“All‐on‐Four” Immediate Function Concept and Clinical Report of Treatment of an Edentulous Mandible with a Fixed Complete Denture and Milled Titanium Framework

Abstract

The "All-on-Four" concept-tilting the distal implants in the edentulous arches improves the prosthetic support-increases the inter-implant distance and provides better implant anchorage in the bone by using longer implants. Computer milling of a solid block of titanium also provides frameworks with improved fit and fewer technical challenges than conventional cast or noncast approaches. This clinical report describes a method of restoring an edentulous mandible with the "All-on-Four" immediate function concept and a milled titanium framework. The patient in our clinical report has reported for follow-up visits for 1 year and is satisfied with the outcome of the treatment. No discernable clinical and radiographic changes were noted around the dental implants. To date, there have been no prosthetic complications. The patient is scheduled for quarterly follow-ups to determine the effectiveness of home care.

Evaluation of “All‐on‐Four” Concept and Alternative Designs with 3D Finite Element Analysis Method

“…[39][40][41][42][43] The results of this study are in harmony with these studies. However, it has a little effect in reducing the stresses occurring in the crest hills and supportive tissues around the implants against the occlusal loads.…”

The All‐on‐Four Treatment Concept: A Systematic Review

“…Vague documentation of results Jensen et al 52 Case report Bedrossian 53 Zygoma implants Khatami and Smith 54 Case report Bedrossian 55 Zygoma implants Krekmanov et al 11 Number of implants/study design Butura et al 56 Case report Menini et al 33 Literature review Cannizzaro et al 57 Study design/no survival rates reported 64 Case report, zygoma implants Penarrocha-Oltra et al 65 Literature review Graves et al 66 Zygoma implants Pomares 67 Number of implants Graves et al 68 Zygoma implants Rosen and Gynther 69 Number of implants Jensen et al 70 Case report Wu et al 71 Language 74 Number of implants/study design Penarrocha-Oltra et al 75 Not tilted/study design Astrand et al 76 Number of implants/overdentures Pieri et al 77 Number of implants Eccelente et al 78 Removable prosthesis Pomares 79 Number of implants Ekelund et al 80 Number of implants Pomares 67 Number of implants Friberg and Jemt 81 Not tilted Romanos et al 82 Removable prosthesis Heschl et al 83 Removable prosthesis Wolfinger et al 84 Number of implants/study design Li et al 85 Number of implants/study design Wu et al 71 Language…”

Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses

“…9 The success of using 4 implants to support the fixed complete prosthesis, originally described as the ''all-on-4 technique,'' has also been described in the literature by such authors as Maló et al, 6 Ferreira et al, 12 and Khatami and Smith. 13 The distal inclination of the implants is to reduce deleterious effects of the cantilever. In this connection, the studies of Sertgö z 9 using the finite element method showed that higher stresses were also concentrated on the distal implant on the same loading side and the presence of the cantilever increased stress around implants.…”