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Ongoing Crestal Bone Loss around ImplantsSubjected to Computer-Guided FlaplessSurgery and Immediate Loading Usingthe All-on-4® Concept
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2015 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 17, no 5, p. 831-843Article in journal (Refereed) Published
Abstract [en]

Background: The All-on-4® concept is widely applied for full-arch rehabilitations, using two tilted and two axially loadedimplants in order to overcome anatomical constraints.Purpose: The aim of this study was to assess the survival and individual success of implants immediately loaded with anAll-on-4 full-arch screw-retained prosthetic bridge i n fully edentulous mandibles or maxillae over up to 3 years.Materials and Methods: In total, 20 patients with atrophic jaws (9 maxillae, 11 mandibles) were treated with computer-guided flapless surgery and immediately provided with a provisional bridge. The final prosthesis was delivered after6 months. In total, 80 TiUnite™ Brånemark implants were placed. Radiographs were taken after surgery and 1 and 3 yearslater.Results: A 3-year survival rate of 100% was seen for all implants, both in lower and in upper jaw. None of the temporaryor definite prostheses were lost over the follow-up period of 3 years. After 1 year, the mean bone loss was 1.13 mm (SD 0.94;range −0.1 to 3.8), and after 3 years, it was 1.61 mm (SD 1.40; range 0 to 5). The mean bone loss between the 1-year and3-year follow-ups was 0.48 mm (SD 0.66; range −1.2 to 3.6). This difference was statistically significant (p < .001), indicativeof ongoing bone loss. Twenty-six percent of the implants had bone loss above 1.5 mm after 1 year, but after 3 years, 30%of the implants had already lost more than 1.9 mm.Conclusion: The implant and prosthetic survival was 100%, and patients benefited from the All-on-4 treatment. However,unacceptable ongoing bone loss was seen in 49.2% of the patients; this may be a warning sign for future problems and needsclinical attention. Overloading and surgery-related aspects need to be investigated as potential explanations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015. Vol. 17, no 5, p. 831-843
Keywords [en]
All-on-4, bone level, bone remodeling, immediate loading, one-stage, surgery, prosthetic complications, success
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-6704DOI: 10.1111/cid.12197ISI: 000362432900001PubMedID: 24397413Scopus ID: 2-s2.0-84943362902Local ID: 19979OAI: oai:DiVA.org:mau-6704DiVA, id: diva2:1403654
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved

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Vandeweghe, Stefan

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