ABSTRACT
A 63-year-old male patient, who had a severely resorbed edentulous maxillary arch and partially edentulous mandibular arch decided on the implant-supported fixed treatment option to replace the edentulous maxillary arch. The fully guided implant placement that utilizes the computer-generated guide is more accurate than traditional surgical guides and free-hand placements. The researchers have correlated possible implant failure risk factors with age, sex, smoking, type of edentulism, bone quality and volume, implant location, angulation, diameter, length, and various systemic factors. This case report demonstrated the failure cause of virtually planned anterior implants in All-on-4 and how to manage it by free-hand surgery without surgical guides.
ABSTRACT
In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.
Subject(s)
Humans , Absorption , Bite Force , Denture, Complete , Gingiva , Mandible , Mandibular Nerve , Mastication , Maxilla , MethodsABSTRACT
Recently, digital implant systems are expanding its influence in dental area. Due to technical improvement, they jumped over their limits nowadays. We can use these newest systems to treat edentulous patient, from implant surgery to fabrication of prosthesis. In this case, The patient was a fifty years old female. She had a full edentulous ridge on mandible and wanted to reconstruct occlusion with using implants. We planned to use digital implant system with “all-on-4” concept on mandible and produced surgical guide for flapless implant surgery. After the surgery, we tried to fabricate full arch prosthesis just using a digital devices and confirmed satisfying result.
Subject(s)
Female , Humans , Mandible , Prostheses and ImplantsABSTRACT
In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.
Subject(s)
Aged , Humans , Centric Relation , Dentistry , Denture, Complete , Diagnosis , Hand , Printing, Three-Dimensional , Prostheses and Implants , Vertical DimensionABSTRACT
Objective@#To analyze implant survival rate and incidence rate of complications after All-on-4 implantation, and to discuss the technical points and consideration of All-on-4.@*Methods @#According to the criteria of inclusion and exclusion, 23 cases treated with All-on-4 immediate restoration were referred, from January 2007 to December 2015, including 5 cases of edentulous maxillary, 14 cases of edentulous mandibular and 4 cases of both maxillary and mandibular were edentulous. All the patients received immediate function with provisional prostheses at the surgery day. Definitive prostheses were delivered to patients after 3-6 months post operation and follow-up visits were performed up to 9 years (average 3 years) after placement of definitive prostheses.@*Results @# In this study, the rate of implant retention of 108 implants and 27 final restorations was 100% until the last review. Among the 23 patients, 3 patients had complications and the incidence of complications was 13.0%. @*Conclusion@# All-on-4 is an effective and reliable method in the treatment of dentures denture. The incidence of complications is low. All-on-4 is a practical method.
ABSTRACT
The implant-supported fixed dental prosthesis in irradiated maxilla needs meticulous treatment planning due to low bone healing capacity. All-on-4 concept implantation can reduce the number of implants to be placed avoiding bone grafting procedure. Conventionally, prefabricated angled abutments for tilted implants have been used. However, in this case, it was replaced with computer-aided design and computer-aided manufacturing (CAD/CAM) abutment. This case report described all-on-4 concept implantation and fabrication of CAD/CAM zirconia fixed dental prostheses using CAD/CAM titanium abutments.
Subject(s)
Bone Transplantation , Ceramics , Computer-Aided Design , Dental Prosthesis , Maxilla , TitaniumABSTRACT
Objective:To investigate the stress distribution in peri-implant bone with All-on-4 implant with various parameters by three-dimensional finite element method.Methods:An edentulous mandibular specimen was scanned by CT Mimcs.Geomagic,Uni-graphics,HyperMesh modeling software were used to establish All-on-4 implant finite element models with different inclination angles and corresponding cantilever lengths.1 50 N vertical static load was applied at the right end of the cantilever,peri-implant bone stress was analysed using Abaqus software.Results:When the distal implant inclined 0°with cantilever length of 1 9.5 mm,the peak stress in peri-implant cortical bone at the mesial and distal side was 25.526 MPa and 83.026 MPa respectively.When the distal implant in-clined 1 5°,30°and 45°with the cantilever length of 1 7.2 mm,1 3.3 mm and 9.8 mm,the stress in perio-implant cortical bone at distal side of the implant reduced by 1 2.4%,35.6% and 53.1 %,that at mesial side of the implant reduced by 1 3.6%,36.3% and 40.2%,respectively.Conclusion:From the perspective of the stress analysis,the design of All-on-4 distal implant with large incli-nation angle and short cantilever is superior to that with small inclination angle and long cantilever.
ABSTRACT
Objective To explore the effect of different arch forms of maxillary models on stress distribution of peri-implant of All-on-4 implants with 3-dimensional finite element, and to provide evidence for the improvement of implant achievement ratio in clinic. Methods 3-dimensional finite element analysis models of Tapered,Square and Ovoid arch form maxillary based on the MBTTM Arch Form Templates were constructed by using Solidworks software.The cortical bone thickness was defined as 2 mm at all points.The implants with 13 mm in length were inserted between the mental foramina.The 2 posterior implants were set at 4 inclination angle,from 0°to 45°.All implants were splinted with superstructure.A 100 N pressure was applied to 2 kinds of loading positions on the superstructure models. The maximum Von-Mises stress on cortical bone around the implants was measured by using Abaqus software.Results The maximum Von-Mises value in maxillary cortical bone with All-on-4 implants in 3 arch forms showed significant differences. In Square model the concentration of stress was advanced with the increasing of implant inclination angle;In Ovoid model, the maximum Von-Mises value was observed at 1 5°in posterior region,and was increased significantly by pasted 15°in anterior region;In Tapered model,the Maximum Von-Mises value was increased greatly at 45°. Conclusion Arch forms have appreciable impact on stress distribution of peri-implant.In Square arch form,the inclination of implant should be avoided;in Ovoid arch form, the inclination angle should be under 15°;in Tapered arch form,the inclination should be under 30°.
ABSTRACT
La Técnica TODO SOBRE -4 (All-on-4) desarrollada por el Dr. Paulo Maló, está basada en la rehabilitación completa de los maxilares con una prótesis fija de carga inmediata sobre 4 implantes adecuadamente distribuidos; 2 implantes angulados posteriores y 2 implantes axiales anteriores, sin la utilización de injertos óseos. En este trabajo presentamos un caso clínico de rehabilitación completa del maxilar superior con la técnica Todo Sobre -4
The All-on-4 technique developed by Dr. Paulo Maló, is based on the full arch rehabilitation of the jaws with a fixed prostheses on four implants immediately loaded and adequately distributed; 2 tilted posterior implants and 2 axial anterior implants without the need of bone grafts. In this work we present a clinical case of full arch rehabilitation of the maxilla with the All-on-4 technique