Using the “final-on-four” concept to deliver an immediate metal-resin implant-fixed complete dental prosthesis

Clinical Effect and Aesthetic Observation of All-on-4 Immediate Loading Implant Denture in Severe Periodontitis

Objective

To explore the clinical effect and aesthetics of All-on-4 immediate loading implant denture in severe periodontitis.

Methods

Totally, 60 patients with dentition loss caused by severe periodontitis who were admitted to our hospital from February 2017 to February 2019 were selected. The patients were randomly divided into the observation group (n = 30) and the control group (n = 30) according to different restoration methods. The control group was used in traditional implant restoration treatment, and the observation group was used in All-on-4 immediate loading implant denture restoration. The clinical effect, periodontal index, aesthetic effect, and complications of the two groups were compared, and the levels of serum leptin (LEP), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6) were measured.

Results

The total effective rate of the observation group (83.33%) was higher than that of the control group (60.00%) (P < 0.05). After treatment, the plaque index, gingival sulcus bleeding index, and depth of exploration of the two groups were lower than those before treatment (P < 0.05), and there was no significant difference between the two groups (P > 0.05). After treatment, the serum LEP, TNF-α, CRP, and IL-6 in both groups were lower than before treatment, and the serum LEP, TNF-α, CRP, and IL-6 in the observation group were lower than that in the control group (P < 0.05). The aesthetic rate of teeth in the observation group (90.00%) was higher than that in the control group (66.67%) (P < 0.05). There was no significant difference in the total incidence of complications between the two groups (P > 0.05).

Conclusion

All-on-4 immediate loading implant denture has a good effect in the treatment of severe periodontitis, which is conducive to maintaining periodontal health, reducing the level of inflammation, improving aesthetics, and has high safety.

Using the "One Shot" Concept for Immediate Loading Implant Protocol in Edentulous Patient Rehabilitation with a Fixed Prosthesis: A 6-Year Follow-Up

Immediate-loaded implants with a fixed prosthesis are a viable option for the restoration of edentulous ridges. Several procedures now allow for the fabrication of immediate-loading provisional and definitive prostheses. However, this complex treatment is not accessible to all patients with budget restrictions. By using a unique master model with a single titanium framework prosthesis can simplify and shorten the treatment, as well as reduce costs. After surgical placement of implant fixtures, an interim prosthesis was fabricated using a laser-welded definitive titanium framework. The prosthesis was fitted intraorally following the immediate loading protocols. The master cast model used to fabricate interim prosthesis was conserved and subsequently used in modifying the final prosthesis. After the healing process and complete soft tissue stability, an impression was made to register the clearance between the gingiva and resin. The light silicone material was directly injected under the prosthesis screwed in the mouth. In the master cast model, the stone was eliminated between the implants and a new plaster was poured to modify the crest profile with the posthealing new shape. With this modified model, it is possible to rehabilitate the denture to the new gingival anatomy in 3 to 4 hours and, if necessary, the tooth rearrangement. This "one shot" concept combines the single definitive titanium welded framework and limited laboratory work with a unique master model thereby decreasing the cost and the time of treatment.

Combining guided alveolar ridge reduction and guided implant placement for all-on-4 surgery: A clinical report

Immediate restoration with the all-on-4 concept has become an established treatment option. The technique involves alveoloplasty before implant placement to provide space for the prosthetic components and to provide a platform on which dental implants can be placed in clinical situations where a knife-edge alveolar ridge is present. Guided implant surgery involves the fabrication of a guide by using data from cone-beam computed tomography (CBCT) and implant surgery performed without flap reflection. In the presented technique, a printed cast based on a CBCT is used to fabricate a guide for both alveolar ridge reduction and guided implant surgery. The alveolar ridge reduction and implant surgery are virtually simulated in the laboratory to provide space for the restorative components and to avoid critical anatomic landmarks (mental nerve or perforation of the lingual mandibular plate). The described surgical guide enables guided alveolar ridge reduction and guided implant placement where the implant placement performed in the laboratory can be duplicated clinically during implant surgery.