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

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


Purpose: 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.

Materials and methods: 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.

Results: 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.

Conclusions: 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.

Keywords: dental implants; edentulous maxilla; immediate loading; tilted implant.

MeSH terms

  • Adult
  • Aged
  • Dental Implants*
  • Female
  • Humans
  • Immediate Dental Implant Loading*
  • Jaw, Edentulous / diagnostic imaging
  • Jaw, Edentulous / rehabilitation
  • Jaw, Edentulous / surgery*
  • Male
  • Maxilla / surgery*
  • Middle Aged
  • Prospective Studies
  • Radiography, Panoramic


  • Dental Implants