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Abstract
Edentulism is an important public health problem that causes numerous sequelae and significantly reduces the patient's quality of life, both in functional and aesthetic terms. Tooth loss of the upper arch may be accompanied by maxillary atrophy, which hinders the rehabilitation process, since it prevents the performance of procedures that depend on a good amount of local bone mass. The present study is a narrative literature review that aims to describe the use of the all-on-4 technique in the rehabilitation of atrophic maxilla in edentulous patients. Thus, one of the approaches for better rehabilitation of the edentulous atrophic maxilla is the all-on-4 technique, a surgical procedure that uses four implants to anchor the total prosthesis of the upper or lower arch. The adequate angulation of the implants during the technique results in a larger surface for anchoring the fixed prosthesis, which presents great stability and excellent aesthetic standard. It is a minimally invasive and relatively low-cost procedure that brings satisfactory results in most cases of edentulism with maxillary atrophy, with advantages that include predictability, shorter procedure execution time, reduction of posterior cantilever and high biomechanical stability, in addition to reduced cost and shorter recovery time. However, it is a difficult method to perform that requires good planning and pre-surgical elaboration, besides being contraindicated in cases of hematological dyscrasias, diabetes, immunosuppression and chronic diseases. Its realization is done in stages that involve selection of the case; analysis of the feasibility of applying the protocol; case planning; choice of implant sites; placement of the implants and, finally, the prosthetic phase. In the vast majority of cases the post-procedure inflammatory signs are reduced and the survival of the implants is long. Thus, it can be concluded that the rehabilitation of edentulism with atrophic maxilla by the all-on-4 technique is an effective approach that allows the edentulous patient to recover both the functions of chewing, swallowing and speech, as well as improve the aesthetic aspect of the face.
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