Angulated implants: a novel concept for the rehabilitation of severe atrophic maxilla with 3 years follow up supported by Finite Element Analysis

Aim Rehabilitation of maxillary edentulous arches is a challenging task for the Dentists. Angulated implants used for implant placement which utilizes bicortical engagement of implants at the nasal cortex and pterygoid region in a flapless manner. The aim of this study was to evaluate the clinical outcome when 6 tall angulated implants were placed in a maxilla and restored with screw-retained fixed prosthesis after 3 years follow up.  Methods Total of 40 patients were considered for implant placement in the maxilla, 20 patients who underwent implant placement followed by delayed loading and 20 patients who underwent the same surgical procedure followed by immediate loading. Angulated implants were supported by Finite element analysis (FEA) comparing stress distribution on cortical, cancellous and basal bone on mesial and distal side of each implant with All-on-6 concept for maxillary arch.   Results Angulated implant shows 100% survival rate in implants and prosthesis, in both delayed and immediate loading protocols of maxillary rehabilitation. The FEA based on von Misses stress, shows little higher values for All-on-6 for cortical, cancellous and basal bone when compared with Angulated 6 implants design.   Conclusions Angulated implants a novel concept shows a good survival rate. Due to the bicortical engagement of implant the chances of marginal bone resorption around the implant, implant and prosthesis failure is minimal.