Rehabilitation of atrophic maxilla with tilted implants - Case report

Abstract

Purpose: An 81-year-old male patient, without systemic disorders, came to the appointment referring lack of masticatory function. It was planned a rehabilitation with six implants in upper atrophic maxilla (Implant Direct – Swish Plus), including immediate placing of 4 implants and 2 posterior tilted implants due to the severe pneumatization of maxillary sinus and bone ridge resorption. The prosthetic phase was initiated 4 months after implants surgery. Case report: The placement of tilted implants with the objective of the necessity of bone grafts and increase bone support has been reported by several authors as a viable rehabilitation. And since it is a minimally invasive surgery, it has good acceptance by the patient. The placement of tilted implants is a viable surgical alternative in anatomic regions such as: the anterior or posterior wall of the maxillary sinus, the palatal curvature or the pterygoid process. This treatment option, allied to the use of longer implants, allows an improved primary stability favoring immediate loading. Also, allows the adequate distribution of the implants, resulting in a more uniform distribution of forces and avoids the necessity of cantilever. Some authors have been questioning the biomechanical qualities of this surgical option; however, there are no statistical differences when compared with implants conventionally placed. ​Conclusions: Tilted implants allow an implant-supported rehabilitation of atrophic maxilla without bone grafts, which decreases the waiting period, the patient’s morbidity and the costs of the treatment.