Tilted Placement of Tapered Implants Using a Modified Surgical Template

PurposeTo avoid complex procedures such as bone grafts in the atrophied edentulous sites, tilted placement of tapered implants using a modified surgical template was evaluated.Materials and MethodsFifteen patients (13 women, 2 men) were treated with 24 fixed implant-supported prostheses. Patients' ages ranged from 31 to 77 yrs (average, 53 yrs). Implant sites, lengths, and angulations were determined by 3-dimensional computed tomographic data. We used tapered implants (Nobel Biocare, Göteborg, Sweden) and modified conventional template and surgical techniques. Implant lengths were 10 mm (48 implants) and 13 mm (17); diameters were 3.5 mm (6 implants), 4.3 mm (33), and 5 mm (26), respectively. Seventeen implants (26.1%) were axially directed, and 48 implants (73.8%) were tilted. Follow-up periods after prosthetic rehabilitation ranged from 24 to 46 months (average, 31.5 months).ResultsClinical results were evaluated through clinical observation and survival data. Of the 65 inserted implants, 2 implants (3.1%) in maxillary molar sites failed due to nonosseointegration before prosthetic rehabilitations. One of the 2 implants was successfully reinserted. The other was not treatable by our method because of insufficient alveolar bone. However, the latter case without reimplantation was rehabilitated by 4 residual implants. The success rate of 24 prostheses was 100%.ConclusionIn the atrophied edentulous sites, tilted placement of tapered implants using our method proves to be a valuable procedure without more complex procedures such as bone grafts. However, the prosthetic procedures are a little complicated.