Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants

Clin Implant Dent Relat Res. 2012 Jun;14(3):434-41. doi: 10.1111/j.1708-8208.2009.00265.x. Epub 2010 Feb 11.


Purpose: To prospectively assess the outcome of immediate rehabilitation of extremely atrophic mandibles by a full-arch fixed bridge anchored to four implants.

Material and methods: Twenty patients with edentulous mandibles were included in the study. Each patient received a full-arch fixed bridge supported by two axial and two distal tilted implants. Prosthetic loading was applied within 48 hours of surgery. Patients were scheduled for follow-up every 6 months up to 2 years and annually until 5 years. Radiographic evaluation of marginal bone level change was performed at 1 year.

Results: All patients were followed for a minimum of 1 year (range 20-48 months, mean 30.1 months). No failures were recorded to date. The 1-year implant survival rate and prosthesis success rate were 100%. Marginal bone loss around axial and tilted implants was similar at 12-month evaluation, being, respectively, 0.6 ± 0.3 (standard deviation) mm and 0.7 ± 0.4 mm. High patient's level of satisfaction was recorded for function, phonetics, and aesthetics.

Conclusion: This technique could be considered a viable treatment option for the rehabilitation of the atrophic mandible.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Alveolar Bone Loss / pathology
  • Alveolar Bone Loss / rehabilitation*
  • Alveolar Bone Loss / surgery
  • Computer-Aided Design
  • Dental Abutments
  • Dental Implantation, Endosseous / methods*
  • Dental Prosthesis Design
  • Dental Prosthesis Retention
  • Dental Prosthesis, Implant-Supported*
  • Dental Restoration Failure
  • Dental Restoration, Temporary
  • Female
  • Humans
  • Immediate Dental Implant Loading*
  • Jaw, Edentulous / pathology
  • Jaw, Edentulous / rehabilitation
  • Jaw, Edentulous / surgery*
  • Male
  • Mandible / diagnostic imaging
  • Mandible / pathology
  • Mandible / surgery*
  • Middle Aged
  • Patient Satisfaction
  • Prospective Studies
  • Radiography
  • Surveys and Questionnaires
  • Time Factors
  • Tooth Socket / surgery