Comparative evaluation between the “All on Four” and “Four on Pillars” techniques in 3D virtual planning associated with guided surgery on atrophic jaws
DOI:
https://doi.org/10.33448/rsd-v10i14.22021Keywords:
Bioengineering; Odontology; Dentistry; 3D surgical planning.Abstract
Thorough technical knowledge and anatomical understanding are critical for optimal surgical results. The difficulty of complete maxillary surgery can vary significantly depending on the complexity of the anatomy or bone defect. In this work, we analyze and compare two methods of software-guided planning for the manipulation of dental implants, associated with the All on Four (ALL) and Four on pillars (FOUR) techniques used in patients with atrophic maxillae. Forty-two images of totally edentulous patients were analyzed, and surgical planning was performed using both methods. The average area of the Four on pillars technique is 4.9x (p<0.0001) greater than the average area of the All on four technique, this represents a difference of 489%. This means that, for the same force applied by the jaw, we will have a 4.9x smaller pressure, that is, a better distribution of forces on the jaws. It was not possible to notice a statistical difference between the success proportions (p=0.2542), this means that both techniques have a non-different (similar) success proportion. We conclude that the area of the polygon formed in the Four on pillars surgical plan is larger than in the All on four plan and this results in significantly less pressure on the implants. We also concluded that it was not possible to notice a statistical difference between the proportions of success, which shows that there is no technique with successful performance advantages over the other.
References
Al Yafi, F., Camenisch, B., & Al-Sabbagh, M. (2019). Is Digital Guided Implant Surgery Accurate and Reliable? Dental Clinics, 63(3), 381 – 397.
Alevizakos, V., Mitov, G., Stoetzer, M., & Von See, C. (2019). A retrospective study of the accuracy of template-guided versus freehand implant placement: A nonradiologic method. Oral Surg Oral Med Oral Pathol Oral Radiol. 128(3):220-226. 10.1016/j.oooo.2019.01.009
Anandakrishna, G. N., & Rao, G. (2012). Pterygomaxillary implants: a graftless solution to deficient maxillary bone. J Indian Prosthodont Soc. 12(3):182-186. doi:10.1007/s13191-012-0121-1
Balshi, T. J., Lee, H. Y., & Hernandez, R. E. (1995). The use of pterygomaxillary implants in the partially edentulous patient: a preliminary report. The International journal of oral & maxillofacial implants, 10(1), 89–98.
Balshi, T. J., Wolfinger, G. J., & Balshi, S. F., 2nd (1999). Analysis of 356 pterygomaxillary implants in edentulous arches for fixed prosthesis anchorage. The International journal of oral & maxillofacial implants, 14(3), 398–406.
Brunetti, F. (2008). Mecânica dos fluídos. (2a ed.), Pearson Prentice Hall.
Bidra, A. S., May, G. W., Tharp, G. E., & Chambers, M. S. (2013). Pterygoid implants for maxillofacial rehabilitation of a patient with a bilateral maxillectomy defect. J Oral Implantol. 39(1):91-97. 10.1563/AAID-JOI-D-10-00181
De Rossi, M., Santos, C. M., Migliorança, R., & Regalo, S. C. (2014). All on Four® fixed implant support rehabilitation: a masticatory function study. Clin Implant Dent Relat Res. 16(4):594-600. doi:10.1111/cid.12031
Dérig (2021). Dérig - Implantes do Brasil. <https://derig.com.br/en/>.
Durkan, R., Oyar, P., & Deste, G. (2019). Maxillary and mandibular all-on-four implant designs: A review. Nigerian journal of clinical practice, 22(8), 1033–1040. https://doi.org/10.4103/njcp.njcp_273_18
Greenberg A. M. (2017). Advanced dental implant placement techniques. Journal of Istanbul University Faculty of Dentistry, 51(3 Suppl 1), S76–S89. https://doi.org/10.17096/jiufd.17594
Implantviewer (2021). Implantviewer – Planejamento Cirúrgico Com Tomografia. Versão 3.5, 2021. <http://www.annesolutions.com.br/implantviewer/>
Lund, T. W., & Marshall W. (1993). Use of Osseointegrated Implants to Support a Maxillary Denture for a Patient with Repaired Cleft Lip and Palate. The Cleft Palate-Craniofacial Journal 30(4)418–20. 10.1597/1545-1569_1993_030_0418_uooits_2.3.co_2.
Maló, P., Rangert, B., & Nobre, M. (2003). "All-on-Four" immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study. Clinical implant dentistry and related research, 5 Suppl 1, 2–9. https://doi.org/10.1111/j.1708-8208.2003.tb00010.x
Peñarrocha, M., Carrillo, C., Boronat, A., & Peñarrocha, M. (2009). Retrospective study of 68 implants placed in the pterygomaxillary region using drills and osteotomes. The International journal of oral & maxillofacial implants, 24(4), 720–726.
Rasband, W. S. (2018). ImageJ, U. S. National Institutes of Health, Bethesda, Maryland, USA, https://imagej.nih.gov/ij/, 1997-2018.
Salinas-Goodier, C., Rojo, R., Murillo-González, J., & Prados-Frutos, J. C. (2019). Three-dimensional descriptive study of the pterygomaxillary region related to pterygoid implants: A retrospective study. Sci Rep. (1):16179. doi:10.1038/s41598-019-52672-x
Schneider, D., Sancho-Puchades, M., Schober, F., Thoma, D., Hämmerle, C., & Jung, R. (2019). A Randomized Controlled Clinical Trial Comparing Conventional and Computer-Assisted Implant Planning and Placement in Partially Edentulous Patients. Part 3: Time and Cost Analyses. Int J Periodontics Restorative Dent. 39(3):e71-e82. 10.11607/prd.4146
Siadat, H., Rokn, A., & Beyabanaki, E. (2018). Full Arch All-on-4 Fixed Implant-Supported Prostheses with 8.5 Years of Follow-Up: A Case Report. J Dent (Tehran). 15(4): 259-265.
Smidt, R., Schneider, L. E., Nacanecy, M. M., Ozcamur A. (2018). Reabilitação de maxila edêntula atrófica utilizando um novo conceito biomecânico Four on Pillars. INPerio 3(5): 857-863.
Soto-Penaloza, D., Zaragozí-Alonso, R., Penarrocha-Diago, M., & Penarrocha-Diago, M. (2017). The all-on-four treatment concept: Systematic review. Journal of clinical and experimental dentistry, 9(3), e474–e488. https://doi.org/10.4317/jced.53613
Tannyhill, R. J. 3rd, & Jensen, O. T. (2019). Computer Simulation and Maxillary All-on-Four Surgery. Oral Maxillofac Surg Clin North Am. 31(3):497-504. doi:10.1016/j.coms.2019.03.011
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Marcelo do Lago Pimentel Maia; Daniel Souza Ferreira Magalhães
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
