The NobelGuide<sup>®</sup> All‐on‐4<sup>®</sup> Treatment Concept for Rehabilitation of Edentulous Jaws: A Retrospective Report on the 7‐Years Clinical and 5‐Years Radiographic Outcomes
Bibliographic record
Abstract
Abstract Background There is a necessity of studies documenting the long‐term outcome of full‐arch flapless rehabilitations. Purpose To evaluate the 7 years implant and prosthesis survival rate and 5‐years marginal bone loss of full‐arch fixed prosthetic rehabilitations supported by implants in immediate function with the All‐on‐4® treatment concept using a computer guided surgical protocol (NobelGuide®, Nobel Biocare). Materials and Methods This retrospective clinical study included 111 edentulous patients (n = 53 bruxers; n = 21 smokers; n = 59 systemically compromised), rehabilitated between February 2005 and November 2010 with 532 implants with the All‐on‐4® treatment concept using NobelGuide®. Outcome measures were implant and prosthesis survival, marginal bone loss at 5‐years and the incidence of mechanical and biological complications. Survival was calculated using life‐table analysis. Inferential analysis was performed to compare the difference in marginal bone loss between axial and tilted implants. Results Sixteen patients were lost to follow‐up. The implant cumulative survival rate was 94.5% at 7 years. Prosthetic survival was 97.8% (n = 3 prosthetic failures). The average (standard deviation) marginal bone loss at 5 years was 1.3 mm (1.06 mm) overall, 1.27 mm (1.02 mm) for tilted implants and 1.34 mm (1.1 mm) for axial implants (p < .001). Ninety‐one patients experienced complications in the provisional prostheses (n = 47 patients who were bruxers; n = 25 patients with implant‐supported rehabilitation as opposing dentition) ranging from prosthetic fracture (n = 66 patients) to abutment or prosthetic screw loosening (n = 74 patients). Thirty‐three patients experienced complications in the definitive prostheses (all exclusive to patients who were bruxers or had implant‐supported rehabilitations as opposing dentition) ranging from acrylic‐resin prosthetic/crown fracture (n = 23 patients) to abutment or prosthetic screw loosening (n = 10 patients). Twenty‐five patients (22%) registered peri‐implant pathology. Conclusions Within the limitations of this study, it is possible to conclude that this treatment modality for completely edentulous jaws is possible with high long‐term survival outcomes. Bruxing and smoking habits had a negative impact on implant failure, mechanical, and biological complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".