Dental Tribune Europe

Dental implant enables more options for atrophic patients

By Dental Tribune International
July 17, 2013

ZURICH, Switzerland/CLEVELAND, Ohio, USA: Patients with severe atrophy of the jaw are not typically considered good candidates for dental implants. However, according to the latest research, a new type of implant introduced five years ago offers a solution. Combined with the All-on-4 concept for restoring edentulous jaws, the implant can benefit a wider range of patients, including those with degeneration of the bone in the upper or lower jaw.

Researchers from the Cleveland ClearChoice Dental Implant Center reported on the results of the All-on-4 treatment used with the NobelActive implant by Swiss-based dental manufacturer Nobel Biocare. After one to three years of follow-up of 227 implants, they found a cumulative implant survival rate of 98.7 per cent at the end of three years.

In the All-on-4 concept, four implants are used to support an acrylic, screw-retained provisional prosthesis, then a final prosthesis about four months later. Two of the implants are distally tilted in areas where bone height, nerve proximity, or other conditions make it impossible to place the implant axially. This tilting allows the placement of longer implants that have good anchorage in the best positions for prosthetic support.

Previously, standard practice called for dental implants of at least 4 mm in diameter. For tilted implants in particular, this was considered the smallest diameter that could guarantee sufficient anchorage. The NobelActive implant, introduced in 2008, made it possible to use a 3.5 mm diameter implant for patients with atrophic jaws.

With a variable thread and an inward-tapered collar, this tapered implant is self-drilling and condenses bone gradually. High torque values can be achieved, giving the implant high initial stability.

Previous studies have found that failed implants using the All-on-4 method were a result of soft bone and lower insertion torque values. The combination of a 3.5 mm diameter implant and the All-on-4 technique offers new treatment possibilities for patients with severe bone deficiencies.

The study, titled “A new approach to the All-on-Four treatment concept using narrow platform NobelActive implants”, was published in the June issue of the Journal of Oral Implantology.

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