Surgical phase of rehabilitation treatment in the maxilla with implants using the All On Four technique: case report.

Abstract

Introduction: For a long time, the main alternative for oral rehabilitation treatment in individuals with tooth loss was limited to the use of removable total and partial dentures. However, with the advent of implantology, several techniques for implant installation have emerged, allowing the production of implant-supported prostheses, which bring numerous benefits to the patient when compared to their predecessors. Case report: Patient Z. B. S., female, 55 years old, 66 kg, with no allergies or systemic comorbidities, has been using a complete denture (denture) for approximately 28 years. She attended the teaching clinic of Faculdade Estácio São Paulo - FSP to have this upper mucosa-supported total denture replaced. After analyzing the patient's bone characteristics, 4 implants were installed in the maxilla using the “All-on-Four” technique to support a fixed total denture. Discussion: The option for a prosthesis supported by implants is a good choice when one wants to avoid bone resorption that occurs in removable prostheses, in addition to obtaining greater stability. In some cases, such as the one presented in this study, the amount of bone structure is insufficient for the installation of these implants, a problem that can be solved by using the technique discussed, where the implants are tilted to target areas where there is sufficient bone structure. Conclusion: Oral rehabilitation in edentulous patients using the all-on-four technique in its clinical protocol has proven to be a viable option for patients with atrophic maxilla. However, bone quality is a factor that can alter this planning, as seen in this clinical case, crucial for the impossibility of immediate loading.