{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:06:14Z","timestamp":1789841174079,"version":"4.0.1"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Oral Implants Res"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to determine whether distally angulating an implant is a successful strategy to avoid the maxillary sinus and the need for bone augmentation, while increasing the anterior\u2010posterior (A\u2010P) implant distribution in the edentulous maxilla.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In 115 patients with edentulous maxillae, virtual implant planning was performed utilizing cone\u2010beam computer tomographs. Axial (8\u00a0mm length) and tilted (12\u00a0mm length) dental implants with 30\u2010degree and 45\u2010degree angulation were virtually positioned to avoid entering the maxillary sinus, while maximizing A\u2010P distribution. Measurements were made between the tilted and axial implants to assess the change in A\u2010P distribution of implants at the implant and abutment levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010seven sites (20.4%) were not able to have either treatment modality with insufficient bone for implant placement. Axial implants were placed more distally than 45\u2010degree and 30\u2010degree tilted implants in 24% and 42% of sites, respectively. The average change in A\u2010P spread measured at the implant level, for 30\u2010 and 45\u2010degree tilted implants was \u22120.25\u00a0mm (95% CI \u22120.76, 0.26) and 1.9\u00a0mm (95% CI 1.4, 2.3), respectively. When measured from the center of each multi\u2010unit abutment the average increase in A\u2010P distances for tilted implants appears larger in the 30\u2010degree and 45\u2010degree groups by 0.97\u00a0mm and 1.74\u00a0mm, respectively compared to measurements at the implant level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Angulating 12\u00a0mm implants provides a limited increase in A\u2010P distribution of implants in edentulous rehabilitation in most situations. In certain patients, the use of 8mm axial implants may provide a greater A\u2010P spread.<\/jats:p><\/jats:sec>","DOI":"10.1111\/clr.13836","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T11:44:28Z","timestamp":1629719068000},"page":"1357-1365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Tilted versus axial implant distribution in the posterior edentulous maxilla: A CBCT analysis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1523-1904","authenticated-orcid":false,"given":"Adam","family":"Hamilton","sequence":"first","affiliation":[{"name":"Division of Regenerative and Implant Sciences Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston Massachusetts USA"},{"name":"Division of Oral Restorative and Rehabilitative Sciences University of Western Australia Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5416-8322","authenticated-orcid":false,"given":"Faris Z.","family":"Jamjoom","sequence":"additional","affiliation":[{"name":"Division of Regenerative and Implant Sciences Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston Massachusetts USA"},{"name":"Department of Restorative and Prosthetic Dental Sciences College of Dentistry King Saud bin Abdulaziz University for Health Sciences Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhsen","family":"Alnasser","sequence":"additional","affiliation":[{"name":"Division of Regenerative and Implant Sciences Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline R.","family":"Starr","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine Brigham and Women's Hospital Boston Massachusetts USA"},{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Friedland","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6386-594X","authenticated-orcid":false,"given":"German O.","family":"Gallucci","sequence":"additional","affiliation":[{"name":"Chair of the Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"issue":"7","key":"e_1_2_10_2_1","first-page":"384","article-title":"Immediate loading: Are implant surface and thread design more important than osteotomy preparation?","volume":"41","author":"Abboud M.","year":"2020","journal-title":"Compendium of Continuing Education in Dentistry"},{"issue":"1","key":"e_1_2_10_3_1","first-page":"89","article-title":"Influence of implant length, diameter, and geometry on stress distribution: A finite element analysis","volume":"30","author":"Anitua E.","year":"2010","journal-title":"The International Journal of Periodontics & Restorative Dentistry"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12038"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13279"},{"issue":"6","key":"e_1_2_10_6_1","first-page":"1323","article-title":"Survival of short dental implants for treatment of posterior partial edentulism: a systematic review","volume":"27","author":"Atieh M. 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