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Fig. 7. Vestibular view of the final restoration :...

Fig. 7. Vestibular view of the final restoration Fig. 7. Vestibular view of the final restoration

Fig. 6. Occlusal view of the final restoration. In...

Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective

Fig. 5. One-year post-surgery panoramic radiograph...

Fig. 5. One-year post-surgery panoramic radiograph with final restoration Fig. 5. One-year post-surgery panoramic radiograph with final restoration

Fig. 4. Occlusal view of implant-abutments 3 mont...

Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration

Fig. 3. Fill-in of the occlusal perforations with ...

Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders

Fig. 2. Preparation of the composite veneers for m...

Fig. 2. Preparation of the composite veneers for making the temporary restoration Fig. 2. Preparation of the composite veneers for making the temporary restoration

Fig. 1. Preparation of implant cavity through corr...

Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth

Table 5 Marginal bone loss measured in mm : Six-im...

Collective Mesial Distal 1 year 55 months (40–84) 1 year ...

Table 4 Mean implant stability quotients (ISQ) of ...

Collective ISQ P At insertion 3 months Total (n = 57) 61.3 ± 7.8 ...

Table 3 Mean Periotest values (PT) of survived axi...

Collective PT value P At insertion 3 months Total (n = 57) −1.8 ± 2.4 ...

Table 2 Life table of implants : Six-implant-suppo...

Period # of implants # of failures Survival rate (%) Cumulative survival rate (%) 0 t...

Rights and permissions : Six-implant-supported imm...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Ethics declarations : Six-implant-supported immedi...

The retrospective data analysis was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2008, and all patients signed an informed consent. After consulting the local ethic committee, the decision was that due to the retrospective character of this study, with no additional data acquisition, no ethical approval is needed according to the hospital laws of the appropriate sta...

Author information : Six-implant-supported immedia...

Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany S. Wentaschek & S. Hartmann Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany C. Walter & W. Wagner You can also search for ...

Acknowledgements : Six-implant-supported immediate...

The authors would like to thank Bredent Medical (Senden, Germany) for providing the 3D-planning system and supporting the treatment nonfinancially.

References : Six-implant-supported immediate fixed...

Download references

References : Six-implant-supported immediate fixed...

Bayer G, Kistler F, Kistler S, Adler S, Neugebauer J. Sofortversorgung mit reduzierter Implantatanzahl: Wissenschaftliche Konzeption und klinische Ergebnisse. Berlin: Quintessenz; 2011. Hanley JA. Receiver operating characteristic (ROC) methodology: the state of the art. Crit Rev Diagn Imaging. 1989;29(3):307–35. Atieh MA, Alsabeeha NH, Payne AG, de Silva RK, Schwass DS, Duncan WJ. The prognos...

References : Six-implant-supported immediate fixed...

Pommer B, Mailath-Pokorny G, Haas R, Busenlechner D, Furhauser R, Watzek G. Patients’ preferences towards minimally invasive treatment alternatives for implant rehabilitation of edentulous jaws. Eur J Oral Implantol. 2014;7(Suppl 2):S91–109. Monje A, Suarez F, Galindo-Moreno P, Garcia-Nogales A, Fu JH, Wang HL. A systematic review on marginal bone loss around short dental implants (

Abbreviations : Six-implant-supported immediate fi...

Area under the curve Implant stability quotient Periotest Receiver operating characteristic

Conclusions : Six-implant-supported immediate fixe...

Within the limits of this small group (n = 10 patients/60 implants), the failure rate of the analyzed implant system (n = 3 respective 5% implant loss) seems to be comparable with other immediate-loading protocols. On the other side, the implant loss rate of tilted implants (n = 2 of 20) in the atrophic upper jaw was quite high, but still, the aimed treatment concept could be achieved in eve...

Discussion : Six-implant-supported immediate fixed...

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 pre...

Discussion : Six-implant-supported immediate fixed...

The overall implant survival rate of 95% is slightly lower than the reported mean survival rates of the concept of tilted implants and immediate loading in edentulous jaws [11] but still close to them and maybe more comparable to investigations in which implants were also immediately loaded in the edentulous maxilla which were partly placed in fresh extraction sites [15, 16]. Nevertheless, what is...

Results : Six-implant-supported immediate fixed re...

After the temporary restoration with a fixed prosthesis, all 10 patients selected a fixed final restoration. These consisted of a cast metal framework with a full ceramic veneering including the replacement of at least the second premolars. They were made after a new impression on the abutment level (Figs. 6 and 7). The neck of the 20 tilted distal implants was positioned in region 4 (n = 5 impl...

Results : Six-implant-supported immediate fixed re...

Ten patients with a mean age at implant insertion of 64 ± 11.3 years (range 38 to 81 years; six women, four men) were included. Sixty titanium screw implants (Table 1) were inserted and immediately loaded between 09/2009 and 01/2013. Seven patients had remaining teeth until implant surgery (two patients with 4, four patients with 7, and one patient with 12 teeth). Twenty-one (35%) of the 60 ...

Methods : Six-implant-supported immediate fixed re...

Changes in marginal bone level were measured using the routinely made digital panoramic radiographs if these were available. The measurement tool was calibrated with the known respective implant length. To evaluate the bone loss, the difference was formed between the bone level at follow-up examination (Fig. 5) and at implant placement which is the baseline. An implant was considered as successfu...

Methods : Six-implant-supported immediate fixed re...

The patients were screened with preliminary panoramic radiographs, and since all the implants were 3D planned (SKYplanX™ program, Bredent GmbH, Senden, Germany) and inserted with a guiding template, a cone-beam CT (CBCT) was obtained eventually (KaVo 3D eXam™ unit, KaVo Dental GmbH, Biberach/Riss, Germany). The drillings were performed using a 3D-planned surgical template with different metal...

Methods : Six-implant-supported immediate fixed re...

In a retrospective study, all patients with immediately loaded implants in an edentulous maxillae with limited posterior ridge dimensions that received an equal concept were included if they had a follow-up of at least 3 years. The concept contained immediate loading with distal tilted implants and six implants per edentulous maxillae of a single implant system (blueSky™ implants, Bredent GmbH,...

Background : Six-implant-supported immediate fixed...

For a few years, there has been a trend towards minimally invasive implant treatment concepts avoiding bone augmentation even in very atrophic edentulous jaws. These concepts aim to make an implant treatment with a shorter duration, with less inconvenience such as swelling or pain and possibly also economically more attractive [1]. If the implant treatment is less invasive, because of the possible...

Abstract : Six-implant-supported immediate fixed r...

The aim of this retrospective study was to evaluate the treatment outcome of six Bredent blueSky™ implants (Bredent GmbH, Senden, Germany) immediately loaded with a fixed full-arch prosthesis (two tilted posterior and four axial frontal and premolar implants). All 10 patients with atrophic edentulous maxillae being treated with a standardized procedure from 09/2009 to 01/2013, who had a follow-...

Fig. 7. Vestibular view of the final restoration :...

Fig. 7. Vestibular view of the final restoration Fig. 7. Vestibular view of the final restoration

Fig. 6. Occlusal view of the final restoration. In...

Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective

Fig. 5. One-year post-surgery panoramic radiograph...

Fig. 5. One-year post-surgery panoramic radiograph with final restoration Fig. 5. One-year post-surgery panoramic radiograph with final restoration

Fig. 4. Occlusal view of implant-abutments 3 mont...

Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration

Fig. 3. Fill-in of the occlusal perforations with ...

Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders

Fig. 2. Preparation of the composite veneers for m...

Fig. 2. Preparation of the composite veneers for making the temporary restoration Fig. 2. Preparation of the composite veneers for making the temporary restoration

Fig. 1. Preparation of implant cavity through corr...

Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth

Table 5 Marginal bone loss measured in mm : Six-im...

Collective Mesial Distal 1 year 55 months (40–84) 1 year ...

Table 4 Mean implant stability quotients (ISQ) of ...

Collective ISQ P At insertion 3 months Total (n = 57) 61.3 ± 7.8 ...

Table 3 Mean Periotest values (PT) of survived axi...

Collective PT value P At insertion 3 months Total (n = 57) −1.8 ± 2.4 ...

Table 2 Life table of implants : Six-implant-suppo...

Period # of implants # of failures Survival rate (%) Cumulative survival rate (%) 0 t...

Table 1 Diameters and lengths of immediately loade...

  Diameter Length 10 mm 12 mm 14 mm 16 mm Axial ...

About this article : Six-implant-supported immedia...

Wentaschek, S., Hartmann, S., Walter, C. et al. Six-implant-supported immediate fixed rehabilitation of atrophic edentulous maxillae with tilted distal implants. Int J Implant Dent 3, 35 (2017). https://doi.org/10.1186/s40729-017-0096-0 Download citation Received: 14 March 2017 Accepted: 13 July 2017 Published: 25 July 2017 DOI: https://doi.org/10.1186/s40729-017-0096-0

Rights and permissions : Six-implant-supported imm...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Ethics declarations : Six-implant-supported immedi...

The retrospective data analysis was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2008, and all patients signed an informed consent. After consulting the local ethic committee, the decision was that due to the retrospective character of this study, with no additional data acquisition, no ethical approval is needed according to the hospital laws of the appropriate sta...

Author information : Six-implant-supported immedia...

Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany S. Wentaschek & S. Hartmann Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany C. Walter & W. Wagner You can also search for ...

Acknowledgements : Six-implant-supported immediate...

The authors would like to thank Bredent Medical (Senden, Germany) for providing the 3D-planning system and supporting the treatment nonfinancially.

References : Six-implant-supported immediate fixed...

Download references

References : Six-implant-supported immediate fixed...

Bayer G, Kistler F, Kistler S, Adler S, Neugebauer J. Sofortversorgung mit reduzierter Implantatanzahl: Wissenschaftliche Konzeption und klinische Ergebnisse. Berlin: Quintessenz; 2011. Hanley JA. Receiver operating characteristic (ROC) methodology: the state of the art. Crit Rev Diagn Imaging. 1989;29(3):307–35. Atieh MA, Alsabeeha NH, Payne AG, de Silva RK, Schwass DS, Duncan WJ. The prognos...

References : Six-implant-supported immediate fixed...

Pommer B, Mailath-Pokorny G, Haas R, Busenlechner D, Furhauser R, Watzek G. Patients’ preferences towards minimally invasive treatment alternatives for implant rehabilitation of edentulous jaws. Eur J Oral Implantol. 2014;7(Suppl 2):S91–109. Monje A, Suarez F, Galindo-Moreno P, Garcia-Nogales A, Fu JH, Wang HL. A systematic review on marginal bone loss around short dental implants (

Abbreviations : Six-implant-supported immediate fi...

Area under the curve Implant stability quotient Periotest Receiver operating characteristic

Conclusions : Six-implant-supported immediate fixe...

Within the limits of this small group (n = 10 patients/60 implants), the failure rate of the analyzed implant system (n = 3 respective 5% implant loss) seems to be comparable with other immediate-loading protocols. On the other side, the implant loss rate of tilted implants (n = 2 of 20) in the atrophic upper jaw was quite high, but still, the aimed treatment concept could be achieved in eve...

Discussion : Six-implant-supported immediate fixed...

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 pre...

Discussion : Six-implant-supported immediate fixed...

The overall implant survival rate of 95% is slightly lower than the reported mean survival rates of the concept of tilted implants and immediate loading in edentulous jaws [11] but still close to them and maybe more comparable to investigations in which implants were also immediately loaded in the edentulous maxilla which were partly placed in fresh extraction sites [15, 16]. Nevertheless, what is...

Results : Six-implant-supported immediate fixed re...

After the temporary restoration with a fixed prosthesis, all 10 patients selected a fixed final restoration. These consisted of a cast metal framework with a full ceramic veneering including the replacement of at least the second premolars. They were made after a new impression on the abutment level (Figs. 6 and 7). The neck of the 20 tilted distal implants was positioned in region 4 (n = 5 impl...

Results : Six-implant-supported immediate fixed re...

Ten patients with a mean age at implant insertion of 64 ± 11.3 years (range 38 to 81 years; six women, four men) were included. Sixty titanium screw implants (Table 1) were inserted and immediately loaded between 09/2009 and 01/2013. Seven patients had remaining teeth until implant surgery (two patients with 4, four patients with 7, and one patient with 12 teeth). Twenty-one (35%) of the 60 ...

Methods : Six-implant-supported immediate fixed re...

Changes in marginal bone level were measured using the routinely made digital panoramic radiographs if these were available. The measurement tool was calibrated with the known respective implant length. To evaluate the bone loss, the difference was formed between the bone level at follow-up examination (Fig. 5) and at implant placement which is the baseline. An implant was considered as successfu...

Methods : Six-implant-supported immediate fixed re...

The patients were screened with preliminary panoramic radiographs, and since all the implants were 3D planned (SKYplanX™ program, Bredent GmbH, Senden, Germany) and inserted with a guiding template, a cone-beam CT (CBCT) was obtained eventually (KaVo 3D eXam™ unit, KaVo Dental GmbH, Biberach/Riss, Germany). The drillings were performed using a 3D-planned surgical template with different metal...

Methods : Six-implant-supported immediate fixed re...

In a retrospective study, all patients with immediately loaded implants in an edentulous maxillae with limited posterior ridge dimensions that received an equal concept were included if they had a follow-up of at least 3 years. The concept contained immediate loading with distal tilted implants and six implants per edentulous maxillae of a single implant system (blueSky™ implants, Bredent GmbH,...

Background : Six-implant-supported immediate fixed...

For a few years, there has been a trend towards minimally invasive implant treatment concepts avoiding bone augmentation even in very atrophic edentulous jaws. These concepts aim to make an implant treatment with a shorter duration, with less inconvenience such as swelling or pain and possibly also economically more attractive [1]. If the implant treatment is less invasive, because of the possible...

Abstract : Six-implant-supported immediate fixed r...

The aim of this retrospective study was to evaluate the treatment outcome of six Bredent blueSky™ implants (Bredent GmbH, Senden, Germany) immediately loaded with a fixed full-arch prosthesis (two tilted posterior and four axial frontal and premolar implants). All 10 patients with atrophic edentulous maxillae being treated with a standardized procedure from 09/2009 to 01/2013, who had a follow-...