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    • Effect of alveolar bone recontouring of mandibular atrophied ridge on clinical and radiographic outcomes of implants supporting All on 4 fixed restorations. A two- years clinical trial

    Hosam El Dein Said Hesain
    Lecturer Oral and Maxillofacial Surgery, Faculty of Dentistry, Delta University

    Purpose: This study aimed to evaluate the influence of alveolar bone recontouring of mandibular atrophied ridge on outcomes of implants supporting All on 4 fixed restorations. Materials and methods: Six edentulous participants (study group) with inadequate buccolingual ridge width (knife edge ridge) received alveolar ridge recontouring (osteoplasty) before implant placement. Control group consisted of 6 patients with normal ridge width (with no need of osteoplasty) who were case matched to study group. Four implants were inserted in both groups according to the All on 4 protocol and the implants were immediately loaded with fixed acrylic prosthesis. After 3 months final prosthesis was delivered. Clinical (survival rate, pocket depth, and implant stability) and radiographic (crestal bone loss) outcomes were measured at baseline, 3 months, 6 months, 12 months and 24 months after implant insertion. Results: The survival rate was 97.9% and 100% in control and study groups respectively without significant difference between groups. For both groups, probing depths significantly increased from baseline to 6 months, then significantly decreased at 12 months. For control group, implant stability significantly decreased from baseline to 3 months, then significantly increased from 3 months to 6 months, then significantly increased later. In study group, implant stability did not differ between baseline, 3 months and 6 months, then increased significantly at 12 months. Crestal bone loss significantly increased from base line to 12 months. No significant difference in pocket depth, implant stability and bone loss were observed between 12 and 24 months. Study group had significant higher pocket depth and implant stability than control group, while control group had significant higher crestal bone loss than study group. Conclusion: Within the limitation of this study, alveolar bone recontouring (osteoplasty) of mandibular knife edge ridge before insertion of implants according to the All on 4 concept has improved clinical and radiographic outcomes compared to implant insertion without osteoplasty as it was associated with excellent implant survival rate, increased implant stability and reduced crestal bone loss. However, it was associated with increased pocket depth in the first 6 months.

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