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Clin Implant Dent Relat Res. 2012 Jun;14(3):434-41. doi: 10.1111/j.1708-8208.2009.00265.x. Epub 2010 Feb 11.

Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants.

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Centre for Research in Oral Implantology, Department of Health Technologies, Istituto Ortopedico Galeazzi I.R.C.C.S., University of Milan, Milan, Italy.



To prospectively assess the outcome of immediate rehabilitation of extremely atrophic mandibles by a full-arch fixed bridge anchored to four implants.


Twenty patients with edentulous mandibles were included in the study. Each patient received a full-arch fixed bridge supported by two axial and two distal tilted implants. Prosthetic loading was applied within 48 hours of surgery. Patients were scheduled for follow-up every 6 months up to 2 years and annually until 5 years. Radiographic evaluation of marginal bone level change was performed at 1 year.


All patients were followed for a minimum of 1 year (range 20-48 months, mean 30.1 months). No failures were recorded to date. The 1-year implant survival rate and prosthesis success rate were 100%. Marginal bone loss around axial and tilted implants was similar at 12-month evaluation, being, respectively, 0.6 ± 0.3 (standard deviation) mm and 0.7 ± 0.4 mm. High patient's level of satisfaction was recorded for function, phonetics, and aesthetics.


This technique could be considered a viable treatment option for the rehabilitation of the atrophic mandible.

[Indexed for MEDLINE]

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