Maxilar Fixed rehabilitation: All on four, All on six. Comparative study
Introduction: The rehabilitation of fully edentulous patients with whole fixed prostheses over implants is a viable option that allows us to meet the patient's expectations regarding stability, retention, function and aesthetic requirements for each patient. However, this prosthesis can be supported by 4 or 6 implants.
Method: A 63-year-old female patient, her motive for consultation is to finish her oral rehabilitation. She presents a temporary fixed superior prosthesis on 5 implants placed before the maxillary sinus, to the tomographic inspection it was possible to observe 1 implant fenestrated by the vestibular part and in a bad position. The current prosthesis presented two bilateral distal cantilever teeth, presenting a short-term biomechanical risk. Therefore it was decided to remove the fenestrated implant and to place 2 implants of 4.1 x 8mm and 4.1 x 10mm at the level of the first bilateral maxillary molar, to eliminate the cantilever avoiding the stress generated towards the anterior implants.
Results: With the placement of 2 implants at the first molars level, it was possible to avoid the cantilevers and occlusal overload present in the prosthesis on 4 implants, allowing to leave a mutually protected occlusal scheme on 6 implants.
Conclusions: It has been reported in the literature that there is a higher survival rate of both implants and implants over prosthesis when supported by at least 6 splinted implants and avoiding distal cantilevers as much as possible.