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Updated: May 27, 2026
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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
A prospective study on implants installed with flapless-guided surgery using the all-on-four concept in the mandible
R A Landázuri-Del Barrio1, J Cosyn, W N De Paula
1Department of Oral Diagnosis and Surgery, Araraquara Dental School, UNESP-Univ. Estadual Paulista, Araraquara, São Paulo, Brazil.
Clinical Oral Implants Research
|November 19, 2011
Summary
Flapless all-on-four surgery in the mandible showed a 90% implant survival rate but frequent technical complications. Immediate loading requires prosthesis fabrication based on actual implant impressions, not virtual positions.
Area of Science:
- Dental Implantology
- Oral Surgery
- Prosthodontics
Background:
- Limited clinical data exists for flapless-guided surgery in the mandible using the all-on-four concept.
- Documentation on immediate loading with pre-fabricated bridges in this context is scarce.
Purpose of the Study:
- To document the clinical and radiographic outcomes of flapless-guided all-on-four surgery in the mandible.
- To identify and report complications associated with this surgical approach and immediate loading.
Main Methods:
- A cohort of 16 systemically healthy patients underwent flapless-guided all-on-four surgery in the mandible.
- Clinical and radiographic data, including complications, were collected at 3, 6, and 12 months post-surgery.
Main Results:
- The overall implant survival rate was 90%, with a trend towards higher failure in short implants.
- Mean bone loss after 12 months was 0.83 mm.
- Technical complications, primarily prosthesis misfit, affected 15 out of 16 patients.
Conclusions:
- Immediate loading of dental implants in the mandible requires the implant bridge to be fabricated from actual impressions taken during surgery.
- Relying on virtual implant positions for pre-fabricated bridge fabrication can lead to significant misfit and complications.