title: A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up.
abstract: BACKGROUND
  Immediate-function implants have become an accepted alternative for fixed restoration protocols in edentulous mandibles on the basis of documented high success rates. The All-on-4 concept (Nobel Biocare, Göteborg, Sweden), a surgical and prosthetic protocol for immediate function involving the use of four implants to support a fixed prosthesis in patients with completely edentulous mandibles, represents one of these protocols. The authors conducted a study to document long-term follow-up of the All-on-4 concept.
  
  
  METHODS
  This longitudinal study included 245 patients with a total of 980 immediate-function implants (four per patient), all placed in the anterior region, to support fixed full-arch mandibular prostheses. The inclusion criterion was having an edentulous mandible, or a mandible with hopeless teeth, in need of fixed implant restorations.
  
  
  RESULTS
  A total of 21 implants failed in 13 patients, giving cumulative patient-related and implant-related success rates of 94.8 percent and 98.1 percent, respectively, at five years, and 93.8 percent and 94.8 percent, respectively, with up to 10 years of follow-up. The prostheses' survival rate was 99.2 percent with up to 10 years of follow up.
  
  
  CONCLUSIONS
  The results support the conclusion that use of the All-on-4 immediate-function implant concept in completely edentulous mandibles is viable in the long term.
  
  
  CONCLUSIONS
  High prosthesis survival rates can be achieved by the use of four implants to support a full-arch fixed prosthesis in the mandible.
authors.affiliation: Malo Clinic Lisbon, Lisboa, Portugal. mnobre@maloclinics.com
authors.forename: Paulo
authors.initials: P
authors.lastname: Malo
authors.forename: Miguel
authors.initials: M
authors.lastname: de Araújo Nobre
authors.forename: Armando
authors.initials: A
authors.lastname: Lopes
authors.forename: Steve M
authors.initials: SM
authors.lastname: Moss
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Molina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible; D008875:Middle Aged; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D015921:Dental Implants