Implant-prosthetic Rehabilitation Research Articles

Complications of zygomatic implantology: observational clinical study

Background: The rehabilitation of the atrophic maxilla with zygomatic implants appears to be a complex challenge as this surgery is not without complications. For this reason, the operator approaching it must be aware of the possible surgical complications. The aim of this study was firstly to assess the incidence of complications following zygomatic implant operations performed using the intrasinus technique and to compare the data obtained with the results already present in the literature. Materials And Methods: The methods chosen for the evaluation of implant success were those reported in the article by Chrcanovic et al which refers to factors such as implant survival rate, percentage of failed implants and,incidence of post-operative complications. A total of 174 implants were included in the study. The study comprised three phases: Phase 1 -collection of the personal, anamnestic, clinical and radiological data of each patient participating in the study -detection of the number of zygomatic implants, the number of failed implants and any post- operative complications resulting from the intrasinus technique and subsequent comparison with data reported in the literature. Phase 2 -comparison of complications arising with intrasinusal and extrasinusal technique Phase 3 -administration of the satisfaction questionnaire of patients treated with the extrasinusal technique. Results: Complications occurred in 14 patients and the most frequent complication was sinusitis, followed by soft tissue infections, 3 implants failed. Specifically, the most frequent complication related to intrasinusal technique surgery is sinusitis, caused by invasion of the Higmoro antrum by the implant. Frequency analysis of the patient questionnaire shows high satisfaction with implant-prosthetic rehabilitation with zygomatic implants. Patients appear very satisfied with the aesthetics and functionality provided by the rehabilitation. Conclusion: Zygomatic implants allow the fixed rehabilitation of patients with severe upper jaw atrophies, and although complications may occur, patient satisfaction was very high as it allows them to fully recover aesthetics and function, facilitating a rapid return to social life.

Customized 3D-Printed Mesh, Membrane, Bone Substitute, and Dental Implant Applied to Guided Bone Regeneration in Oral Implantology: A Narrative Review.

Background: The new frontiers of computer-based surgery, technology, and material advances, have allowed for customized 3D printed manufacturing to become widespread in guided bone regeneration (GBR) in oral implantology. The shape, structural, mechanical, and biological manufacturing characteristics achieved through 3D printing technologies allow for the customization of implant-prosthetic rehabilitations and GBR procedures according to patient-specific needs, reducing complications and surgery time. Therefore, the present narrative review aims to elucidate the 3D-printing digital radiographic process, materials, indications, 3D printed manufacturing-controlled characteristics, histological findings, complications, patient-reported outcomes, and short- and long-term clinical considerations of customized 3D printed mesh, membranes, bone substitutes, and dental implants applied to GBR in oral implantology. Methods: An electronic search was performed through MEDLINE/PubMed, Scopus, BioMed Central, and Web of Science until 30 June 2024. Results: Three-dimensionally printed titanium meshes and bone substitutes registered successful outcomes in vertical/horizontal bone defect regeneration. Three-dimensionally printed polymeric membranes could link the advantages of conventional resorbable and non-resorbable membranes. Few data on customized 3D printed dental implants and abutments are available, but in vitro and animal studies have shown new promising designs that could improve their mechanical properties and tribocorrosion-associated complications. Conclusions: While 3D printing technology has demonstrated potential in GBR, additional human studies are needed to evaluate the short- and long-term follow-up of peri-implant bone levels and volumes following prosthetic functional loading.

IMPLANT-PROSTHETIC REHABILITATION OF PARTIALLY EDENTULOUS PATIENTS WITH SURGICAL GUIDES

Nowadays, the main goal of the oral rehabilitation treatment plan is not only to insert an implant into the bone, but to insert and integrate it so that the surrounding hard tissues and soft tissues are adequate. In this way, the long-term success of the treatment plan will be achieved. Background: The main purpose of the study was to present the advantages and disadvantages of using the dental implant insertion technique through the surgical guide as well as to evaluate the degree of its use among implantologists. Material and Methods: The study involved 120 patients who presented in the dental clinic requesting complex oral rehabilitation with restorations supported by implants. Following the anamnesis, intraoral clinical examination, laboratory and radiological evaluation, the type of edentulism was diagnosed, for which classical and alternative treatment plans were proposed. Results: From the group of edentulous patients, 40 patients chose the implant-prosthetic rehabilitation. Among them, 29 patients chose the guided method of implant insertion. Conclusions: Guided placement implant restorations are a viable solution for a painless and successful protocol in implant oral rehabilitation.

Implant-Prosthetic Rehabilitation of the Agenesis of Maxillary Lateral Incisors: A 2-Year Prospective Clinical Study with Full Digital Workflow

Implant-Prosthetic Rehabilitation of the Agenesis of Maxillary Lateral Incisors: A 2-Year Prospective Clinical Study with Full Digital Workflow

A Post-Implanto-Prosthetic Rehabilitation Study Regarding the Degree of Improvement in Patients' Quality of Life: A Before-After Study.

Implant-prosthetic rehabilitation has the ability to improve the quality of life of patients, because, in addition to the role of restoring masticatory function, they also have many other benefits, such as restoring aesthetics or improving speech. This study aimed to analyze whether patients' quality of life was improved by implanto-prosthetic rehabilitation and which were the most important aspects. In this before-after study, we applied the Oral Health Impact Profile (OHIP-14) questionnaire to analyze the degree to which complex implanto-prosthetic rehabilitation led or not to an increase in patients' quality of life. The present study was carried out at the level of a private medical center in a city in the central region of Romania and included patients who visited this medical center between January and June 2022 and who benefited from a complex implanto-prosthetic rehabilitation, with the total number of patients eligible for inclusion in the study being 116. Overall, an improvement in quality of life after implant-prosthetic rehabilitation was found. Patients' gender, age, or educational level did not significantly influence their responses. The network analysis offered an overview (intuitive visual representation) of the similarities but also the differences in the OHIP-14 item relationships in both situations: before and after oral rehabilitation. A better understanding of how patients perceive implanto-prosthetic rehabilitation and the aspects that influence this perception can lead to an improvement in their quality of life, increasing the addressability of this type of medical procedure.

Additively manufactured custom-made subperiosteal implant rehabilitation for severely atrophic maxillary molar area: A technical note

Implant-prosthetic rehabilitations of severely atrophic posterior maxillary sectors currently is challenging, often requiring multiple surgeries and long rehabilitation times. Recently, graftless techniques (e.g. zygomatic, pterygoid and nasal implants) have gained popularity as they offer a reduction in rehabilitation time, aligning more closely with patient preferences but may not be feasible for sectorial rehabilitations. Subperiosteal implants, suggested for full-arch rehabilitations of atrophic maxilla, haven't been explored for sectorial rehabilitations. In this report we present the case of a patient with maxillary molar edentulism, rehabilitated with a subperiosteal implant.

Ridge Preservation Combined With Open Barrier Membrane Technique in Case of Postextractive Oroantral Communication: A Case Series Retrospective Study.

After dental extraction, a physiological phenomenon of reabsorption of the dentoalveolar process is triggered, especially if periradicular lesions are present, which can sometimes be associated with oroantral communication in the upper posterior maxilla. To investigate a minimally invasive approach, 19 patients undergoing tooth extraction in the posterosuperior maxilla were recruited. All cases presented an oroantral communication with a diameter of 2-5 mm after tooth extraction and the alveolar process and, in some cases, with a partial defect of 1 or more bony walls. In these cases, a single surgical procedure was used to preserve the alveolar ridge using an open barrier technique with an exposed dense polytetrafluoroethylene membrane. The bottom of the extraction socket was filled with a collagen fleece. The residual bone process was reconstructed using a biomaterial based on carbonate-apatite derived from porcine cancellous bone. After 6 months, all patients were recalled and subjected to radiographic control associated with an implant-prosthetic rehabilitation plan. Data relating to the sinus health status and the average height and thickness of the regenerated bone were collected. Radiographic evaluation verified the integrity of the maxillary sinus floor with new bone formation, detecting a vertical bone dimension between 3.1 mm and 7.4 mm (average 5.13 ± 1.15 mm) and a horizontal thickness between 4.2 mm and 9.6 mm (average 6.86 ± 1.55 mm). The goal of this study was to highlight the advantage of managing an oroantral communication and, simultaneously, obtain the preservation and regeneration of the alveolar bone crest. The open barrier technique appears to be effective for the minimally invasive management of oroantral communication up to 5 mm in diameter in postextraction sites, with a good regeneration of hard and soft tissue.

Comparison between Conventional and Digital Workflow in Implant Prosthetic Rehabilitation: A Randomized Controlled Trial.

The progress of digital technologies in dental prosthodontics is fast and increasingly accurate, allowing practitioners to simplify their daily work. These technologies aim to substitute conventional techniques progressively, but their real efficiency and predictability are still under debate. Many systematic reviews emphasize the lack of clinical RCTs that compare digital and traditional workflow. To address this evidence, we conducted a three-arm designed clinical RCT, which compares fully digital, combined digital, and analogic and fully analog workflows. We aimed to compare the clinical properties of each workflow regarding interproximal (IC) and occlusal contact (OC), marginal fit, impression time (IT), and patient satisfaction through a VAS scale. In total, 72 patients were included in the study. The IC and OC of the digital workflow were better than the others (p < 0.001), which obtained similar results. No difference between implant-abutment fit was observed (p = 0.5966). The IT was shorter in the digital workflow than the others (p < 0.001), which were similar. Patient satisfaction was higher in the digital workflow than in the conventional one. Despite the limitations, this study's results support better accuracy and patient tolerance of digital workflow than of conventional techniques, suggesting it as a viable alternative to the latter when performed by clinicians experienced in digital dentistry.

A review on guided bone regeneration using titanium mesh.

The gold standard for bone regeneration in atrophic ridge patients is guided bone regeneration (GBR). This makes it possible to get enough bone volume for an appropriate implant-prosthetic rehabilitation. The barrier membranes must meet the primary GBR design requirements, which include adequate integration with the surrounding tissue, spaciousness and clinical manageability. Titanium mesh's superior mechanical qualities and biocompatibility have broadened the indications of GBR technology, enabling it to be used to restore alveolar ridges with more significant bone defects. GBR with titanium mesh is being used in many clinical settings and for a range of clinical procedures. Furthermore, several advancements in digitalization and material modification have resulted from the study of GBR using titanium mesh. Hence, we report a review on the various characteristics of titanium mesh and its current use in clinical settings for bone augmentation.

Oral health-related quality of life in implant-supported rehabilitations: a prospective single-center observational cohort study

BackgroundOral Health-Related Quality of Life (OHRQoL) is a comprehensive concept covering daily comfort, self-esteem, and satisfaction with oral health, including functional, psychological, and social aspects, as well as pain experiences. Despite abundant research on OHRQoL related to oral diseases and hygiene, there is limited data on how patients perceive changes after implant-prosthetic rehabilitation. This study aimed to evaluate OHRQoL and aesthetic perception using OHIP-14 and VAS scales respectively, before (baseline-TB), during (provisional prostheses-TP), and after (definitive prostheses-TD) implant-prosthetic rehabilitation. It also explored the impact of biological sex, substitution numbers, and aesthetic interventions on OHRQoL and VAS scores, along with changes in OHIP-14 domains.MethodsA longitudinal prospective single-center observational cohort study was conducted with patients requiring implant-prosthetic rehabilitation. Quality of life relating to dental implants was assessed through the Italian version of Oral Health Impact Profile-14 (IOHIP-14), which has a summary score from 14 to 70. Patients’ perceived aesthetic was analyzed through a VAS scale from 0 to 100. Generalized Linear Mixed Effect Models, Linear Mixed Effect Models, and Friedman test analyzed patient responses.Results99 patients (35 males, 64 females) aged 61–74, receiving various prosthetic interventions, were enrolled. Both provisional and definitive prosthetic interventions significantly decreased the odds of a worse quality of life compared to baseline, with odds ratios of 0.04 and 0.01 respectively. VAS scores increased significantly after both interventions, with estimated increases of 30.44 and 51.97 points respectively. Patient-level variability was notable, with an Intraclass Correlation Coefficient (ICC) of 0.43. While biological sex, substitution numbers, and aesthetic interventions didn’t significantly affect VAS scores, OHRQoL domains showed significant changes post-intervention.ConclusionsThese findings support the effectiveness of implant-prosthetic interventions in improving the quality of life and perceived aesthetics of patients undergoing oral rehabilitation. They have important implications for clinical practice, highlighting the importance of individualized treatment approaches to optimize patient outcomes and satisfaction in oral health care.

One Piece CAD/CAM Abutment for Screw-Retained Single-Tooth Restorations: A 5-Year Prospective Cohort Study.

The use of ceramic-coated patient-specific CAD/CAM titanium abutments represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly customized abutments enables the accurate three-dimensional positioning of the prosthetic emergence. This study evaluates the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/CAM titanium abutments. Thirty implants were placed in thirty patients and rehabilitated with thirty single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, with implant placement after post-extraction socket healing and prosthetic restoration after implant healing. Implants of lengths ranging from 6-15 mm and widths of 3.6, 4.2, and 4.8 mm were used in this study. At the time of prosthesis delivery (T0), after two years (T1), and after five years (T2), plaque (PI) and bleeding (BoP) indices, probing depths (PPD), marginal bone levels (MBL), and PES/WES were evaluated for each implant. No patient dropped out of the study during the follow-up period. All thirty implants were clinically successful at five years post-prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05±0.56 mm at T0, 1.992±0.6 mm at T1, and 1.867±0.439 mm at T2. The mean MBL at T0 was 0.413±0.440 mm, at T1 was 0.306±0.388 mm, and at T2 was 0.263±0.368 mm. The mean PES, WES, and PES/WES indices, 7.43±1.04, 7.57±0.82, and 15.00±1.17, respectively, indicate good integration of soft tissues, satisfactory aesthetics, and an overall positive outcome. The success rates, maintenance of marginal bone levels, and periodontal and aesthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns.

Outcomes of treatment with short dental implants compared with standard-length implants: a retrospective clinical study

BackgroundThe size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants.MethodsPatients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed.ResultsThirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally).ConclusionsIn this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.

Computer-guided Surgery in Anterior Esthetic Area with Autologous Deciduous Tooth-Derived Material: Case Report

Background The literature has described several biomaterials for guided bone regeneration. Some authors have proposed using a material derived from dentin/ enamel among autologous biomaterials. This study aims to test the effectiveness of autologous material derived from deciduous teeth in guided bone regeneration. Case Presentation A 24-year-old female shows up with missing tooth #1.1 for a domestic accident. This requires implant-prosthetic rehabilitation. It is decided to be performed before implant therapy, a bone regeneration guided using biomaterial resulting from the patient’s deciduous teeth stored in a plastic box. GBR (Guided Bone Rehabilitation) is performed, and after 6 months, the implant is inserted by computer-guided surgery, and then a provisional prosthesis is placed. Discussion The material deriving from deciduous teeth, not preserved with precautions, has had excellent integration results. This allowed the implant to be placed in the best position for the final prosthetic rehabilitation. Conclusion This clinical case shows that using biomaterial derived from deciduous teeth has allowed an excellent result with negligible biological cost.

Full Arch Implant-Prosthetic Rehabilitation in Patients with Cardiovascular Diseases: A 7-Year Follow-Up Prospective Single Cohort Study.

Aim: The rising average age increases edentulous cases, demanding more implant-prosthetic rehabilitation, with cardiovascular diseases being significant factors. This study compared healthy patients (CG = Control Group) and those with cardiovascular disease (TG = Test Group) for implant survival, Marginal Bone Loss (MBL), peri-implant tissue level parameters as Periodontal Screening and Recording (PSR), Plaque Index (PI), Bleeding on Probing (BoP) Peri-implant Probing Depth (PPD), and surgical complications. Smoking impact on both groups and medication influence in the TG were secondary outcomes. Patients underwent full-arch implant prosthetic rehabilitation. Methods: Implant survival rate, MBL, and surgical complications were recorded during the monitoring period (7 years), while peri-implant parameters were assessed at the end of the observational time. A total of 26 and 28 CG and TG patients were recruited, respectively. Results: A total of 128 implants were placed in CG, while 142 in the TG. Implant survival and MBL showed no significant differences (p > 0.05). Nevertheless, peri-implant parameters were more unfavorable in TG. The only significant surgical complication was higher bleeding rates in the TG (p < 0.05). Conclusions: Cardiovascular patients showed similar implant survival and MBL but had adverse peri-implant parameters and increased bleeding rates. Higher smoking levels may relate to unfavorable implant outcomes. Further investigation is needed on drug impact with larger samples.

The possibilities of additive technologies for targeted tissue regeneration and implantation in a patient with a mandibular defect. A clinical case

After injury or removal of neoplasms, bone, soft tissue scar defects and deformities are formed. Methods of reconstructive bone surgery do not reliably allow to restore defects in full. The main problem is constriction, subsequent atrophy and deformation of soft tissues in the defect area. Dental implant-prosthetic rehabilitation in the area of significant bone defects requires the use of design and prototyping of the final result using computer programs and diagnostic models. The clinical experience of using an individual temporary endoprosthesis, a «tissue expander» made by layer-by-layer synthesis (3D printing) of biologically inert plastic according to CT data of the patient is presented. The expander is made in the form of a 3D element for the formation of the necessary volume of soft tissues in the patient for a period of 2–4 months, fixed under the periosteum, in the area of the lateral defect of the lower jaw with intraosseous screws. Dental implants are installed in front. Intraoperative direct prosthetics was performed. A temporary screw prosthesis is installed in the mouth. After 3 months, 3 implants were installed and bone grafting was performed. Final prosthetics 7 months after the start of treatment.

Rehabilitation of patients with severe atrophy of the upper jaw using the “quad zygoma” protocol. Clinical case

The implant-prosthetic rehabilitation of patients with severe atrophy of the upper jaw can be postponed only after the necessary bone supply has been created or through alternative implantation methods in anatomical areas adjacent to available bone, such as the zygomatic bone. Objective: To present the method of inserting zygomatic implants and analyzing the efficacy of the method. Based on a clinical case of implant-prosthetic rehabilitation using the “Quad Zygoma” protocol, patient A.M., aged 58, was diagnosed with “Kennedy Class I Partial Subtotal Edentulism. Misch Class D bone atrophy in the anterior region and Misch SA-4 in the posterior sectors of the maxilla. Generalized chronic periodontitis of moderate-advanced form.” The effectiveness of the applied method was demonstrated.

Early implant placement Type 2, using flapless technique in one surgical stage. Five years follow-up

Postextractional implants placement is frecvently discussed in the literature as a method aimed to facilitate implant-prosthetic rehabilitation and preservation of alveolar bone. However, the opinions are divergent while the obtained results often are unfavorable due to bone loss and mucosal recessions. An alternative for postextractional placement is early type 2 implants placement. The study was based on results evaluation of 51 implants insearted in early period after teeth extractions (type 2) in one surgical step, using flapless surgery, without removing the socket content. For evaluation of healing process in the socket, histological analyses of it’s content were performed at 2, 4 and 8 weeks periods. The obained results showed that early implant placement type 2 is a safe method with an integration rate similar to the conventional method. The presence of healed soft tissues is an advantage upon the postextractional placement. The preservation of socket primary matrix lead to a good bone healing around implants without necessity of grafting.

Peri-implant health after microvascular head and neck reconstruction-A retrospective analysis.

Prosthodontic rehabilitation after reconstruction with microvascular revascularized free flaps following ablative tumor surgery is challenging due to the altered anatomical and functional conditions. The aim of this retrospective study was to determine whether the type of graft and the type of peri-implant tissue have an effect on peri-implant inflammatory parameters and implant survival. Patients who received a free flap reconstruction with subsequent implant-prosthetic rehabilitation between 2010 and 2022 were retrospectively included. The primary outcome variable was the probing depth (PPD) at a minimum of 1 year after completion of prosthetic restoration. Predictive variables were type of free flap, emergence profile, and history of radiation. Seventy-one patients after free flap reconstruction were included in the analysis. At a minimum of 24 months after implant insertion the primary outcome, PPD showed no clinically relevant differences between the types of free flaps used. The emergence profile through a skin island resulted in an increase in BOP compared to native mucosa in the descriptive analysis (p-value > .05). The analysis showed a 5-year implant survival of 96.2% (95% CI: 0.929-0.996) in cases without irradiation and 87.6% (95% CI: 0.810-0.948) with irradiation of the region evaluated (p-value .034). Flap and associated soft tissue type had no significant effect on 5-year implant survival or peri-implant inflammatory parameters. However, the large heterogeneity of the patient population indicates that further prolonged studies are required for a more differentiated assessment of the long-term success.

Full-Arch Implant-Prosthetic Rehabilitation in Patients Affected by Hypertension: A Randomized Clinical Trial at 7 Years Follow-Up

The aim of this clinical study was to investigate and compare implant survival rates, marginal bone loss, and surgical and prosthetic complications of healthy patients and subjects affected by hypertension receiving full-arch implant-prosthetic rehabilitation. From January 2016 to November 2016, patients affected by total edentulism of one or both arches or severe impairment of residual teeth who needed full-arch implant-prosthetic rehabilitation and who had the absence of any systemic diseases or the presence of hypertension as a single pathology were randomly selected. According to the inclusion criteria, 39 patients were enrolled for this study. The sample was divided into two groups: A total of 18 patients were included in Group A (healthy patients), and 21 patients were included in Group B (patients affected by hypertension). No statistically significant difference in implant survival rates, marginal bone loss, and prosthetic complications were observed between Group A and Group B. Except for variable bleeding, the results of the Pearson’s chi-square test and z-test at a 99% confidence level suggest that there is no statistically significant difference in clinical complications between the groups. Within the limitations of this study, full-arch implant-prosthetic rehabilitation could be a feasible option for treating patients with hypertension, provided that hypertension is compensated and controlled.

Clinical and Radiographic Follow-Up of Full-Arch Implant Prosthetic Rehabilitations: Retrospective Clinical Study at 6-Year Follow-Up

Aim: the aim of this retrospective clinical study was to evaluate clinically and radiographically full-arch implant prosthetic rehabilitations supported by six axial implants or four implants placed according to the All-on-Four protocol. Materials and methods: Patients in need of immediately loaded full-arch implant prosthetic rehabilitations of one or both arches were considered. Follow-up visits were performed one week after surgery, at 3 and 6 months and then once a year for the next 6 years to record implant survival, peri-implant parameters, marginal bone loss, bone cortical thickness and possible muscular, articular and prosthetic complications. A satisfaction evaluation questionnaire was also made available to all patients at the end of the follow-up period. Results: A total of 30 patients with total edentulism of one or both arches or need for avulsion of residual impaired teeth were enrolled for this study and underwent implant prosthetic rehabilitation on four or six implants. The overall implant survival rate at the six-year follow-up was 98.09%. Statistical analysis revealed a significant association between implant site and higher plaque and bleeding index in the posterior site. The extent of keratinized tissue was statistically superior in anteriorly located implants. Statistical analysis showed a significant difference between the values of bone-marginal levels as a function of time. The vestibular and palatal/lingual bone cortices were preserved, with an increasing trend in the apical direction. Regarding muscular and articular complications, the results of this study showed statistically significant differences between the mean values recorded in male and female subjects, while the most frequently encountered problems during the clinical evaluation were the presence of joint clicks and pain in the masseter muscles. Two of the patients examined showed problems with mandibular latero-deviation and prosthetic fracture. Conclusion: within the limitations of the present study, immediate implant-retained prosthetic rehabilitations supported by six axial implants or four fixtures placed according to the All-on-Four method could represent a valid therapeutic alternative to provide edentulous patients with restoration of masticatory function and aesthetics and promote their acceptance.