Evaluation of Dental Implant Stability Regarding All-on-4 Concept Utilizing Two Different Angles

Abstract

Background: The “All-on-4” technique using 4 implants that has gained popularity in full arch edentulism
cases in recent years was presented as a modern technique in implant-denture rehabilitation by Malo in
Lisbon, Portugal, for the first time in 2003 and the all-on-four concept that began to be used in atrophic full
arch mandibular and in the maxilla in 2005 has emerged.
Aim: evaluation of dental implant stability in relation to All-on-4 concept.
Materials and Methods: This was a clinical prospective comparative study organized from February 2019
to March 2020 in the College of Dentistry Teaching Hospital, Department of Oral & Maxillofacial Surgery/
Dental Implant Unit/University of Baghdad. A total of 15 Iraqi patients aged 41-73 years, 9 males & 6
females were enrolled in this study receiving 80 Dental implants (All-on-4 concept). Patients classified into
two groups, group A (All-on-4 with 2 anterior axial and 2 posterior with angulation of 17°) and group B
(All-on-4 with 2 anterior axial and 2 posterior with angulation of 30°). For both, the surgical site of dental
implant was examined for the hard and soft tissues clinically and radiographically utilizing OPG and CBCT.
Results: The mean of ISQ values obtained in this study at each time point in the total dental implant,
axially placed and angled implant stability demonstrated significant increase (P = 0.000, 0.031 and 0.004)
respectively at different times. There was a significant increase in the mean stability of axial and angled
implants concerning males (P = 0.001 and P =0.002) respectively than females. Significant correlation
between implant stability and the regions at the three times periods. There was a significant difference in
angled implants stability between different intervals (P = 0.001) in patients >50y. Success of dental implants
95.24%.
Conclusion: All-on-4–style full-arch dental implant procedures have one of the highest success rates of
dental treatment; the dental implant stability had significant effect in mandible in comparison to maxilla.
There was irrelevant clinical analysis result in comparison to the statical analysis in relation to stability with
different variables.