Rehabilitation of severely atrophic maxilla with protocol type prosthesis using the All-on-Four technique

Abstract

Currently, there is still a large number of patients with total edentulism and in need of oral rehabilitation. There are numerous factors that are associated with tooth loss, however, bone atrophy is one of the aspects that causes the most difficulty in rehabilitation treatment. Patients with edentulous and atrophic jaws often require grafts and maxillary sinus lifting, but with the advent of the All-on-Four anchorage technique, which aims at rehabilitation with osseointegrated implants and total fixed prostheses supported by four implants, consisting of two in the inclined posterior region and two vertical anterior regions, rehabilitation is achieved with lower surgical morbidity, avoiding bone grafts and maxillary sinus lifting. The contraindications of the technique are related to patients with morbidity, the use of some medications and parafunctional habits. The present clinical case reported the rehabilitation of a female patient, 65 years old, with hypertension. During the treatment, the All-on-Four anchorage technique was used with inclined posterior implants touching the anterior wall of the maxillary sinus bilaterally and straight anterior implants, rehabilitating a completely atrophic maxilla, associated with a total metaloplastic prosthesis on implants. In this way, the technique demonstrated high success rates when it comes to locking tilted implants and anchoring stability, making it an effective treatment.