title: The NobelGuide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Prospective Report on Medium- and Long-Term Outcomes.
abstract: BACKGROUND
  There is a need for long-term studies on complete edentulous flapless rehabilitations.
  
  
  OBJECTIVE
  This study aimed to evaluate the long-term outcomes of the rehabilitation of completely edentulous jaws for immediate function with the All-on-4® treatment concept using a computer-guided surgical protocol (NobelGuide®, Nobel Biocare, Göteborg, Sweden).
  
  
  METHODS
  This prospective clinical study included 23 totally edentulous patients rehabilitated between February 2005 and May 2006 with 92 implants with the All-on-4 treatment concept using NobelGuide. Outcome measures were implant survival, marginal bone loss at 1, 3, and 5 years, and the incidence of mechanical and biological complications. Survival was calculated using life-table analysis.
  
  
  RESULTS
  Two dropouts occurred. The cumulative implant survival rate was 96.6% at 5 years of follow-up. Prosthetic survival was 100%. The average marginal bone loss was 1.7 mm (standard deviation 1.4 mm) at 1 year, 1.7 mm (standard deviation 0.9 mm) at 3 years, and 1.9 mm (standard deviation 1.1 mm) at 5 years. Seven patients experienced fracture of the definitive prosthesis (6 patients were heavy bruxers), and abutment screw loosening occurred in 2 patients. Two implants in 2 patients showed peri-implant pathology.
  
  
  CONCLUSIONS
  Within the limitations of this study, it is possible to conclude that this treatment modality for completely edentulous jaws is safe and predictable with good long-term outcomes.
authors.affiliation: Department of Oral Surgery, Maló Clinic, Lisbon, Portugal.
authors.forename: Armando
authors.initials: A
authors.lastname: Lopes
authors.affiliation: Department of Oral Surgery, Maló Clinic, Lisbon, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Maló
authors.affiliation: Research and Development, Maló Clinic, Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: de Araújo Nobre
authors.affiliation: Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Sanchez-Fernández
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: fixed implant prosthesis; flapless implant surgery; immediate function