A prospective study on implants installed with flapless-guided surgery using the all-on-four concept in the mandible

Authors

  • R. A. Landázuri-Del Barrio,

    1. Department of Oral Diagnosis and Surgery, Araraquara Dental School, UNESP—Univ. Estadual Paulista, Araraquara, São Paulo, Brazil
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  • J. Cosyn,

    1. Department of Periodontology & Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
    2. Department of Periodontology, School of Dental Medicine, Free University of Brussels (VUB), Brussels, Belgium
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  • W. N. De Paula,

    1. Department of Oral Diagnosis and Surgery, Araraquara Dental School, UNESP—Univ. Estadual Paulista, Araraquara, São Paulo, Brazil
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  • H. De Bruyn,

    1. Department of Periodontology & Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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  • E. Marcantonio Jr

    Corresponding author
    • Department of Oral Diagnosis and Surgery, Araraquara Dental School, UNESP—Univ. Estadual Paulista, Araraquara, São Paulo, Brazil
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Corresponding author:

Dr Elcio Marcantonio Júnior

Rua Humaitá 1680

2 andar. CEP 14801-903 – Araraquara

SP, Brazil

Tel.: + 55 16 3301 6369

Fax: + 55 16 3301 6369

e-mail: elciojr@foar.unesp.br

Abstract

Aim

Clinical data are scarce on flapless-guided surgery in the mandible using the all-on-four concept. In addition, limited documentation exists on the latter under immediate loading conditions with a pre-fabricated implant bridge. The aim was to provide detailed documentation focusing on clinical and radiographic outcome and complications.

Material and methods

Sixteen systemically healthy non-smoking patients (10 women, 6 men, average age 59 years) with sufficient bone volume in the mandible were operated via flapless-guided surgery using the all-on-four concept. Clinical and radiographic data and complications were registered at 3, 6 and 12 months.

Results

The overall implant survival rate was 90% with a trend for higher failure of short implants (P = 0.098). The mean bone level after 12 months of function was 0.83 mm with a maximum of 1.07 mm. Technical complications were common (15/16 patients). These mainly related to a misfit between the pre-fabricated prosthesis and abutment(s) (13/16 patients).

Conclusion

If immediate loading of implants is pursued fabrication of the implant bridge should be based on actual impression of the implants at the time of surgery and not on their virtual position.

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