Patients with severe atrophy of the jaw are not typically considered good candidates for dental implants. However, the introduction of a new type of implant five years ago is challenging that standard. Combined with the All-on-Four concept of inserting the implants, the new implant can benefit a wider range of patients, including those with degeneration of bone in the upper or lower jaw.
The Journal of Oral Implantology reports outcomes of the All-on-Four treatment used with the NobelActive implant. Follow-up evaluations of 227 implants from one to three years after the procedure show a 98.7 per cent implant survival rate.
In the All-on-Four concept, four implants are used to support an acrylic, screw-retained provisional prosthesis, then a final prosthesis about four months later. Although this method uses only four implants, two of them are placed 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 4.0 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.
Featuring tapering, a variable thread, and an inward tapered collar, this implant offers self-drilling capacity and bone compression qualities. High torque values can be reached, giving the implant high initial stability.
Prior studies have found that failed implants using the All-in-Four 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-Four technique brings new treatment possibilities to patients with severe bone deficiencies.