Dr. Ryne Johnson
, prosthodontist and managing partner of Newton Wellesley Dental Partners
recently participated in the American College of Prosthodontics annual meeting in San Diego where he discussed the All-on-4® treatment concept
. It provides edentulous and soon-to-be edentulous patients with an efficient and effective restoration using four dental implants
to support an immediately-delivered full-arch prosthesis. Dr. Johnson has been called a pioneer in the synergistic use of computers in implant dentistry. His first case, using a CT scan generated model was performed in 1988.
After the first dental implant patient was treated in the 1980s, a discussion began around the optimal number of implants needed to anchor a fixed dental prosthesis in edentulous patients. Some clinicians tended to install as many implants as possible, often one per tooth. Others argued that biomechanically, only four or even three were needed. Only long-term clinical data could provide answers.
At the forefront
The records of the early patients of P-I Brånemark allowed for an early retrospective study. After a 10-year observation period, the survival rates were demonstrated to be the same for restorations with four and six implants assuming that the bone levels and distribution of implants were ideal. The challenge of advanced resorption remained, however. Because it is not possible in many cases to insert distal implants without grafting and/or nerve lateralization, the concept of tilting the two distal implants was introduced.
In 2003, the concept of immediate loading (placing a dental prosthesis on implants the same day the implants are placed) of four implants in edentulous lower—and soon after also upper—jaws with two tilted distal implants. This one-stage procedure substantially reduced the costly and time-consuming bone grafting procedures, number of surgeries and healing time.
The success continues
In an early reported a cumulative survival rate of 96.7% for implants and 100% for prostheses at up to 3-year follow up.2 Since then, he and others have repeatedly reproduced high survival rates for both upper and lower jaws. Today, the All-on-4® treatment concept is used around the world with similar high survival rates and patient satisfaction that is enhanced by limited costs.
Dr. Johnson, with his in-office periodontist, has done hundreds of implant cases with outstanding results. To arrange a consultation with Dr. Johnson, contact Newton Wellesley Dental Partners.
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Original article and artwork: www.nobelbiocare.com