Rehabilitation of Atrophic Maxilla with Tilted Implants - Case Report

Description of the case: A 81-year-old male patient, without systemic disorders, came to the appointment referring lack of masticatory function. It was planned six implants in upper atrophic maxilla (Implant Direct - Swish Plus), with immediate placing of 2 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. Discussion: The placement of tilted implants with the objective of reduce the necessity of bone grafts and increase bone support has been reported by several authors and allows a viable rehabilitation, minimally invasive and with 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 the decrease or elimination of the cantilever. Some authors have been questioning the biomechanical qualities of this surgical option; however there are no statistical differences when compared with implants placed conventionally. Conclusions: Tilted implants allow an implant-supported rehabilitation of atrophic maxilla, decreasing the waiting time, the patient's morbility and the costs of the treatment. Keywords: rehabilitation, atrophic maxillar, tilted implants