From the 1960s to early 1980s, research on dental implants peaked. Prior to this period, dental implants were mainly used to treat simple cases, but patients left without any teeth at all with severe bone loss was still a challenge.
When complete tooth loss is the main problem, dentures enable the individual to chew and smile with a full set of teeth. The titanium implant surface is treated with special surface roughening techniques for better integration with the jawbone. Full arch (full jaw) implant-supported fixed dentures are made of either zirconia or porcelain crowns secured onto titanium dental implants which enable the patient chew properly with a trustworthy esthetics.
The restoration of a jaw, with partial or complete missing teeth, using load-bearing implants has proven to be a dependable treatment option over time. The survival rate has shown to be 94.7–99.4% over the last 5 years. The success of implants and implant-supported prostheses depend on the proper treatment plan.
Dental restoration with implant retained full arch prostheses (All-on-4 or All-on-6) is often restricted by a lack of residual bone or poor bone quality. The lower sinus pockets and the mandibular nerve also present challenges when restoring missing teeth or full extraction candidate patients due to gum disease or extensive tooth decay. In more complex cases, several treatment options are available to make implant placement possible, including guided bone regeneration, split crest technique, sinus lift, osteogenic distraction, or bone blocking. However, these procedures make the treatment more complicated, technique sensitive, expensive and time consuming.
When bone is lacking and extensive bone augmentation surgeries are rejected by the patient or the dentist, due to harder and longer healing period, cost and time, short implants offer an alternative to advanced bone augmentation surgeries.
Another option is to place tilted rear implants. This treatment modality places the implants in preexisting bone, improving bone anchorage and prosthetic support. Tilting the rear implants may have other advantages such as the possibility of placing longer implants, which increases the bone-implant contact area especially for primary stability which enables immediate implant placement. It also provides better load distribution and avoids long cantilevers. Using this technique, the fixed provisional prostheses are delivered to the patient in the same or the next day of surgery.
This option enables the dentist to use only 4 to 6 implants supporting a long bridge containing 10 to 14 dental crowns when restoring a patient with complete tooth loss. A full arch (full jaw) implant supported dental bridge will look, feel, and function like natural teeth. Imitating the last gum tissue as well gives the opportunity to provide better esthetic results as the crowns will be in harmony with the newly constructed gum.
