scholarly journals Rehabilitation of the Completely Edentulous Mandible by All-on-Four Treatment Concept: A Retrospective Cohort Study with Up to 10 Years Follow-Up

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 10
Author(s):  
Tommaso Grandi ◽  
Luca Signorini

(1) Background and Objectives. Currently, there are no definitive long-term data about clinically significant difference in the failure of prosthesis and implant or marginal bone loss related to the rehabilitation of the completely edentulous mandible by all-on-four treatment concept. The main aim of present investigation was to report the long-term outcomes (10-years follow-up) of complete-arch mandibular rehabilitations based on the all-on-four concept. (2) Materials and Methods. Patients in need of extractions of teeth due to the occurrence of caries and/or severe periodontal disease and patients presented with edentulous mandibles were enrolled to the study. A total of 96 participants (mean follow-up period after intervention of 3185.2 days) were enrolled in the study. Participants were evaluated at the first visit, 10 days after intervention and every year after the intervention. Implant and prosthesis survival, bone loss and both local biological and mechanical complications were evaluated during the follow-up period. (3) Results. An implants’ survival rate of 97.9% was observed at the end of the follow-up period. Biological complications were reported in 19.8% of patients, whereas mechanical complications were reported in 27.1% of cases. The average marginal bone level at baseline was −0.03 mm. A significant marginal bone loss was observed after 10-years follow-up (2.5 mm). Binary logistic regression analysis showed significant association between smoke and both marginal bone loss and local biological complications. Lastly, a significant association was observed between bruxism and mechanical complications. (4) Conclusions. The high implant and prosthesis survival rate and the moderate incidence of biological and mechanical complications observed in present investigation can be associated to several factors such as high implant primary stability, prosthetic design, and control of the occlusal forces.

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Marco De Gori ◽  
Guido Scoccianti ◽  
Filippo Frenos ◽  
Leonardo Bettini ◽  
Filippo Familiari ◽  
...  

The use of modular endoprostheses is a viable option to manage both tumor resection and severe bone loss due to nonneoplastic conditions such as fracture sequelae, failed osteoarticular grafts, arthroplasty revisions, and periprosthetic fractures. We sought to investigate both midterm complications and failures occurred in 87 patients who underwent a megaprosthetic reconstruction in a nonneoplastic setting. After a mean follow-up of 58 (1–167) months, overall failure-free survival was 91.5% at 1 year, 80% at 2 years, 71.6% at 5 years, and 69.1% at 5 and 10 years. There was no significant difference in the survival rate according to the diagnosis at the index procedure (p=0.921), nor to the reconstruction site (p=0.402). The use of megaprostheses in a postneoplastic setting did not affect survival rate in comparison with endoprosthetic reconstruction of pure nonneoplastic conditions (p=0.851). Perimegaprosthetic infection was the leading complication, occurring in 10 (11.5%) patients and implying a megaprosthetic revision in all but one case. Physicians should consider these results when discussing with patients desired outcomes of endoprosthetic reconstructions of a nonneoplastic disease.


2020 ◽  
Vol 9 (7) ◽  
pp. 2187 ◽  
Author(s):  
Miguel de Araújo Nobre ◽  
Carlos Moura Guedes ◽  
Ricardo Almeida ◽  
António Silva ◽  
Nuno Sereno

Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome.


Materials ◽  
2020 ◽  
Vol 13 (9) ◽  
pp. 2190
Author(s):  
Bruna Sinjari ◽  
Gianmaria D’Addazio ◽  
Manlio Santilli ◽  
Barbara D’Avanzo ◽  
Imena Rexhepi ◽  
...  

Marginal bone loss (MBL) is a key factor in long-term implant success rate. Among the different factors that influence MBL, it is the different implant shoulder designs, such as scalloped or non-scalloped, which have been widely studied on screw retained but not on cemented retained implants. Thus, the aim of the present study was to evaluate the MBL around scalloped and non-scalloped cemented retained dental implants after 4 years of loading, in humans. A total of 15 patients were enrolled in the present study. A radiographic and clinical examination was performed after implant placement (T0) and after 4 years from it (T1). The results demonstrated a differential MBL (T1-T0) of 2.436 ± 1.103 mm and 1.923 ± 1.021 mm, respectively for test (scalloped) and control (non-scalloped) groups with a statistically significant difference between them. On the other hand, no statistically significant differences were found between the groups in terms of prosthetic complication and abutment decementation, whilst ceramic crowns chipping was shown in both groups. In conclusion, the use of a scalloped platform did not provide better results on the maintenance of MBL after 4 years follow-up. In this study, this probably was determined by multiple factors, among which was the subcrestal insertion of scalloped implants.


2019 ◽  
Vol 40 (5) ◽  
pp. 553-561 ◽  
Author(s):  
Sajeeban Krishnapillai ◽  
Boudijn Joling ◽  
Inger N. Sierevelt ◽  
Gino M.M.J. Kerkhoffs ◽  
Daniël Haverkamp ◽  
...  

Background: Total ankle replacement (TAR) is gaining popularity as a treatment option for ankle osteoarthritis. Long-term implant survival is a critical outcome to determine the success of the TAR implant. The Buechel-Pappas (BP) implant is a second-generation mobile bearing implant. The aim of this study was to analyze the BP implant survivorship at 10-year follow-up, make a subanalysis between patient groups, and evaluate long-term functional outcomes. Methods: Data of 86 patients who received 101 BP implants between 1993 and 2010 were obtained from a prospectively documented database. Subanalyses were done for patients diagnosed with inflammatory joint disease and noninflammatory joint disease, and patients with preoperative tibiotalar neutral and nonneutral alignment. A Kaplan-Meier curve was used for survival analysis. Long-term functional outcomes were assessed with the following patient-reported outcome measures: Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), Short Form-36 (SF-36) Stand Version 2.0 Health Survey and 3 anchor questions. Results: The survival rate of the BP implant at 10 years was 86% (95% confidence interval, 78%-93%). A total of 31 patients (36%) required 55 reoperations, and in 13 patients (15%) a revision procedure was performed. In this series, no significant difference in 10-year survival rate was found between neither the inflammatory joint disease and noninflammatory joint disease group ( P = .47), nor the tibiotalar neutral and nonneutral alignment group ( P = .16). At a mean follow-up of 16.8 years for 21 patients, the mean FAOS activities of daily living (ADL) and FAAM ADL subscale scores were 75/100 and 56/100 points. The mean physical component summary (PCS) and mental component summary (MCS) of the SF-36 were 34/100 and 51/100 points, respectively. Conclusion: A survival rate of 86% was found at 10-year follow-up for the Buechel-Pappas implant. Our series demonstrated no significant difference in 10-year survival rates between the 2 patient subgroups. Long-term results of the various functional outcomes varied between poor and moderate. Level of Evidence: Level II, prospective cohort study.


2016 ◽  
Vol 10 (1) ◽  
pp. 680-691 ◽  
Author(s):  
Jakob Zwaan ◽  
Leonardo Vanden Bogaerde ◽  
Herman Sahlin ◽  
Lars Sennerby

Purpose: To study the clinical/radiographic outcomes and stability of a tapered implant design with a hydrophilic surface when placed in the maxilla using various protocols and followed for one year. Methods: Ninety-seven consecutive patients treated as part of daily routine in two clinics with 163 tapered implants in healed sites, in extraction sockets and together with bone augmentation procedures in the maxilla were evaluated after one year in function. Individual healing periods varying from 0 to 6 months had been used. Insertion torque (IT) and resonance frequency analysis (RFA) measurements were made at baseline. Follow-up RFA registrations were made after 6 and 12 months of loading. The marginal bone levels were measured in intraoral radiographs from baseline and after 12 months. A reference group consisting of 163 consecutive straight maxillary implants was used for the comparison of baseline IT and RFA measurements. Results: Five implants failed before loading, giving an implant survival rate of 96.9% and a prosthesis survival rate of 99.4% after one year. The mean marginal bone loss after one year was 0.5 mm (SD 0.4). The mean IT was statistically significantly higher for tapered than for straight reference implants (41.3 ± 12.0 Ncm vs 33.6 ± 12.5 Ncm, p < 0.001). The tapered implants showed a statistically insignificantly higher mean ISQ value than the straight references implants (73.7 ± 6.4 ISQ vs 72.2 ± 8.0 ISQ, p=0.119). There was no correlation between IT and marginal bone loss. There was a correlation between IT and RFA measurements (p < 0.001). Conclusion: The tapered implant showed a high survival rate and minimal marginal bone loss after one year in function when using various protocols for placement. The tapered implant showed significantly higher insertion torque values than straight reference implants.


2009 ◽  
Vol 11 (1) ◽  
pp. 11-23 ◽  
Author(s):  
Solweig Sundén Pikner ◽  
Kerstin Gröndahl ◽  
Torsten Jemt ◽  
Bertil Friberg

2020 ◽  
Vol 10 (23) ◽  
pp. 8709
Author(s):  
Diego Lops ◽  
Riccardo Guazzo ◽  
Alessandro Rossi ◽  
Antonino Palazzolo ◽  
Vittorio Favero ◽  
...  

The aim of the present investigation is to evaluate the implant therapy outcomes over a period of 5 years and to analyze several patient risk factors influencing the stability of the peri-implant tissues. Seventy-eight patients were consecutively treated between 2009 and 2017 and restored with implant-supported fixed prostheses. The following inclusion criteria were considered: partial or complete edentulism; residual bone volume of at least 3.3 mm in diameter and 8 mm in length; a favorable relationship between maxilla and mandible; at least a minimum 5 year follow-up for each implant included in the statistical analysis. Intraoral radiographs were taken at implant loading and every 12 months during the follow-up visits. They were subsequently stored on a personal computer and analyzed to determine the changes in bone level. Seventy-eight patients receiving 209 implants completed a minimum follow-up period of 5 years. One-hundred dental implants were inserted in the maxilla while 109 were placed in the mandible. Eleven (14.1%) out of 78 treated patients who received 29 (13.9%) dental implants were considered as drop-outs. On the whole, peri-implantitis was diagnosed in three implants. The average final pocket probing depth at implant level was 2.5 ± 1.2 mm. The average final bone loss after 5 years was 0.3 ± 0.4 mm, both at the mesial and distal aspect of the implant. The effects of the prosthesis type, sex and implant site did not statistically influence the marginal bone loss; on the contrary, a statistically significant difference regarding marginal bone loss was detected between smoker and non-smoker patients (p = 0.021). Implants with internal-conical abutment connection showed stable peri-implant bone levels at the medium-term follow-up. Nevertheless, further prospective long-term clinical studies are necessary to confirm these data.


Author(s):  
Eugenio Velasco-Ortega ◽  
Alvaro Jiménez-Guerra ◽  
Ivan Ortiz-Garcia ◽  
Jesús Moreno-Muñoz ◽  
Enrique Núñez-Márquez ◽  
...  

The aim of this study was to show the clinical outcomes of the immediate loading of implants inserted by guided surgery in edentulous mandible patients. Edentulous mandible patients were diagnosed with oral examination, cone beam computerized tomography and diagnostic casts for intermaxillary relations and treated with 8–10 implants for rehabilitation with guided surgery and immediate loading. After flapless surgery, implants were loaded with an immediate acrylic temporary prosthesis. After a period of six months, a ceramic definitive full-arch prosthesis was placed. A total of 22 patients (12 females and 10 males) were treated with 198 implants. Eleven patients (50%) had a previous history of periodontitis. Six patients (27.3%) were smokers. The follow-up was 84.2 ± 4.9 months. Clinical outcomes showed a global success rate of 97.5% of implants. Five implants were lost during the healing phase with provisional prosthesis. Twenty-two fixed full-arch rehabilitations were placed in the patients over the 193 remaining implants. Mean marginal bone loss was 1.44 mm ± 0.45 mm. Six patients (27.3%) showed some kind of mechanical prosthodontic complication. Eighteen (9.3%) of the 193 remaining implants were associated with peri-implantitis. The antecedents of peri-implantitis are critical elements for the survival of the implants. The loss of implants was significant in patients who smoked up to 10 cigarettes, compared to non-smokers. Peri-implantitis is one of the key elements in the long-term follow-up of implants and it was more manifest in smoking patients, and in those with a history of peri-implantitis. Marginal bone loss was more significant in smokers. Full-arch rehabilitation is presented as a predictable alternative with minor fatigue problems that are easily solvable.


Author(s):  
Francesca Cattoni ◽  
Luca Chirico ◽  
Alberto Merlone ◽  
Michele Manacorda ◽  
Raffaele Vinci ◽  
...  

The aim of the present study was to evaluate and compare the traditional “All on Four” technique with digital smile designed computer-aided “All on Four” rehabilitation; with a 4-years follow-up. The protocol was applied to a total of 50 patients randomly recruited and divided in two groups. Digital protocol allows for a completely virtual planning of the exact position of the fixtures, which allows one to perform a flapless surgery procedure with great accuracy (mini-invasive surgery) and also it is possible to use virtually planned prostheses realized with Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) (methods for an immediate loading of the implants. After 4 years from the treatments 98% of success were obtained for the group of patients treated with the traditional protocol and 100% for the digital protocol. At each time interval a significant difference in peri-implant crestal bone loss between the two groups was detected; with an average Marginal Bone Loss (MBL) at 4 years of 1.12 ± 0.26 mm in the traditional group and 0.83 ± 0.11 mm in the digital group. Patients belonging to the digital group have judged the immediate loading (92%), digital smile preview (93%), the mock-up test (98%) and guided surgery (94%) as very effective. All patients treated with a digital method reported lower values of during-surgery and post-surgery pain compared to patients rehabilitated using traditional treatment. In conclusion, the totally digital protocol described in the present study represents a valid therapeutic alternative to the traditional “All on Four” protocol for implant-supported rehabilitations of edentulous dental arches.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
S. Storelli ◽  
A. Caputo ◽  
G. Palandrani ◽  
M. Peditto ◽  
M. Del Fabbro ◽  
...  

Objective. The objective of the present review is to assess the implant survival, marginal bone loss, and biomechanical features of narrow-diameter implants (2.5-3.5 mm) supporting or retaining full-arch fixed or removable restorations. Materials and Methods. Three operators screened the literature (PubMed, Cochrane Library, and Google Scholar) and performed a hand search on the main journals that focus on implantology until 24 March 2019. Only articles that considered full-arch restorations supported or retained by narrow-diameter implants (2.5-3.5 mm) were considered if they have a minimum of 10 patients and a mean follow-up of at least 6 months. The outcome variables were survival of implants and marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure rates were analyzed using random effect Poisson regression models to obtain the summary estimate of 5-year survival rate and marginal bone loss. Results. A total of nine papers were finally selected, reporting a high survival rate of the implants. Eight studies focused only on the mandible while one study reported data from both mandible and maxilla. All studies reported on removable restorations; none focused on fixed rehabilitations. The estimated survival rate for 5 years of follow-up was calculated to be 92.25% for the implants. The estimated marginal bone loss after 5 years was calculated to be 1.40 mm. No study reported implant fractures. Conclusions. With the limitations of the present study, there is evidence that 2.5-3.5 mm narrow-diameter implants retaining a removable restoration can be a successful treatment in fully edentulous patients. No data on fixed restorations was available.


Sign in / Sign up

Export Citation Format

Share Document