[Tilted implants treatment without maxillary sinus grafting in severely resorbed posterior maxilla]

To evaluate the surgical outcome of tilted implants as an alternative to sinus grafting and the prosthodontic outcome of the bridges on tilted implants in severely resorbed posterior maxilla.

A total of twenty-one patients were rehabilitated with 27 fixed prostheses supported by 78 Branemark and ITI System implants between January 2005 and December 2007. Forty-four implants were placed in an axial and 34 in a tilted direction. In these patients, the maxillary bone volumes were insufficient for conventional placement of implants to support a fixed prosthesis. After an average healing period of 3 months, all implants were functionally loaded with cemented bridges or screw retained bridges. Each patient was recalled at 12th, 24th and 36th month for clinical and radiographic examinations. SPSS11.0 software package was used for statistical analysis.

One of the 44 axial implants was lost 2 months postoperatively. After 3 years, the implant survival rate was 100% for the tilted implants and 97.72% for the axial implants, and the prosthesis survival rate was 100%. The peri-implant soft tissues were stable over time; the mean probing depths and mean attachment levels did not change during the follow-up period.

This study demonstrates that patients with a severely resorbed maxilla can be treated successfully with tilted implant treatment; the use of tilted implants is an effective and safe alternative to maxillary sinus floor augmentation procedure.