Consensus

Clinical Performance of Intentionally Tilted Implants Versus Axially Positioned Implants

Consensus Statements

Consensus Statement 1: There is no statistically significant difference in primary or secondary outcomes for implants placed in axial or tilted configuration to support full-arch FDPs

There is no statistically significant difference in primary outcomes (survival rates for implant and prosthesis) or secondary outcomes (peri-implant marginal bone loss, soft and hard tissue complications, prosthetic complications and patient- centred outcomes) for implants placed in an axial or in a tilted configuration when used to support full-arch FDPs. This statement is based on 20 studies (2 RCTs, 1 CT and 17 Prospective Cohort).

Consensus Statement 2: Common complications associated with an interim full-arch fixed acrylic resin prosthesis were prosthesis fracture, screw loosening and fracture of the veneering material

The most common complications associated with an interim full-arch fixed acrylic resin prosthesis were prosthesis fracture, screw loosening and fracture of the veneering material. This statement is based on 20 studies (2 RCTs, 1 CT and 17 Prospective Cohort).

Consensus Statement 3: Metal framework fracture was uncommon for definitive prostheses

For definitive prostheses, metal framework fracture was uncommon. More commonly encountered complications included wear or fracture of the veneering material or artificial teeth, need for re-adaptation of prostheses to tissue to compensate for continuing resorption, abutment or prosthetic screw loosening, prosthetic screw fracture and loss of screw access restoration. This statement is based on 21 studies (2 RCTs, 1 CT and 18 Prospective Cohort).

Consensus Statement 4: Studies report satisfactory patient-reported aesthetics, phonetics and functional efficiency outcomes

The studies report satisfactory patient-reported outcomes measures. These include aesthetics, phonetics, ease of maintenance and functional efficiency. This statement is based on nine studies (1 RCT, 8 Prospective Cohort).

Clinical Recommendations

1) Anterior posterior implant distribution should be maximized for full-arch FDPs

The anterior posterior implant distribution should be maximized for full-arch FDPs. When conditions allow implants should be positioned axially. If anatomic limitations or prosthetic indications exist, the posterior implants can be intentionally tilted.

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