Between baseline and first removal of the temporary restoration after 3 months, the mean ISQ increased and the mean PT value decreased significantly in the axial and tilted implants. This is in contrast to some other studies which evaluated no significant differences of stability parameters between primary and secondary stability with immediate loading in edentulous maxilla [16, 21, 22].

The present study shows that immediate splinted loading on six implants with tilted distal implants is a potential predictable treatment modality for edentulous maxilla even if extraction of remaining teeth and simultaneous implant placement is performed or if very limited bone is available in very atrophic jaws. Immediate implant placement and fractures of provisional prostheses seem to increase the risk of implant failure.

Immediate loading in edentulous maxilla with tilted implants could have a higher risk of initial implant failure, but treatment is less time consuming, less invasive, and in case of immediate implantation may be more comfortable and enhance or restore life quality. If a patient is informed in detail, this protocol seems to have an adequate success probability and treatment of choice for specific situations and patient’s need.