Tilted Versus Nontilted Implants in an Edentulous Maxilla

Dental implants have been used extensively for the rehabilitation of completely and partially edentulous patients. Edentulous patients rehabilitated with fixed prostheses supported by osseointegrated implants have shown improved masticatory function,increased bite force, security and self esteem as compared to patients rehabilitated with overdentures. The behavior of bone in the peri- implant region is closely related to the direction, magnitude and concentration of stresses transmitted to the implant.The angulation of the implants is one of the most important factors in management of the stress around the implants. Large moments may develop from vertical axis force component in prosthetic environment designed with cantilever extension or offset load from rigidly fixed implants. As a consequence, bilateral cantilevers are often necessary to provide the patient with a good chewing capacity.The application of occlusal forces induces stresses and strains within the implant prostheses complex and affects bone remodeling around implants. Excessive stress levels at the bone implant interface may lead to marginal bone loss thus affecting implant survival.