All-on-4 Concept Update

Chan, Michael Ho Ming; Nudell, Yoav

doi:10.1016/j.cden.2020.09.014

Cited by 14 publications

(13 citation statements)

References 38 publications

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“…5 Although the success rates reported for this technique are high, 18-20 a very long size of cantilever in these applications may cause various technical complications, especially on prosthetic materials. [21][22][23] Due to such factors, distal-angled implant placement has been studied over recent years to allow more posterior positioning of the implants to benefit from the interforaminal space and reduce the length of the cantilever. 6,21,24 The ALL4 treatment concept was proposed by Malo et al 6 to be used in the fixed prosthetic rehabilitation of completely edentulous jaws.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23] Due to such factors, distal-angled implant placement has been studied over recent years to allow more posterior positioning of the implants to benefit from the interforaminal space and reduce the length of the cantilever. 6,21,24 The ALL4 treatment concept was proposed by Malo et al 6 to be used in the fixed prosthetic rehabilitation of completely edentulous jaws. Following the reports of long-term data published by Malo et al, 24 other authors confirmed the high success rates associated with the use of this protocol.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Four Implant-Supported Fixed Rehabilitation Options of the Edentulous Mandible: A 3D Finite Element Analysis

Küçükkurt

Tükel

2020

Journal of Advanced Oral Research

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Aim: This study aims to compare four implant-supported rehabilitation concepts of an edentulous mandible and determines the most biomechanically advantageous technique. Materials and Methods: Five models with four implants in different configurations were formed: four axial interforaminal implants, All-on-4 concept (two anterior axial and two posterior distally tilted implants), All-on-4v4 concept (four distally tilted interforaminal implants), All-on-4W (two anterior mesially tilted and two posterior distally tilted implants), and two axial interforaminal implants and two posterior extra-short implants. Straumann bone-level (4.1 × 12 mm) and tissue-level (4.1 × 4 mm) extra-short implants were used for this study. Spherical loadings from canine and molar regions were applied to evaluate tension, compression, and von Mises stresses by implementing 3D finite element analysis. Results: Among the alternative concepts, the classic All-on-4 and the All-on-4v4 techniques were the most successful treatment option in biomechanical terms. On the other hand, the use of extra-short implants in the posterior region was found to be the last method of choice. This was because of the high stresses on bones in most conditions, even though it balances the forces from the molar region on the implants. Conclusion: The results of the present study indicate that the classic All-on-4 and the All-on-4v4 techniques were the most successful treatment options in biomechanical terms for the rehabilitation of an edentulous mandible with four implant-supported fixed full-arch prostheses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Four Implant-Supported Fixed Rehabilitation Options of the Edentulous Mandible: A 3D Finite Element Analysis

Küçükkurt

Tükel

2020

Journal of Advanced Oral Research

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“…In the literature, the number of the studies focusing on the prosthesis related complications in All-on-Four concept is limited. Acrylic prosthesis fracture is reported to be the most common complication followed by provisional screw loosening of the multi-abutment screws for the provisional period [ 15 ]. Lopes et al [ 16 ] have stated that, bruxism responsible for a good majority of the fractures of the provisional prostheses.…”

Section: Discussionmentioning

confidence: 99%

“…In their recent review, Chan and Nuddel [ 15 ] have subdivided the studies focusing on assessment of marginal bone loss following All-on-Four concept as short term (< 3 years), medium term (3–7 years), and long term (> 7 years). According to this, marginal bone loss ranges from 0.14 mm ± 0.59 to 1.19 mm ± 0.33, 0.39 mm ± 0.18 to 1.9 mm ± 1.1, and 1.30 mm ± 0.63 SD to 2.30 mm for short term, medium term, and long term, respectively [ 7 , 8 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Six-year clinical outcomes of implant-supported acrylic vs. ceramic superstructures according to the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla

et al. 2021

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The aim of the current study was to document the long-term clinical results of the use of two prosthetic techniques for the rehabilitation of completely edentulous maxillae according to the “All-on-Four” concept: Fixed, screw-retained prosthesis mounted on a chrome-molybdenum framework with (1) metal-ceramic veneers and (2) Acrylic prosthesis with acrylic resin prosthetic teeth. A total of 34 patients were assigned to subgroups according to their own preference of the superstructure type (ceramics [n: 17] or acrylic resin [n: 17]). Prosthetic complications, marginal bone loss, plaque accumulation, bleeding on probing, bite force and oral-health-related quality of life were assessed over a period of 6 years. Marginal bone loss around implants of the ceramic group remained well within the limits for ‘success’, as defined by the 2007 Pisa consensus over the time (1.43 ± 0.35 mm). However, marginal bone loss was significantly more pronounced around the implants in the acrylic group (2.15 ± 0.30) and the difference between two groups was statistically significant (p: 0.00). Bleeding on probing and plaque accumulation showed also positive correlation with marginal bone loss. Both acrylic and ceramic suprastructures appeared to be equivalent after 6 years; however, ceramic suprastructures revealed superior clinical results in terms of bone loss and plaque accumulation. Current study determines the long-term clinical outcomes of different prosthetic management alternatives in All-on-Four and aids to increase dental professionals’ ability to meet the patients’ expectations.

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“…Two implants are inserted anteriorly in an axial orientation, and two implants are installed posteriorly with a 30 o -45 o distal tilt. 8 This concept has gained popularity as a treatment plan for edentulous maxillae and mandibles. The tilting of posterior implants has a number of benefits, including shorter cantilever lengths, better anterior-posterior spread, the ability to utilize longer implants, and a larger base of the prosthesis.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation of the Edentulous Maxilla With All-on-Four Hybrid Prosthesis and Bar-Clip Retained Overdenture in Patients With Mandibular Hybrid Prostheses: Clinical, Radiographic, and Prosthetic Outcomes

Youssef

Maged

2023

Egyptian Dental Journal

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Purpose:The purpose was to compare the clinical, radiographic, and prosthetic results of an All-On-Four maxillary hybrid prosthesis and a bar-clip retained maxillary overdenture after one year of follow-up in patients with mandibular hybrid prostheses. Materials and methods: Twelve participants with completely edentulous maxillae and mandibular hybrid prostheses were selected. Participants were randomly assigned to one of two groups: All-On-Four maxillary hybrid prosthesis group (HP) and bar-clip retained maxillary overdenture (BO) group. In the HP group, the patients received four maxillary implants in accordance with the All-On-Four concept. The implants were functionally loaded with maxillary fixed detachable hybrid prostheses. In the BO group, the patients received four parallel implants supporting bar-clip retained maxillary overdentures. Results: At 12 months, there were significant differences in gingival and plaque indices and probing depth between both groups for anteriorly placed implants. The plaque and gingival indices, and probing depth of the HP group were significantly greater than those of the BO group. For anterior implants, there was no difference in implant stability or marginal bone loss between the two prostheses. Group comparisons at the posteriorly placed implants revealed significant differences in plaque and gingival indices at 12 months. The total number of prosthetic complications required for the BO group was significantly higher than for the HP group. Conclusion: Within the limitations of this study, it was possible to conclude that, in patients with mandibular hybrid prostheses, both All-On-Four hybrid prostheses and bar-clip retained overdentures may be effectively utilized for rehabilitation of the edentulous maxilla using four implants since the clinical, radiological, and prosthetic outcomes were clinically acceptable and manageable. However, bar-clip retained overdentures may produce better clinical outcomes than All-On-Four hybrid prostheses, but they require more prosthetic maintenance.

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All-on-4 Concept Update

Cited by 14 publications

References 38 publications

Comparison of Four Implant-Supported Fixed Rehabilitation Options of the Edentulous Mandible: A 3D Finite Element Analysis

Comparison of Four Implant-Supported Fixed Rehabilitation Options of the Edentulous Mandible: A 3D Finite Element Analysis

Six-year clinical outcomes of implant-supported acrylic vs. ceramic superstructures according to the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla

Rehabilitation of the Edentulous Maxilla With All-on-Four Hybrid Prosthesis and Bar-Clip Retained Overdenture in Patients With Mandibular Hybrid Prostheses: Clinical, Radiographic, and Prosthetic Outcomes

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