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Background:
There is little evidence from randomised clinical trials (RCT) or systematic reviews on the preferred or best number of implants to be used for the support of a fixed prosthesis in the edentulous maxilla or mandible, and no consensus has been reached.
Aim/Hypothesis:
To compare the clinical and radiological outcomes of edentulous patients rehabilitated according to the ‘all on four’ or the ‘all on six’ immediate function concept.
Material and Methods:
Twenty-eight edentulous patients and twelve patients presenting failing dentition randomly received 4 (n=20) or 6 (n=20) implants to support a cross arch fixed dental prosthesis. A total of 200 implants were inserted. All the implants were immediately loaded. Last follow-up were scheduled at 5 years post-loading. The primary outcome measures were the success rates of the implants and prostheses. Secondary outcome measures were the occurrence of any surgical and prosthetic complications during the entire follow-up, and vertical peri-implant marginal bone level changes.
Results:
No drop-out occurred. Seven implants failed at the 5-year follow-up examination. Six implants failed in the all-on-6 group (5%), while 1 implant failed in the all-on-4 group (1.25%). No prosthesis failed. Both group experienced some technical and biologic complications with no differences between them. All-on-4 treatment concept showed a slightly risk of complications during osseointegration period (P=0.19; RR=1.7; 95% CI 0.7 - 4.2), while, the all-on-6 treatment concept showed a higher risk of implant failure during the entire follow-up (P=0.30; RR=3; 95% CI 0.3 - 24.6). The overall marginal bone level changes from baseline to the 5-year follow-up was not statistically different between the all-on-4 (1.71±0.42 mm) and the all-on-6 (1.51±0.36 mm) groups (P=0.12). Nevertheless, the marginal bone level changes between 48 and 60 months were statistically significant different, with lower value for the all-on-6 group (0.14±0.06 versus 0.09±0.04; P=0.01).
Conclusions and clinical implications:
The results of this research suggest that both treatment concepts could be a viable and predictable treatment option for the rehabilitation of complete edentulous patients in the medium term, both with possible complications. All-on-4 treatment concept showed a trend of a slightly higher bone resorption whit time, but lower implant failure. Further long term randomized controlled study are needed to confirm this results.
Background:
There is little evidence from randomised clinical trials (RCT) or systematic reviews on the preferred or best number of implants to be used for the support of a fixed prosthesis in the edentulous maxilla or mandible, and no consensus has been reached.
Aim/Hypothesis:
To compare the clinical and radiological outcomes of edentulous patients rehabilitated according to the ‘all on four’ or the ‘all on six’ immediate function concept.
Material and Methods:
Twenty-eight edentulous patients and twelve patients presenting failing dentition randomly received 4 (n=20) or 6 (n=20) implants to support a cross arch fixed dental prosthesis. A total of 200 implants were inserted. All the implants were immediately loaded. Last follow-up were scheduled at 5 years post-loading. The primary outcome measures were the success rates of the implants and prostheses. Secondary outcome measures were the occurrence of any surgical and prosthetic complications during the entire follow-up, and vertical peri-implant marginal bone level changes.
Results:
No drop-out occurred. Seven implants failed at the 5-year follow-up examination. Six implants failed in the all-on-6 group (5%), while 1 implant failed in the all-on-4 group (1.25%). No prosthesis failed. Both group experienced some technical and biologic complications with no differences between them. All-on-4 treatment concept showed a slightly risk of complications during osseointegration period (P=0.19; RR=1.7; 95% CI 0.7 - 4.2), while, the all-on-6 treatment concept showed a higher risk of implant failure during the entire follow-up (P=0.30; RR=3; 95% CI 0.3 - 24.6). The overall marginal bone level changes from baseline to the 5-year follow-up was not statistically different between the all-on-4 (1.71±0.42 mm) and the all-on-6 (1.51±0.36 mm) groups (P=0.12). Nevertheless, the marginal bone level changes between 48 and 60 months were statistically significant different, with lower value for the all-on-6 group (0.14±0.06 versus 0.09±0.04; P=0.01).
Conclusions and clinical implications:
The results of this research suggest that both treatment concepts could be a viable and predictable treatment option for the rehabilitation of complete edentulous patients in the medium term, both with possible complications. All-on-4 treatment concept showed a trend of a slightly higher bone resorption whit time, but lower implant failure. Further long term randomized controlled study are needed to confirm this results.
Background:
There is little evidence from randomised clinical trials (RCT) or systematic reviews on the preferred or best number of implants to be used for the support of a fixed prosthesis in the edentulous maxilla or mandible, and no consensus has been reached.
Aim/Hypothesis:
To compare the clinical and radiological outcomes of edentulous patients rehabilitated according to the ‘all on four’ or the ‘all on six’ immediate function concept.
Material and Methods:
Twenty-eight edentulous patients and twelve patients presenting failing dentition randomly received 4 (n=20) or 6 (n=20) implants to support a cross arch fixed dental prosthesis. A total of 200 implants were inserted. All the implants were immediately loaded. Last follow-up were scheduled at 5 years post-loading. The primary outcome measures were the success rates of the implants and prostheses. Secondary outcome measures were the occurrence of any surgical and prosthetic complications during the entire follow-up, and vertical peri-implant marginal bone level changes.
Results:
No drop-out occurred. Seven implants failed at the 5-year follow-up examination. Six implants failed in the all-on-6 group (5%), while 1 implant failed in the all-on-4 group (1.25%). No prosthesis failed. Both group experienced some technical and biologic complications with no differences between them. All-on-4 treatment concept showed a slightly risk of complications during osseointegration period (P=0.19; RR=1.7; 95% CI 0.7 - 4.2), while, the all-on-6 treatment concept showed a higher risk of implant failure during the entire follow-up (P=0.30; RR=3; 95% CI 0.3 - 24.6). The overall marginal bone level changes from baseline to the 5-year follow-up was not statistically different between the all-on-4 (1.71±0.42 mm) and the all-on-6 (1.51±0.36 mm) groups (P=0.12). Nevertheless, the marginal bone level changes between 48 and 60 months were statistically significant different, with lower value for the all-on-6 group (0.14±0.06 versus 0.09±0.04; P=0.01).
Conclusions and clinical implications:
The results of this research suggest that both treatment concepts could be a viable and predictable treatment option for the rehabilitation of complete edentulous patients in the medium term, both with possible complications. All-on-4 treatment concept showed a trend of a slightly higher bone resorption whit time, but lower implant failure. Further long term randomized controlled study are needed to confirm this results.
Background:
There is little evidence from randomised clinical trials (RCT) or systematic reviews on the preferred or best number of implants to be used for the support of a fixed prosthesis in the edentulous maxilla or mandible, and no consensus has been reached.
Aim/Hypothesis:
To compare the clinical and radiological outcomes of edentulous patients rehabilitated according to the ‘all on four’ or the ‘all on six’ immediate function concept.
Material and Methods:
Twenty-eight edentulous patients and twelve patients presenting failing dentition randomly received 4 (n=20) or 6 (n=20) implants to support a cross arch fixed dental prosthesis. A total of 200 implants were inserted. All the implants were immediately loaded. Last follow-up were scheduled at 5 years post-loading. The primary outcome measures were the success rates of the implants and prostheses. Secondary outcome measures were the occurrence of any surgical and prosthetic complications during the entire follow-up, and vertical peri-implant marginal bone level changes.
Results:
No drop-out occurred. Seven implants failed at the 5-year follow-up examination. Six implants failed in the all-on-6 group (5%), while 1 implant failed in the all-on-4 group (1.25%). No prosthesis failed. Both group experienced some technical and biologic complications with no differences between them. All-on-4 treatment concept showed a slightly risk of complications during osseointegration period (P=0.19; RR=1.7; 95% CI 0.7 - 4.2), while, the all-on-6 treatment concept showed a higher risk of implant failure during the entire follow-up (P=0.30; RR=3; 95% CI 0.3 - 24.6). The overall marginal bone level changes from baseline to the 5-year follow-up was not statistically different between the all-on-4 (1.71±0.42 mm) and the all-on-6 (1.51±0.36 mm) groups (P=0.12). Nevertheless, the marginal bone level changes between 48 and 60 months were statistically significant different, with lower value for the all-on-6 group (0.14±0.06 versus 0.09±0.04; P=0.01).
Conclusions and clinical implications:
The results of this research suggest that both treatment concepts could be a viable and predictable treatment option for the rehabilitation of complete edentulous patients in the medium term, both with possible complications. All-on-4 treatment concept showed a trend of a slightly higher bone resorption whit time, but lower implant failure. Further long term randomized controlled study are needed to confirm this results.