The all-on-four treatment concept: Systematic review

Soto-Peñaloza, David; Zaragozí-Alonso, Regino; Peñarrocha-Diago, María; Peñarrocha‐Diago, Miguel

doi:10.4317/jced.53613

Cited by 102 publications

(117 citation statements)

References 63 publications

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“…For the nonrandomized studies, the studies were considered at low risk of bias in the case of Newcastle‐Ottawa Scale (NOS) scores of 7 stars or higher. (Soto‐Peñaloza, Zaragozí‐Alonso, Peñarrocha‐Diago, & Peñarrocha‐Diago, ) Among all the studies evaluated, both level I studies and 12 out of 20 level II studies showed high risk of bias (Tables and ).…”

Section: Discussionmentioning

confidence: 99%

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review

Lin

Eckert

2018

Clinical Oral Implants Res

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Objectives:The aim of this review was to determine the clinical performance of dental implants that are intentionally tilted when compared with implants that are placed following the long axis of the residual alveolar ridge. Materials and methods:A systematic review of the scientific literature using a predefined research question (PICO) and search strategy was undertaken. This search included five electronic databases. Two independent reviewers examined electronic databases and performed a manual review following search strategy to accomplish the item generation and reduction. Included articles were evaluated to determine the level of evidence. Data were extracted only from level I and level II studies, based on the Oxford Centre for Evidence-based Medicine-Levels of Evidence (March 2009).If included studies were homogeneous in nature, data were to be accumulated.However, if included studies were heterogeneous in nature, only descriptive data would be reviewed and analyzed.Results: A total of 811 articles were identified through the PICO question and search strategy. Detailed review of the abstracts and articles resulted in further item reduction, and 46 articles were included for full-text review. A total of 42 articles were then selected for inclusion in the systematic review. The identified articles included two level I and 20 level II studies. In addition, 15 level IV, one gray literature, and four previous systematic reviews with meta-analyses were also used in the study. The extracted data from the included studies demonstrated heterogeneity that prevented quantitative assessment, and only one level II study directly compared tilted and axially placed implants. Assessment of the descriptive data demonstrated no differences in implant survival, marginal bone loss, prosthesis survival, or patient-reported outcome measures (PROMs) whether implants are placed axially or with intentional inclination of the coronal aspect of the implant toward the distal aspect of edentulous jaws.Conclusions: Based upon the systematic review of the literature, an analysis of the descriptive data suggested no differences in clinical performance between implants that are placed in an axial position relative to the residual alveolar ridge when compared with implants that are intentionally tilted toward the distal aspect of edentulous jaws. K E Y W O R D Sclinical assessment, clinical research, clinical trials, diagnosis, prosthodontics tilted, axialThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Section: Discussionmentioning

confidence: 99%

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review

Lin

Eckert

2018

Clinical Oral Implants Res

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“…9 The "All-on-4" treatment concept was developed to maximize the use of the available residual bone in atrophic jaws, allowing immediate function and avoiding regenerative procedures (such as bone grafting) that increase treatment costs, patient morbidity, and complications inherent to these procedures. 18,19 Nevertheless, long term evidence of the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla is lacking. 18,19 Nevertheless, long term evidence of the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla is lacking.…”

Section: Introductionmentioning

confidence: 99%

“…5,[11][12][13][14][15][16][17] The All-on-4 concept was further validated in the short and midterm outcomes considering the results of two systematic reviews that reported high survival rates in the rehabilitation of completely edentulous patients. 18,19 Nevertheless, long term evidence of the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla is lacking.…”

Section: Introductionmentioning

confidence: 99%

The All‐on‐4 concept for full‐arch rehabilitation of the edentulous maxillae: A longitudinal study with 5‐13 years of follow‐up

Maló

Nobre

Lopes

et al. 2019

Clin Implant Dent Rel Res

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Background: Full-arch immediate function protocols such as the All-on-4 concept need long-term validation.Purpose: To report the 5-13 year outcomes of the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla. Materials and Methods: This retrospective case series study involved 1072 patients (4288 maxillary implants) rehabilitated through the All-on-4 treatment concept. Primary outcome measures were cumulative prosthetic and implant success (life table analysis). Secondary outcome measures consisted in marginal bone loss (MBL) at 5 and 10 years, biological and mechanical complications. The estimation of risk indicators was performed through multivariable analysis for the outcome variables implant failure (Cox regression to estimate hazard ratios and 95% confidence intervals [95% CI]), MBL > 2.8 mm at 5 years, MBL > 3.0 mm at 10 years, biological and mechanical complications (binary logistic regression to estimate odds ratios [OR] with 95% CI). Results: Eighteen patients deceased unrelated to the implant treatment (1.7%) and 219 patients (20.4%) were lost to follow-up. The prosthetic success rate was 99.2%; Implant cumulative survival and success rate was 94.7% and 93.9%, respectively, with up to 13 years of follow-up. Male gender (HR = 1.73), smoking (HR = 1.94), and mechanical complications (HR = 0.59) were significantly associated with implant failure.Average MBL at 5 and 10 years was 1.18 mm (95% CI: 1.16, 1.21) and 1.67 mm (95% CI: 1.58, 1.77) with age (OR = 0.97), male gender (OR = 0.58), smoking (OR = 1.73), and biological complications (OR = 2.1) associated with MBL > 2.8 mm at 5 years. The incidence of biological complications was 7.8% at implant level, with age (OR = 0.98) and smoking (OR = 1.53) significantly associated. The incidence of mechanical complications was 58.8% for the provisional prostheses and 7.3% for the definitive prostheses. Conclusions:The high success rates registered for both implants and prostheses together with the low MBL confirm the All-on-4 treatment concept is predictable and safe in the long term outcome.

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“…Dental implants are a popular treatment option for patients that need to replace one tooth or more. Survival rates of dental implants are reported to be very high in the recent literature . These rates seem to indicate minimal complications with dental implants, however, careful consideration should be taken prior to implant placement as peri‐implantitis and other problems can be encountered .…”

Section: Introductionmentioning

confidence: 99%

“…Survival rates of dental implants are reported to be very high in the recent literature. [1][2][3][4] These rates seem to indicate minimal complications with dental implants, however, careful consideration should be taken prior to implant placement as peri-implantitis and other problems can be encountered. 5,6 It is important to note the difference between implant survival and implant success.…”

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confidence: 99%

Incidental findings of implant complications on postimplantation CBCTs: A cross‐sectional study

Clark

Barbu

Lorean

et al. 2017

Clin Implant Dent Rel Res

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Despite the popularity of dental implants, the surgical placement of these implants is not a riskless procedure. Implant mal-positioning might be life-threatening and can lead to serious bleeding, airway obstruction, and unnecessary postoperative surgeries. Complications of dental implants are not obsolete and dental implant associated problems may not be apparent immediately. Surgeons must have proper training and use evidenced-based treatment planning in order to prevent dental implant complications.

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The all-on-four treatment concept: Systematic review

Cited by 102 publications

References 63 publications

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review

The All‐on‐4 concept for full‐arch rehabilitation of the edentulous maxillae: A longitudinal study with 5‐13 years of follow‐up

Incidental findings of implant complications on postimplantation CBCTs: A cross‐sectional study

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