Thomas J. Balshi, DDS, PhD, FACP, Glenn J. Wolfinger, DMD, FACP, Robert W. Slauch, BS, & Stephen F. Balshi, MBE
J Prosthodont. The American College of Prosthodontists J Prosthodont. 23 (2014) 83–88.
Purpose: The purpose of this study was to retrospectively evaluate implant survival rates in patients treated with the All-on-Four™ protocol according to edentulous jaws, gender, and implant orientation (tilted vs. axial). Materials and Methods: All Brånemark System implants placed in patients following the All-on-Four™ protocol in a single private practice were separated into multiple classifications (maxilla vs. mandible; male vs. female; tilted vs. axial) by retrospective patient chart review. Inclusion criteria consisted of any Brånemark System implant placed with the All-on-Four™ protocol from the clinical inception (May 2005) until December 2011. Life tables were constructed to determine cumulative implant survival rates (CSR). The arches, genders, and implant orientations were statistically compared with ANOVA.
Results: One hundred fifty-two patients, comprising 200 arches (800 implants) from May 2005 until December 2011, were included in the study. Overall implant CSR was 97.3% (778 of 800). Two hundred eighty-nine of 300 maxillary implants and 489 of 500 mandibular implants survived, for CSRs of 96.3% and 97.8%, respectively. In male patients, 251 of 256 implants (98.1%) remain in function while 527 of 544 implants (96.9%) in female patients survived. Regarding implant orientation, 389 of 400 tilted implants and 389 of 400 axial implants osseointegrated, for identical CSRs of 97.3%. All comparisons were found to be statistically insignificant. The prosthesis survival rate was 99.0%.
Conclusions: The results from this study suggest that edentulous jaws, gender, and implant orientation are not significant parameters when formulating an All-on-Four™ treatment plan. The high CSRs for each variable analyzed demonstrate the All-on- Four™ treatment as a viable alternative to more extensive protocols for rehabilitating the edentulous maxilla or mandible.