The outcome of tilted distal implants immediately loaded under screw-retained cross-arch prostheses. A 5-year retrospective cohort study

Aim The aim of this retrospective cohort study was to evaluate the clinical outcome of tilted distal implants immediately loaded with metal-resin screw-retained cross-arch fixed prostheses 5 years after loading.
Material and Methods One-hundred-seventy-six consecutive patients received four to six implants to be placed with a torque superior 35 Ncm. Two-hundred-nineteen metal-resin screwretained fixed prostheses (120 mandibular and 98 maxillary) were to be delivered within 3 days. Implant failures and biological complications were evaluated by the treating clinician.
Results A total of 922 implants were placed, 407 of which were tilted distal implants. Two patients dropped-out (died). Five years after loading all patients were wearing fixed prostheses. Ten tilted distal implants failed in 9 (5.17%) patients versus six non-distal implants in five patients (2.87%). Fifty-one biological complications occurred at tilted distal implants in 42 patients (24.14%) versus 37 complications occurred at non-distal implants in 24 patients (13.79%).
Conclusions In conclusion, tilted distal implants have a double chance of failing or having biological complications when compared to mesial implants.