All-On-Four Concept in Implant Dentistry: A Literature Review

Durkan R,Oyar P

doi:10.15744/2454-3276.3.205

Abstract

The implant technology developed as the all-on-four concept is offered as an alternative to conventional implant applications. In the all-on-four technique, 4 implants are placed in the interforaminal region in the mandible and in the pre-maxillary region in total edentulism cases. This application is based on the placement of two of these implants to the anterior region so as to be perpendicular to the occlusal plane, and on the placement of two implants to the posterior region so as to be inclined 30-45o.

Highlights

In the all-on-four technique, 4 implants are placed in the interforaminal region in the mandible and in the pre-maxillary region in total edentulism cases
Tuber, and zygomatic implants can be placed in the posterior region, and autogenous or heterogeneous bone grafts can be used for the solution of this [8]
In the review performed in Pubmed and Cochrane Library between 2000 and 2015, Full arch implant-supported prosthesis, 4-implant full arc, osseointegration, inclined implant, total edentulism and different combinations in which some of these keywords were used together were chosen. 100 of the articles achieved from the review were evaluated with respect to the subject we examined

Summary

Introduction

In patients with maxillary and/or mandibular total edentulism, dental implant treatment is a treatment model which has been accepted scientifically, and long-term studies have been carried out on this subject [1,2,3,4,5,6].In recent years, putting implants into immediate function by making implant-supported fixed full-arch restorations and the fact that patients do not remain edentulous have become gold standard in dental implantology [7,8,9,10].It is observed in the literature that successful prostheses are made using 6-8 implants in the maxilla and 6 implants in the mandible and applying posterior cantilever extension where it is necessary, in these treatments [3]. In full arch fixed implant-supported prostheses, patients achieve the comfort, aesthetics, phonetics and functional chewing effectiveness in their natural teeth [11,12,13]. The clinical and hygiene controls can be performed especially in full arch screw-retained fixed prostheses [3]. In these treatments, the presence of overly baggy maxillary sinuses for maxilla restricts the implant placement in the posterior region especially in patients with excessive resorbed crests [14,15,16]. The posterior implant treatment constitutes a disadvantage in patients with resorbed mandible with a mandibular nerve located at the top of the alveolar crest. Graft applications, short and/or angled implant applications bring along surgical and patient based disadvantages [17,18,19]

Objectives

Methods

Results