title: Patient-related and financial outcomes analysis of conventional full-arch rehabilitation versus the All-on-4 concept: a cohort study.
abstract: BACKGROUND
  Patient-related variables such as cost of treatment, length of the treatment period, and comfort provided by the interim prosthesis when treatment planning for full-arch rehabilitation are often neglected in dental publications.
  
  
  METHODS
  Two patient cohorts were followed up longitudinally in this study: the "All-on-4 treatment concept group" and the "historical group." The number of implants, total treatment time, number of surgical procedures, number of sinus grafts, necessity for immediate provisional implants, adjusted cost associated for treatment in each group, and the quality of interim prosthesis were compared.
  
  
  RESULTS
  The total adjusted cost for patients receiving All-on-4 treatment concept averaged at $42,422 ± 3860 (&OV0556;31,392 ± 2856), whereas the mean total adjusted cost for the historical group was $57,944 ± 20,198 (&OV0556;42,879 ± 2113) (P = 0.01). The difference in cost had a mean value of $7307 (&OV0556;5407) per jaw. Factors associated with complexity of treatment and patient comfort, such as the quality of interim prosthesis, number of surgeries, and duration of treatment time, all significantly favored the All-on-4 treatment concept group in comparison with conventional treatment modalities.
  
  
  CONCLUSIONS
  When implant rehabilitation of the total jaw is sought, the All-on-4 treatment concept should be considered the least costly and least time consuming treatment option.
authors.affiliation: *Oral and Maxillofacial Surgeon, ClearChoice Dental Implant Center, Cleveland, OH; Clinical Professor, Case School of Dental Medicine, Case Western Reserve University, Cleveland, OH. †Prosthodontist, ClearChoice Dental Implant Center, Cleveland, Clinical Assistant Professor, Department of Restorative Dentistry, West Virginia University, Morgantown, West Virginia. ‡Resident, Advanced Education Program in Periodontology, Department of Developmental and Surgical Science, University of Minnesota, MN. §Professor and Director, Advanced Education Program in Periodontology, Department of Developmental and Surgical Science, University of Minnesota, MN.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Babbush
authors.forename: Ali
authors.initials: A
authors.lastname: Kanawati
authors.forename: Georgios A
authors.initials: GA
authors.lastname: Kotsakis
authors.forename: James E
authors.initials: JE
authors.lastname: Hinrichs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003757:Dental Implantation / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D003758:Dental Implantation, Endosseous / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D015921:Dental Implants / Q000191:economics* / Q000706:statistics & numerical data; D003794:Dental Restoration, Temporary / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D057893:Immediate Dental Implant Loading / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000191:economics / Q000601:surgery; D013997:Time Factors; D055815:Young Adult
chemical_list: D015921:Dental Implants