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The all-on-four treatment concept: a systematic review
Sebastian B M Patzelt1, Oded Bahat, Mark A Reynolds
1Department of Prosthodontics, School of Dentistry, University Hospital, Freiburg, Germany; Department of Periodontics, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, USA.
Clinical Implant Dentistry and Related Research
|April 9, 2013
Summary
The All-on-4 treatment concept shows promising short-term survival rates for implants and prostheses. Further high-quality studies are needed to confirm long-term clinical outcomes.
Area of Science:
- Dentistry
- Oral Implantology
- Prosthodontics
Background:
- The All-on-4 treatment concept is a popular approach for full-arch rehabilitation.
- Evaluating its efficacy is crucial for evidence-based clinical practice.
Purpose of the Study:
- To systematically review survival rates of implants and fixed dental prostheses (FDPs) using the All-on-4 concept.
- To assess temporal changes in proximal bone levels associated with this treatment.
- To identify factors influencing treatment outcomes.
Main Methods:
- A systematic review of English and German publications was conducted.
- Databases searched included MEDLINE, Cochrane Library, and Google, with hand searches of bibliographies.
- Data extraction and quality assessment were performed independently, followed by weighted least-squared analysis.
Main Results:
- Thirteen studies involving 4,804 implants and 1,201 FDPs were analyzed.
- Mean cumulative survival rates at 36 months were 99.0% for implants and 99.9% for prostheses.
- Average bone loss was 1.3 mm at 36 months, with no significant differences between arches or implant placements.
Conclusions:
- The All-on-4 treatment concept demonstrates favorable short-term outcomes.
- Current evidence is limited by study quality and a lack of long-term data (≥5 years).
- Randomized controlled trials adhering to CONSORT guidelines are recommended for future research.