All‐on‐4® Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7‐Year Clinical and 5‐Year Radiographic Retrospective Case Series with Risk Assessment for Implant Failure and Marginal Bone Level

Clinical Implant Dentistry and Related Research - Tập 17 Số S2 - 2015
Paulo Maló1, Miguel Gus2, Armando Lopes1, Ashley Ferro1, Inês Gravito1
1Oral Surgery Department Maló Clinic Lisbon Portugal
2Research and Development Department Maló Clinic Lisbon Portugal

Tóm tắt

AbstractBackground

Studies are needed to evaluate long‐term outcomes of the All‐on‐4® treatment concept (Nobel Biocare AB) for rehabilitation of edentulous mandibles by assessing marginal bone levels and risk indicators for implant failure.

Purpose

To evaluate 7‐year clinical outcomes and 5‐year radiographic outcomes of the All‐on‐4 treatment concept.

Materials and Methods

This retrospective case series included patients admitted for implant rehabilitations in the mandible, who were followed for 7 years clinically and 5 years radiographically. Primary outcome measures were cumulative prosthetic and implant survival using patient as the unit of analysis (Kaplan‐Meier product limit estimator). Secondary outcome measure was marginal bone level (MBL) at 5 years. Variables associated with implant failure were analyzed using the Cox proportional hazards regression model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Binary logistic regression was used to compute odds ratio (OR) with 95% CIs for variables associated with MBL ≥2.8 mm at 5 years.

Results

A total of 324 patients (194 women, 130 men, average age = 58.9 years) were rehabilitated with 1,296 implants supporting 324 full‐arch fixed immediately loaded mandibular prostheses. Sixty‐four patients (19.8%) were lost to follow‐up. Prosthetic survival was 323/324 (99.7%), and 14 patients lost 18 implants, with an estimated cumulative survival rate of 95.4% at 7 years. Variables associated with implant failure were smoking (HR = 5.28; 95% CI: 1.33, 20.91]) and the learning curve effect (0.69 < HR < 0.33 for more experienced levels). Mean MBL at 5 years was 1.81 mm (95% CI: 1.70, 1.92), and smoking was associated with MBL ≥2.8 mm (OR = 2.4; 95% CI: 1.02, 5.62).

Conclusions

The high implant and prosthetic survival rates and excellent MBL outcome confirm the predictability and safety of the All‐on‐4 treatment concept over a longer term than previously reported.

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Tài liệu tham khảo

Esposito M, 2009, Interventions for replacing missing teeth: different times for loading dental implants, Cochrane Database Syst Rev, 10.1002/14651858.CD003878.pub4

Schnitman PA, 1997, Ten‐year results for Brånemark implants immediately loaded with fixed prostheses at implant placement, Int J Oral Maxillofac Implants, 12, 495

10.1097/00008505-199700620-00002

10.1034/j.1600-0501.1999.100102.x

10.1111/j.1708-8208.2000.tb00108.x

10.1111/j.1708-8208.2003.tb00179.x

10.1563/0-730.1

10.1111/j.1708-8208.2005.tb00043.x

10.1016/j.joms.2007.05.009

Krekmanov L, 2000, Tilting of posterior mandibular and maxillary implants for improved prosthesis support, Int J Oral Maxillofac Implants, 15, 405

10.1111/j.1708-8208.2003.tb00010.x

10.1016/j.coms.2011.01.007

10.1016/j.coms.2011.02.002

Agliardi E, 2010, Immediate loading of full‐arch fixed prostheses supported by axial and tilted implants for the treatment of edentulous atrophic mandibles, Quintessence Int, 41, 285

10.11607/ijp.3602

10.1111/cid.12068

10.1016/S1532-3382(12)70031-3

10.14219/jada.archive.2011.0170

10.1111/jopr.12089

10.1111/cid.12180

10.1016/j.jclinepi.2007.11.008

Albrektsson T, 1986, The long‐term efficacy of currently used dental implants: a review and proposed criteria of success, Int J Oral Maxillofac Implants, 1, 11

10.1016/S0278-2391(16)31192-2

10.1177/154405910508400109

10.1111/j.1708-8208.2000.tb00004.x

10.1111/j.1708-8208.2010.00288.x

10.4317/medoral.17674

Monje A, 2012, Marginal bone loss around tilted implants in comparison to straight implants: a meta‐analysis, Int J Oral Maxillofac Implants, 27, 1576

10.1016/S0022-3913(07)60006-7

10.1016/j.jpor.2010.04.004

Fazi G, 2011, Three‐dimensional finite element analysis of different implant configurations for a mandibular fixed prosthesis, Int J Oral Maxillofac Implants, 26, 752

10.1111/j.1600-051X.2007.01083.x

10.1111/j.1600-0501.2005.01244.x

Roos‐Jansåker AM, 2006, Nine‐ to fourteen‐year follow‐up of implant treatment. Part III: factors associated with peri‐implant lesions, J Clin Periodontol, 3, 296, 10.1111/j.1600-051X.2006.00908.x

Friberg B, 2008, A 5‐year prospective multicenter study on 1‐stage smooth‐surface Brånemark System implants with early loading in edentulous mandibles, Int J Oral Maxillofac Implants, 23, 481

Pomares C, 2010, A retrospective study of edentulous patients rehabilitated according to the “all‐on‐four” or the “all‐on‐six” immediate function concept using flapless computer‐guided implant surgery, Eur J Oral Implantol, 3, 155

Flichy‐Fernández AJ, 2009, Bisphosphonates and dental implants: current problems, Med Oral Patol Oral Cir Bucal, 14, E355

Serra MP, 2008, Oral implants in patients receiving bisphosphonates: a review and update, Med Oral Patol Oral Cir Bucal, 13, E755

Kasai T, 2009, The prognosis for dental implants placed in patients taking oral bisphosphonates, J Calif Dent Assoc, 37, 39, 10.1080/19424396.2009.12222946

10.1016/j.joms.2007.09.019

10.1902/jop.2007.060239

10.1111/j.1600-0501.2009.01772.x

Kumar MN, 2012, Survival of dental implants in bisphosphonate users versus non‐users: a systematic review, Eur J Prosthodont Restor Dent, 20, 159

10.1016/j.joms.2009.09.017

10.1563/AAID-JOI-D-11-00234

10.14219/jada.archive.2008.0016

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Clinical Implant Dentistry and Related Research

Tập 17 Số S2

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