Citation Information :
Mahoorkar SS, Adesh VS, George M. Rehabilitation of Edentulous Arches with Fixed Prosthesis Supported by Tilted Implants: A Systematic Review. Int J Prosthodont Restor Dent 2021; 11 (1):33-53.
Aim and objective: The aim of this systematic review was to seek evidence and to find the favorable and unfavorable factors for the use of a minimum number of implants in complete arch rehabilitation.
Materials and methods: A search of electronic database limited to English language articles was conducted using the following MeSH terms; “dental implant”, “tilted implant”, “axial implant”, “edentulous patient”, “edentulous maxilla”, and “edentulous mandible”, “implant supported dental prosthesis”, “immediate loading and immediate placement”. They were used alone or in combination. Thirty-three articles were selected for the final review which were all clinical studies with human participants and had a follow-up period of 1 year or more. In all the studies included in this review, a minimum of four implants were placed in each arch and one implant placed in each arch was angulated.
Results: Of the 33 articles analyzed, 21 (63.63%) articles reported failure of implants. A total of 161 (1.56%) implants failed out of the 10,300 implants placed. In the 161 failed implants, 63 (39.13%) were axially placed implants and 63 (39.13%) were implants place at an angulation. The orientation of 60 (37.27%) implants was not mentioned.
Conclusion: The survival rate of tilted implants at the implant and prosthetic levels is good. Tilted implants provide greater surface area for osseointegration, provide greater primary stability, reduce cantilever length, reduce bone resorption, and also reduce the need for bone grafting. The angulation of the implant which provided the most success was found to be 30°.
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