Combining All-on-4 treatment with CT-guided technology: technique and report of three cases.

No longer merely a concept for the future, the use of digital technologies in dentistry has become common practice today. Computed tomography (CT)-guided dental implant surgery has greatly expanded over the past decade as concepts and techniques have become increasingly refined and more implant manufacturers have adapted their implant systems to these new technologies. The All-on-4® technique for dental implant placement and restoration, while developed some two decades ago, has recently generated increased interest as a highly functional, esthetic, cost-effective alternative for a large group of patients who could benefit from a full-arch, implant-supported fixed restoration.

The all on 4 shelf: mandible.

The use of full arch alveolar reduction as an aide to doing All on 4 implant restoration in the mandible is presented. The osteoplasty is described as a flat "shelf" on which to place the restoration. The shelf approach is used to establish optimal implant position and angulation as well as to define anatomy to maximize implant fixation for immediate load prosthetics.

The All-on-4 shelf: maxilla.

All-on-4 treatment is facilitated by bone reduction to create prosthetic restorative space, establish maximum anterior posterior spread of implants, and to avoid pneumatized sites. Unlike a reduction alveloplasty for denture placement, the All-on-4 shelf enables optimal surgical prosthetic management of implant placement for the fixed hybrid prosthesis.