Clinical investigation on tilted implant placement in the maxilla using dynamic navigation

doi:10.19438/j.cjoms.2025.06.010

Abstract

Abstract: PURPOSE: To evaluate the accuracy and clinical outcomes of dynamic navigation for the placement of intentionally tilted implants in the posterior maxilla. METHODS: Twenty-eight patients with maxillary edentulism or continuous multiple posterior maxillary tooth loss who were treated in Affiliated Jiangning Hospital of Nanjing Medical University from February 2023 to June 2024 were selected. All patients were treated with axial and tilted implants under dynamic navigation guidance. Implant three-dimensional deviation was calculated after surgery, and survival rate of axial and tilted implants was compared. Follow up visits were performed every 3 months after rehabilitation with definitive prosthesis, and any complication was noted and the stability of the implants and prosthesis as well as proper occlusion were checked. RESULTS: A total of 97 implants were implanted, including 42 tilted implants and 55 axial implants. The accuracy measurement showed that the neck deviations of the inclined implant and the axial implant were (1.03±0.39) and (1.12±0.25) mm, respectively, the tip deviations were (1.21±0.23) and (1.29±0.32) mm, respectively, and the depth deviations were (0.63±0.20) and (0.54±0.34) mm, respectively, the angular deviations were 2.46°±0.68° and 2.22°±0.57°, respectively. There was no significant difference in the various indicators of implant accuracy between the two groups(P>0.05). No complications such as maxillary sinus injury occurred during operation. One tilted implant and one axial implant failed to fall off before restoration. The implant failure rates were 2.38% and 1.82%, respectively, and the difference was not significant(P=0.885). The patients were followed up for 3 to 12 months. The stability of the implants and restorations was good, the masticatory function recovered well, and no maxillary sinusitis occurred. CONCLUSIONS: Tilted implantation in the maxillary posterior region under the guidance of dynamic navigation has the advantages of high accuracy, good safety, minimal trauma and short treatment cycle. It is an effective method for the treatment of alveolar bone atrophy in the maxillary posterior region.

Key words: Dental implants, Tilted implants, Maxillary atrophy, Dynamic navigation, Accuracy

CLC Number:

R783

Zheng Yue, Zhang Senlin. Clinical investigation on tilted implant placement in the maxilla using dynamic navigation[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(6): 600-607.

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