The NobelGuide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Prospective Report on Medium- and Long-Term Outcomes

Background There is a need for long‐term studies on complete edentulous flapless rehabilitations. Purpose This study aimed to evaluate the long‐term outcomes of the rehabilitation of completely edentulous jaws for immediate function with the All‐on‐4® treatment concept using a computer‐guided surgical protocol (NobelGuide®, Nobel Biocare, Göteborg, Sweden). Materials and Methods This prospective clinical study included 23 totally edentulous patients rehabilitated between February 2005 and May 2006 with 92 implants with the All‐on‐4 treatment concept using NobelGuide. Outcome measures were implant survival, marginal bone loss at 1, 3, and 5 years, and the incidence of mechanical and biological complications. Survival was calculated using life‐table analysis. Results Two dropouts occurred. The cumulative implant survival rate was 96.6% at 5 years of follow‐up. Prosthetic survival was 100%. The average marginal bone loss was 1.7 mm (standard deviation 1.4 mm) at 1 year, 1.7 mm (standard deviation 0.9 mm) at 3 years, and 1.9 mm (standard deviation 1.1 mm) at 5 years. Seven patients experienced fracture of the definitive prosthesis (6 patients were heavy bruxers), and abutment screw loosening occurred in 2 patients. Two implants in 2 patients showed peri‐implant pathology. Conclusions Within the limitations of this study, it is possible to conclude that this treatment modality for completely edentulous jaws is safe and predictable with good long‐term outcomes.