COMMON MISCONCEPTIONS ABOUT FULL ARCH RECONSTRUCTION

Ever since Dr. Branemark coined "osseointegration," implant dentistry continued to evolve. Today's breakthrough implant designs, 3D imaging and digital precision CAD/CAM, allow us to enter the era of All-on-4 technology. Below are answers to questions surrounding the proven All-on-4 technique.

1. Bone grafting of posterior segments is often necessary for full-arch implant reconstruction.

It has been widely thought in order to reconstruct the entire dental arch, implants must be placed in the position of the most posterior tooth planned to avoid cantilevers, and must be placed perpendicular to the occlusal plane. This usually requires bone grafting procedures, most commonly sub-antral bone grafts (sinus lifts) in the maxilla and autogenous block grafts in the mandible. By utilizing the All-on-4 (AO4) immediate function technique which incorporates angled implants, grafting rarely, if ever, is necessary. This provides for more cost effective treatment, greatly reduced treatment time, and enhanced patient appreciation.

2. A need of 5-6 implants are required for full arch fixed mandibular reconstruction, and 6-8 implants for full arch fixed maxillary reconstruction.

In the days before predictable implant dentistry was a reality, it was accepted treatment to place a full arch "roundhouse" bridge which was supported by 4 natural tooth abutments, the first molars and canine teeth. Long term studies have shown without a doubt that 4 stable, strategically placed implants can support a full arch (1st molar occlusion) restoration with a high degree of predictability and long term success equal to other, more complex methods of implant reconstruction. A team of European clinicians credited with popularizing this technique - the AO4 technique. They have treated more than 7,000 arches in the last 15 years with success rates of 98% for individual implants and 100% for prostheses. Following strict protocols, Eon Clinics' clinicians have been able to replicate this high success rate for hundreds of satisfied patients. (over)

3. Implants must integrate for 4-6 months prior to loading.

Based on the protocol developed by Dr. Per Ingvar Branemark, it is common for implants to be allowed to integrate prior to loading. Over the past several years advances in implant surface preparation and implant design have allowed for a reduction in the recommended integration period, with immediate loading receiving FDA approval in 2006. Eon Clinics' surgical-prosthetic team is among the most experienced in the country in providing immediate function full arch implant restorations. We can assist you in being able to offer this exciting, life-changing treatment to your patients too. With advanced training that we will provide at no cost, you can become one of our Certified Clinical Partners and add this practice building technique to your clinical armamentarium.

4. Implants must be loaded axially.

Like many commonly accepted axioms in implant dentistry, this too has been disproven. In an article published in the Journal of Oral and Maxillofacial Surgery by Block, et al1, the authors reviewed 9 separate studies involving 482 angled implants in 238 patients. Follow-up ranged from 1-12 years. The success rate of angled versus axially loaded implants was virtually identical (96.47% vs. 96.9% respectively). Our experienced team of prosthodontists and surgeons routinely utilize angled implants as part of the AO4 protocol to deliver predictable, highly-successful immediate function full arch implant restorations.

1 Nongrafting Implant Options for Restoration of the Edentulous Maxilla, Michael S. Block, Christopher J. Haggerty, G. Rawleigh Fisher, Journal of Oral and Maxillofacial Surgery, April 2009 (Vol. 67, Issue 4, Pages 872-881)