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Evaluation of immediately loaded mandibular four vertical versus tilted posterior implants supporting fixed detachable restorations without versus with posterior cantilevers

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Abstract

Background

Distally inclining posterior implants may be technically challenging in certain situations. The presence of a posterior cantilever can also exert unfavorable forces on supporting implants. The aim of the present study was to evaluate and compare peri-implant soft and hard tissues around 4 mandibular interforaminal implants having tilted posterior implants with posterior cantilevers, versus vertical implants, 2 in the interforaminal region and 2 in the first molar regions, without posterior cantilevers. All implants supported full-arch fixed detachable restorations opposing complete dentures.

Material and methods

A total of 80 implants were placed flapless in the mandibles of 20 edentulous participants. Four implants were placed for every participant, who were randomly assigned into 2 equal groups. Axial group implants were vertically aligned, with 2 implants in the interforaminal area and 2 in the molar area. Tilted group implants have 2 anterior axial and 2 posterior distally inclined implants. Interim screw-retained prostheses converted from pre-existing dentures were immediately fabricated and loaded on the same day of surgery. After awaiting period of 3 months, all participants received fixed detachable metal acrylic resin definitive restorations. A follow-up protocol of 3, 6, and 12 months was scheduled to assess the modified gingival index, modified plaque index, peri-implant probing depth, implant stability, and marginal bone level and bone density changes.

Results

No statistically significant differences (P > .05) were found in the modified gingival index, modified plaque index, peri-implant probing depth, implant stability, bone density, and marginal bone level between the axial and tilted implant groups after the 1-year follow-up period.

Conclusion

Placing 4 flapless immediately loaded implants in mandibular edentulous patients that supported full-arch fixed restorations provided high implant and prosthodontic success rates whether posterior implants were tilted with posterior cantilevers or vertically aligned without posterior cantilevers.

Trial registration: Pan African Clinical Trial Registry database, PACTR201907776166846. Registered 3 July 2019, www.pactr.org.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CBCT:

Cone-beam computed tomography

RFA:

Resonance frequency analysis

ISQ:

Implant stability quotient

MPI:

Modified plaque index

MGI:

Modified gingival index

PD:

Peri-implant probing depth

HU:

Hounsfield unit

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Funding

This research was self-funded by the authors.

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Authors and Affiliations

  1. Prosthodontic Department, Faculty of Dentistry, South Valley University, Qena, Egypt

    Latifa Abdallah Mohamed

  2. Prosthodontic Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

    Mohamed Moataz Khamis & Ahlam Mostafa El-Sharkawy

  3. Oral Medicine and Periodontology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

    Rania Abdelaziz Fahmy

Authors
  1. Latifa Abdallah Mohamed
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  2. Mohamed Moataz Khamis
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  3. Ahlam Mostafa El-Sharkawy
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  4. Rania Abdelaziz Fahmy
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Contributions

Latifa Abdallah Mohamed: conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, writing—original draft, writing—review and editing, project administration, funding acquisition.

Mohamed Moataz Khamis: conceptualization, methodology, validation, formal analysis, investigation, data curation, writing—review and editing, visualization, supervision.

Ahlam Moustafa El-Sharkawy: conceptualization, methodology, validation, formal analysis, investigation, data curation, supervision.

Rania Abdelaziz Fahmy: methodology, validation, formal analysis, investigation, data curation, supervision.

Corresponding author

Correspondence to Mohamed Moataz Khamis.

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Mohamed, L.A., Khamis, M.M., El-Sharkawy, A.M. et al. Evaluation of immediately loaded mandibular four vertical versus tilted posterior implants supporting fixed detachable restorations without versus with posterior cantilevers. Oral Maxillofac Surg 26, 373–381 (2022). https://doi.org/10.1007/s10006-021-00993-5

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  • DOI: https://doi.org/10.1007/s10006-021-00993-5

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