Graftless Surgical Protocol
Edentulous patients as well as individuals with a terminal dentition who want a fixed prosthetic rehabilitation face time-consuming, expensive and uncomfortable bone grafting procedures. For patients and dental clinicians treating them, the perceived complexity of rehabilitation is perhaps one of the most difficult obstacles to overcome on the road to treatment acceptance. The All-on-4® treatment concept represents a streamlined approach to treatment with elimination of grafting and utilizing minimal armamentarium available in most surgical offices. However, simplicity of the concept does not always lead to ease of execution or success of overall treatment. To be successful at All-on-4® one must recognize the absolute requirements that must be satisfied in all cases.
This chapter addresses the surgical principles of the All-on-4™ protocol and gives recommendations to guide the practitioner when completing surgery.
Dr. Ana Ferro is a key opinion leader for Nobel Biocare.
- 3.Krekmanov L, Kahn M, Rangert B, Lindström H. Tilting of posterior mandibular and maxillary implants of improved prosthesis support. Int J Oral Maxillofac Implants. 2000;15:405–14.Google Scholar
- 5.Maló P, de Araújo Nobre M, Lopes A, Ferro A , Gravito I. Complete edentulous rehabilitation using an immediate function protocol and an implant design featuring a straight body, anodically oxidized surface, and narrow tip with engaging threads extending to the apex of the implant: a 5-year retrospective clinical study. Int J Oral Maxillofac Implants 2016; 7 (1).Google Scholar
- 6.Maló P, Nobre M, Lopes A, Rodrigues R. Preliminary report on the outcome of tilted implants with longer lengths (20–25 mm) in low-density bone: one-year follow-up of a prospective cohort study. Clin Implant Dent Relat Res. 2013 doi: https://doi.org/10.1111/cid.12444.
- 7.Malo P, de Araújo Nobre M, Lopes A, Ferro A, Moss S. Extramaxillary surgical technique: clinical outcome of 352 patients rehabilitated with 747 zygomatic implants with a follow-up between 6 months and 7 years. Clin Implant Dent Relat Res. 2013;17(Suppl 1):e153–62. https://doi.org/10.1111/cid.12147.CrossRefPubMedGoogle Scholar
- 12.Lopes A, Maló P, de Araújo Nobre M, Sánchez-Fernández E, Gravito I. The Nobelguide® all-on-4® treatment concept for rehabilitation of edentulous jaws: 7-year clinical and 5-year radiographic retrospective. Clin Implant Dent Relat Res. 2016;19(2):233–44. https://doi.org/10.1111/cid.12456.CrossRefPubMedGoogle Scholar