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

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 nobel speedy 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.