This concept was introduced by Nobel Biocare, Sweden. But what is an all\u2010on\u20104 technique? Who should consider it? Is it considered safe? And how is it different from common implants?<\/p>\n
Nobel Biocare presented this treatment as a means of overcoming limitations in the human mandible. This\u00a0 treatment\u00a0 is basically\u00a0 immediate\u2010function protocols involving\u00a0 \u00a0the use\u00a0 of dental\u00a0 implant supported prostheses for the rehabilitation of completely edentulous mandibles and\u00a0 are documented as having a high success rates.<\/p>\n
The loss of alveolar bone with a relative surfacing of the inferior alveolar nerve in the mandible is a result of posterior teeth loss, particularly at an early age, thus often prohibiting placement of implants in the posterior\u00a0 regions.\u00a0 An\u00a0 alternative\u00a0 could\u00a0 be\u00a0 the\u00a0 use\u00a0 of\u00a0 tilted\u00a0 implants, which\u00a0 allows\u00a0 for\u00a0 maximum\u00a0 use\u00a0 of\u00a0 the\u00a0 existing\u00a0 bone\u00a0 and\u00a0 placement\u00a0 of\u00a0 posterior\u00a0 fixed\u00a0 teeth\u00a0 with\u00a0 minimum\u00a0 cantilevers\u00a0 in\u00a0 a\u00a0 region\u00a0 where bone height and nerve proximity does not allow for the placement of axial implants.<\/p>\n
In this\u00a0 treatment,\u00a0 only\u00a0 4\u00a0 implants\u00a0 are\u00a0 utilized.\u00a0 Two are placed\u00a0 vertically\u00a0 in\u00a0 the\u00a0 anterior\u00a0 and\u00a0 the\u00a0 other\u00a0 two placed with an angle up to 45 degrees in the posterior region. Unlike other implants, multi\u2010unit abutments are placed and can provide\u00a0 soon-to-be\u00a0 edentulous\u00a0 patients\u00a0 with\u00a0 an\u00a0 immediate\u00a0 restoration.<\/p>\n
Based\u00a0 on\u00a0 the\u00a0 optimal\u00a0 number\u00a0 of\u00a0 four\u00a0 implants\u00a0 for\u00a0 supporting\u00a0 full\u2010arch\u00a0 prosthesis\u00a0 in\u00a0 an\u00a0 edentulous\u00a0 jaw, the concept benefits from the posterior tilting of the two distal implants with a maximum of a two tooth distal cantilever in the final prosthesis. Optimized bone support with minimum bone volume is provided in\u00a0 this\u00a0 treatment.<\/p>\n
With this said,\u00a0 these\u00a0 are\u00a0 not\u00a0 the\u00a0 only\u00a0 benefits\u00a0 as improved\u00a0 anchorage along with\u00a0 vital\u00a0 structures\u00a0 avoidance\u00a0 (such\u00a0 as\u00a0 mandibular\u00a0 nerve\u00a0 or\u00a0 the\u00a0 maxilla sinus)\u00a0 are\u00a0 also results of the tilting\u00a0 of implants in the maxilla optimizing\u00a0 load distribution and allowing for a\u00a0 final\u00a0 prosthesis\u00a0 with\u00a0 up\u00a0 \u00a0to\u00a0 12 teeth. One can\u00a0 conclude\u00a0 that there\u00a0 is\u00a0 a clear biomechanical\u00a0 advantage\u00a0 in\u00a0 using\u00a0 splinted\u00a0 tilted\u00a0 distal\u00a0 implants,\u00a0 rather\u00a0 than\u00a0 \u00a0axial\u00a0 implants, supporting distal cantilever teeth.<\/p>\n
The step by step procedure of the treatment.<\/p>\n
\u2022 <\/span>The first step of the procedure includes:<\/p>\n Wax Try\u2010in Denture \/Re\u2010mount and Equilibration\/ Cross\u00a0 Mount\u00a0 and\u00a0 \u00a0Occlusal\u00a0 Guide \/\u00a0 Bite Registration \/\u00a0 Duplicate\u00a0 Denture\u00a0 and\u00a0 \u00a0 Surgical\u00a0 Template\/\u00a0 Adding \u066030-45\u00a0 Degree Angulation for Posterior Implant, Indication of the Amount of Ridge Reduction and Marking the Surgical Template.<\/p>\n \u2022 <\/span>The\u00a0 second\u00a0 step\u00a0 involves:<\/p>\n Marking Vertical\u00a0 Dimension\u00a0 of\u00a0 Occlusion\u00a0 prior\u00a0 to\u00a0 \u00a0Surgery\/\u00a0 teeth extraction \/ dental implant placement \/\u00a0 Attachment of Multi\u2010Unit Abutments \/ Index position of Multi\u2010Unit Abutments \/\u00a0 \u00a0Hollowing\u2010out\u00a0 space\u00a0 in\u00a0 denture\u00a0 for Temporary\u00a0 Coping\u00a0 Multi\u2010unit \/\u00a0 Attaching\u00a0 Temporary Coping\u00a0 Multi\u2010unit\u00a0 to\u00a0 Multi\u2010Unit\u00a0 Abutments \/\u00a0 Reducing\u00a0 the\u00a0 Height of\u00a0 Temporary\u00a0 Coping\u00a0 Multi\u2010Unit \/ Rubber Dam attachment \/ Picking\u2010up Temporary Coping Multi\u2010unit cylinders \/ Removing Prosthesis with Temporary\u00a0 Coping\u00a0 Multi\u2010unit\u00a0 cylinders\u00a0 processed\u00a0 in\u00a0 acrylic \/\u00a0 Converting\u00a0 from\u00a0 Immediate\u00a0 Denture\u00a0 to Fixed Implant Bridge \/ Polishing and Smoothing the Surface of Fixed Implant Bridge\u00a0 \u00a0and finally Attaching Provisional\u00a0 Fixed Implant Bridge Prosthesis with Prosthetic Screws.<\/p>\n In a research done on 245 patients with a total of 980 immediate\u2010function implants (four per patient) placed in the anterior region to support fixed full\u2010arch mandibular prostheses. The results were as follows: a total of 21 implants failed in 13 patients, giving cumulative patient\u2010related and implant\u2010related success rates of 94.8% and 98.1%, respectively, at\u00a0 five years, and 93.8% and 94.8%, respectively, with up to 10 years of follow\u2010up. The prostheses\u2019 survival rate was 99.2%\u00a0 with up to 10\u00a0 years\u00a0 of\u00a0 follow\u00a0 \u00a0up.<\/p>\n These\u00a0 \u00a0results\u00a0 support\u00a0 the\u00a0 conclusion\u00a0 that\u00a0 the\u00a0 All\u2010on\u20104 immediate\u2010function\u00a0 implant\u00a0 concept is viable and a patient friendly long term stable treatment.<\/p>","protected":false},"excerpt":{"rendered":" This concept was introduced by Nobel Biocare, Sweden. But what is an all\u2010on\u20104 technique? Who should consider it? Is it considered safe? And how is it different from common implants? Nobel Biocare presented this treatment as a means of overcoming limitations in the human mandible. This\u00a0 treatment\u00a0 is basically\u00a0 immediate\u2010function protocols involving\u00a0 \u00a0the use\u00a0 of […]<\/p>","protected":false},"author":1,"featured_media":343,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_joinchat":[],"footnotes":""},"categories":[11],"tags":[],"class_list":["post-375","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all-on-4-technique"],"_links":{"self":[{"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/posts\/375","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/comments?post=375"}],"version-history":[{"count":0,"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/posts\/375\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/media\/343"}],"wp:attachment":[{"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/media?parent=375"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/categories?post=375"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/algarvedentalimplants.com\/fr\/wp-json\/wp\/v2\/tags?post=375"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}