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Maxillary sinus elevation and bone augmentation are acceptable techniques that may provide sufficient bone quantity and quality for implant support in the posterior atrophic maxilla (Wallace SS et al. 2003). Yet, given the morbidity risk plus cost and time consuming effects, these techniques are to be reconsidered. Simpler and safer protocols are therefore required for the posterior maxilla where bone resorption, deficient posterior alveolar ridge, and increased pneumatisation of the sinus all result in a minimal hard tissue bed thus render implant placement difficult (Frank R et al. 2005)...

cosmetic With the reduced amounts of bone, the use of long implants would be a difficult option. Although several studies in the literature have shown that short implants have risk factors therefore higher failure rate (Winkler S et al. 2005), the recent studies prove the good long term prognosis of short implants (Tawil G et al. 2006). A review of the results displayed above show a range of success between 92 % and 96 % approximately. Failure rates were minimized by using the short implants due to several variables, including among others, change in implant design, splinting implants together, absence of cantilevers in the prosthesis, and additional methods to decrease stress to the implant interface. According to the same results, it is possible to use short implants to support fixed restorations in the atrophic posterior maxilla (Misch et al. 2006). Implant sizes did not appear to compromise the effectiveness (Romeo E et al. 2006), and the short length was not associated with reduced survival rates (Arlin ML 2006). Researchers using finite elemental analysis (FEA) demonstrated that vertical and horizontal occlusal forces placed on implants were distributed primarily in the crestal bone rather than along the implant/bone interface. The group of Lum concludes that short implants serve as well as longer ones. Short implants show a survival rate exceeding five years and crestal bone level maintenance similar to longer implants. They can be successfully used in maxilla with limited bone length (Venuelo C et al. 2008). Tilted implants The results of applying the technique of using posterior tilted implants are comparable with the more resource demanding techniques applying bone grafting which often necessitates general anesthesia and hospitalization and could often lead to the following implications, including but not limited to, postoperative infection problems with the graft or maxillary sinusitis, host morbidity, lower implant success rates, and higher cost of treatment (Yerit KC et al. 2004). In fact, by tilting the posterior implants in the maxilla, the compromised bone of the sinus antrum could be circumvented with the clinical advantage of avoiding cantilever arms and using fewer implants (Calandriello R et al. 2005). Mattsson et al. were the first to report well functioning fixed prostheses with no symptoms after treatment with the tilted implant technique (Annika R et al 2007). The success rate for the patients included in the study was 97%. Krekmanov et al also demonstrate that biomechanical measurements in tilting implants showed no negative effects on load AD dentistry _ beauty & science One issue free of charge! ¢ *Prices include shipping and VAT Subscribe now! I hereby agree to receive a free trail subscription of cosmetic dentistry (4 issues per year). I would like to subscribe to cosmetic dentistry for € 44* for German customers, € 46* for customers outside Germany, unless a written cancellation is sent within 14 days of the receipt of the trial subscription. The subscription will be renewed automatically every year until a written cancellation is sent to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. Reply per Fax +49-(0) 3 41/4 84 74-2 90 to OEMUS MEDIA AG or per E-mail to grasse@oemus-media.de Last Name, First Name IM 1/10 Company Street ZIP/City/Country E-mail Signature Notice of revocation: I am able to revoke the subscription within 14 days after my order by sending a written cancellation to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany. Signature OEMUS MEDIA AG Holbeinstraße 29, 04229 Leipzig, Germany Tel.: +49-(0) 3 41/4 84 74-0, Fax: +49-(0) 3 41/4 84 74-2 90, E-Mail: grasse@oemus-media.de