Immediate Maxillary Full‐Arch Rehabilitation of Periodontal Patients with Terminal Dentition Using Tilted Implants and Bone Augmentation: A 5‐Year Retrospective Cohort Study

Background: All‐on‐four protocols with tilted implants in the maxilla are used to rehabil-itate the terminal dentition of the severe generalized periodontitis patients. Data on long‐term biological complications are scarce. Methods: Eighty‐four axial and forty‐six tilted immediate implants have been placed in the extraction sockets of 23 patients according to a four–six implants protocol combined with ridge augmentation. Within 72 h, a provisional prosthesis was cemented to the im-plants; after 6 months, a cemented ceramic–metallic prosthesis was delivered. The patients were fol-lowed for up to 5 years. Results: The 5‐year survival rate of the straight and tilted implants was 100% and 97.8, and the prosthetic one was 100%. Marginal bone loss (MBL) of the straight implants was 0.42 ± 0.67 and 0.59 ±1.01 mm on the mesial and distal sides; for the tilted, it was 0.37 ± 0.68 and 0.34 ±0.62 mm, and the differences were not statistically significant. Implant position, smoking, ke-ratinized mucosal width, and cantilever did not affect MBL. Peri‐implant mucositis involved 29.4% and 22.2% of the straight and tilted implants, respectively; peri‐implantitis involved 5.8% and 4.4% of the straight and tilted implants, respectively, without statistical significance. Conclusions: This immediate loading protocol’s 5‐year survival and success rates were high. No difference between the straight and tilted implants was found regarding survival, success rates, and MBL.