months (mean 38.8 months). No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients), peri-implantitis (5.9% patients), and temporomandibular joint pain (5.9% patients). The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients) and definitive (17.7% patients) prosthesis and the minor acrylic fractures in the temporary (14.7% patients) and definitive (2.9% patients) prosthesis. Hygienic complications occurred in 38.2% patients. No patients' dissatisfactions were recorded. <italic>Conclusions</italic>. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Adell, R" uniqKey="Adell R">R Adell</name></author><author><name sortKey="Eriksson, B" uniqKey="Eriksson B">B Eriksson</name></author><author><name sortKey="Lekholm, U" uniqKey="Lekholm U">U Lekholm</name></author><author><name sortKey="Br Nemark, Pi" uniqKey="Br Nemark P">PI Brånemark</name></author><author><name sortKey="Jemt, T" uniqKey="Jemt T">T Jemt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jemt, T" uniqKey="Jemt T">T Jemt</name></author><author><name sortKey="Johansson, J" uniqKey="Johansson J">J Johansson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey=" Strand, P" uniqKey=" Strand P">P Åstrand</name></author><author><name sortKey="Ahlqvist, 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Dent</journal-id><journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id><journal-id journal-id-type="publisher-id">IJD</journal-id><journal-title-group><journal-title>International Journal of Dentistry</journal-title></journal-title-group><issn pub-type="ppub">1687-8728</issn><issn pub-type="epub">1687-8736</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23133453</article-id><article-id pub-id-type="pmc">3486129</article-id><article-id pub-id-type="doi">10.1155/2012/180379</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Cavalli</surname><given-names>Nicolò</given-names></name><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Barbaro</surname><given-names>Bruno</given-names></name></contrib><contrib contrib-type="author"><name><surname>Spasari</surname><given-names>Davide</given-names></name></contrib><contrib contrib-type="author"><name><surname>Azzola</surname><given-names>Francesco</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ciatti</surname><given-names>Alberto</given-names></name></contrib><contrib contrib-type="author"><name><surname>Francetti</surname><given-names>Luca</given-names></name></contrib></contrib-group><aff id="I1">Department of Biomedical, Surgical and Dental Sciences, Oral Implantology Research Center, Università degli Studi di Milano, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy</aff><author-notes><corresp id="cor1">*Nicolò Cavalli: <email>cavalli.nicolo@gmail.com</email></corresp><fn fn-type="other"><p>Academic Editor: Silvio Taschieri</p></fn></author-notes><pub-date pub-type="ppub"><year>2012</year></pub-date><pub-date pub-type="epub"><day>23</day><month>10</month><year>2012</year></pub-date><volume>2012</volume><elocation-id>180379</elocation-id><history><date date-type="received"><day>26</day><month>6</month><year>2012</year></date><date date-type="rev-recd"><day>5</day><month>9</month><year>2012</year></date><date date-type="accepted"><day>26</day><month>9</month><year>2012</year></date></history><permissions><copyright-statement>Copyright © 2012 Nicolò Cavalli et al.</copyright-statement><copyright-year>2012</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><italic>Purpose</italic>. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. <italic>Materials and Methods</italic>. Thirty-four patients (18 women and 16 men) were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. <italic>Results</italic>. The overall follow-up range was 12 to 73 months (mean 38.8 months). No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients), peri-implantitis (5.9% patients), and temporomandibular joint pain (5.9% patients). The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients) and definitive (17.7% patients) prosthesis and the minor acrylic fractures in the temporary (14.7% patients) and definitive (2.9% patients) prosthesis. Hygienic complications occurred in 38.2% patients. No patients' dissatisfactions were recorded. <italic>Conclusions</italic>. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Pretreatment orthopantomography.</p></caption><graphic xlink:href="IJD2012-180379.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>One year posttreatment orthopantomography.</p></caption><graphic xlink:href="IJD2012-180379.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Frontal view of the definitive prosthesis.</p></caption><graphic xlink:href="IJD2012-180379.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Lateral view of the definitive prosthesis.</p></caption><graphic xlink:href="IJD2012-180379.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Occlusal view of the definitive prosthesis.</p></caption><graphic xlink:href="IJD2012-180379.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Graphical representation of the patient-related complication incidence.</p></caption><graphic xlink:href="IJD2012-180379.006"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Cumulative survival rate.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Interval</th><th align="center" rowspan="1" colspan="1">Number of implants</th><th align="center" rowspan="1" colspan="1">Failed</th><th align="center" rowspan="1" colspan="1">CSR%</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">0–6 mo</td><td align="center" rowspan="1" colspan="1">136</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">6–12 mo</td><td align="center" rowspan="1" colspan="1">136</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">12–18 mo</td><td align="center" rowspan="1" colspan="1">132</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">18–24 mo</td><td align="center" rowspan="1" colspan="1">108</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">24–36 mo</td><td align="center" rowspan="1" colspan="1">108</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">36–48 mo</td><td align="center" rowspan="1" colspan="1">80</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">48–60 mo</td><td align="center" rowspan="1" colspan="1">36</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr><tr><td align="left" rowspan="1" colspan="1">60–72 mo</td><td align="center" rowspan="1" colspan="1">16</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">100</td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Complication incidence over time.</p></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" rowspan="1" colspan="1">Hygienic problems</td><td align="center" rowspan="1" colspan="1">38,24%</td></tr><tr><td align="left" rowspan="1" colspan="1">Al. mucositis</td><td align="center" rowspan="1" colspan="1">11,76%</td></tr><tr><td align="left" rowspan="1" colspan="1">Peri-implantitis</td><td align="center" rowspan="1" colspan="1">5,88%</td></tr><tr><td align="left" rowspan="1" colspan="1">TMJ pain</td><td align="center" rowspan="1" colspan="1">5,88%</td></tr><tr><td align="left" rowspan="1" colspan="1">Detachment/fracture of tooth/teeth in temporary prosthesis</td><td align="center" rowspan="1" colspan="1">20,59%</td></tr><tr><td align="left" rowspan="1" colspan="1">Detachment/fracture of tooth/teeth in definitive prosthesis</td><td align="center" rowspan="1" colspan="1">17,65%</td></tr><tr><td align="left" rowspan="1" colspan="1">Acrylic fracture in temporary prosthesis</td><td align="center" rowspan="1" colspan="1">14,71%</td></tr><tr><td align="left" rowspan="1" colspan="1">Acrylic fracture in definitive prosthesis</td><td align="center" rowspan="1" colspan="1">2,94%</td></tr><tr><td align="left" rowspan="1" colspan="1">Screw loosening</td><td align="center" rowspan="1" colspan="1">2,94%</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list></list><tree><noCountry><name sortKey="Azzola, Francesco" sort="Azzola, Francesco" uniqKey="Azzola F" first="Francesco" last="Azzola">Francesco Azzola</name><name sortKey="Barbaro, Bruno" sort="Barbaro, Bruno" uniqKey="Barbaro B" first="Bruno" last="Barbaro">Bruno Barbaro</name><name sortKey="Cavalli, Nicol" sort="Cavalli, Nicol" uniqKey="Cavalli N" first="Nicol" last="Cavalli">Nicol Cavalli</name><name sortKey="Ciatti, Alberto" sort="Ciatti, Alberto" uniqKey="Ciatti A" first="Alberto" last="Ciatti">Alberto Ciatti</name><name sortKey="Francetti, Luca" sort="Francetti, Luca" uniqKey="Francetti L" first="Luca" last="Francetti">Luca Francetti</name><name sortKey="Spasari, Davide" sort="Spasari, Davide" uniqKey="Spasari D" first="Davide" last="Spasari">Davide Spasari</name></noCountry></tree></affiliations></record>Pour manipuler ce 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