The All-on-Four Immediate Function Treatment Concept With NobelActive Implants: A Retrospective Study
The All-on-Four treatment concept provides patients with an immediately loaded fixed prosthesis supported by 4 implants. This single-center retrospective study evaluated the concept while using the NobelActive implant (Nobel Biocare, Gothenburg, Sweden). Seven hundred eight implants placed in 165 subjects demonstrated a cumulative survival rate of 99.6% (99.3% in maxilla and 100% in the mandible) for up to 29 months of loading. The definitive prosthesis survival rate was 100%.Abstract
Cumulative survival rate in relation to implant diameter.
Case 1: maxillary and mandibular all-on-Four technique in extraction sites with immediate implant placement. Preoperative computerized tomography scan.
Case 1: maxillary and mandibular All-on-Four technique in extraction sites with immediate implant placement. Figure 3. Extraction sockets in the mandible. Figure 4. All-on-Four surgical guide in situ. Figure 5. Implants in final position. Figure 6. Postoperative radiographs at 4 months. Figure 7. Clinical photograph of patient at 1 year. Figure 8. Postoperative radiographs at 1 year.
Case 2: 50-year history of a severely atrophic edentulous maxilla reconstructed with the All-on-Four technique. Preoperative computerized tomography scan.
Case 2: 50-year history of a severely atrophic edentulous maxilla reconstructed with the All-on-Four technique. Figure 10. Implants in final position. Figure 11. Fixed implant bridge removed to demonstrate soft-tissue health at 1 year. Figure 12. Clinical view at 1 year. Figure 13. Postoperative radiographs at 1 year demonstrating stable bone levels. Figure 14. Postoperative radiographs at 2 years demonstrating stable bone levels.
Case 3: All-on-Four technique in maxillary and mandibular (nonrestorable dentition) extraction sites with immediate implant placement. Figure 15. Preoperative computerized tomography scan. Figure 16. (a, b, c) Preoperative clinical photographs of the terminal nonrestorable dentition. Figure 17. (a) Implants placed in maxilla with abutments and healing caps in position. (b) Implants placed in mandible with abutments and healing caps in position.
Figure 18. Case 3: All-on-Four technique in maxillary and mandibular (nonrestorable dentition) extraction sites with immediate implant placement. Maxillary and mandibular immediate provisional fixed prosthesis in place. Figure 19. Postoperative panoramic radiograph at 4 months. Figure 20. Postoperative radiograph at 15 months demonstrating stable bone levels.
Case 4: edentulous maxilla reconstructed with the All-on-Four technique. Figure 21. Preoperative clinical photograph. Figure 22. Preoperative clinical photograph of the edentulous maxilla. Figure 23. Preoperative panoramic radiograph demonstrating the edentulous maxilla. Figure 24. The abutments and premounted abutment holders adjusting for relative parallelism. Figure 25. (a) The final position of the implants, abutments, and healing caps. (b) The mucoperiosteal flaps repositioned and sutured with 4-0 chromic interrupted sutures.
Case 4: edentulous maxilla reconstructed with the All-on-Four technique. Figure 26. (a, b) The tissue and occlusal views of the all-acrylic fixed provisional implant bridge. Figure 27. Postoperative panoramic radiograph taken immediately after implant placement. Figure 28. Clinical photograph with the definitive prosthesis in place. Figure 29. Postoperative radiographs at 1 year with the definitive fixed implant prosthesis in place.
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