The All on 4 Shelf: Mandible

Mandibular Full‐Arch Fixed Prostheses Supported on 4 Implants with Either Axial Or Tilted Distal Implants: A 3‐Year Prospective Study

“…In addition, the divergences in plaque and calculus indices between axial and tilted group for the posterior implants did also not confirm the initial null hypothesis and may be seen as the result of the varying degree of mandibular atrophy . The axial group was associated with a higher degree of atrophy also reflected by the need of axial implant placement and the impossibility of distal tilting . The increased atrophy in the axial group is associated with an elevated position of the floor of the mouth and consequently with changes in the position of the salivary glands promoting the development of calculus and plaque…”

“…42 The axial group was associated with a higher degree of atrophy also reflected by the need of axial implant placement and the impossibility of distal tilting. 36,43 The increased atrophy in the axial group is associated with an elevated position of the floor of the mouth and consequently with changes in the position of the salivary glands promoting the development of calculus and plaque. 42,44,45 The requirements for postinsertion maintenance efforts as seen in this study may be subdivided into those related to technical and biological complications with the frequency of technical and biological complications showing no difference between the two groups and being consistent with the prevalence found in other studies.…”

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

“…14,20,21,23 The latter four studies did not document or unclearly documented prosthesis failures. With the exception of three Agliardi et al 45 Number of implants Jensen and Adams 46 Case report Aparicio et al 47 Number of implants/study design Jensen et al 48 Case report Ata-Ali et al 49 Literature review Jensen et al 50 Case report Balmer and…”

Computer guided flapless vestibular to lingual trans-alveolar implant insertion for All on four implant prosthesis in case of severely atrophied mandible: A short term clinical and radiographic study

“…When there is a 10mm of bone available above the anterior border of the mental loop, this allows a 10mm distalization of the posterior implants when they inserted at 30 o distal inclination (10) . In case of sever alveolar bone resorption associated with mandibular atrophy and forward positioning of the mental nerve in the mandibular jaw, the implants can be placed trans-alveolarly, buccal to lingual to avoid mandibular nerve repositioning.…”

“…These implants positioned vestibular to lingual over the nerve to engage lingual cortical plate and do not need abundant bone above the nerve. (9)(10)(11) The computer guided flapless approach for All on four implant insertion provide several advantages including accuracy, precise transfer of the virtual planning 3-D model to the surgical template, precise detection and visualization of vital anatomical structures in relation to implant position, and attachment of the prosthesis immediately after abutment connection. Moreover, it simplifies treatment for patient and clinician, due to flapless surgical protocol, reduced operating time, and reduced inflammation and pain after surgery, with minimal complications (12) .…”