Edentulism has been demonstrated to have negative social and psychological effects on individuals that include adverse impacts
on facial and oral esthetics, masticatory function and speech abilities, that when combined, are translated into significant reductions
in patients’ quality of lives. It is well-known that immediate placement of implants is a challenging surgical procedure that requires
proper treatment planning and surgical techniques. There are several prosthetic options to rehabilitate severely atrophic maxillae
and mandibles have been developed such as conventional complete dentures, implant supported removable and implant supported
fixed prosthesis. Implant supported prosthesis may not be feasible in many conditions because of the vicinity of vital anatomical
structures, poor bone quality and quantity.
The implant technology developed as the all-on-four concept is offered as an alternative to conventional implant applications.
In the all-on-four technique, 4 implants are placed in the inter foraminal region in the mandible and in the pre-maxillary region in
total edentulism cases. An exception is the all-on- Four concept, which uses only 4 implants to support an acrylic, screw-retained
provisional prosthesis delivered on the day of implant placement, followed by a definitive prosthesis approximately 4 months later.
The patient can also be benefited with the immediate rehabilitation of edentulous arches which helps maintaining self-confidence
and quality of life.
Keywords: All on four concept; Dental implant; Tilted implant; Severe atrophy
Abbreviation: CT: Computerized Tomography; Ncm: Newton centimeter ; mm: Millimeter