As the number of older adults increases, more people are facing a reduced quality of life because of tooth loss. Edentulism is common among the elderly, and one survey estimates that 37 million Americans will need dentures by 2020. With this increasing demand comes an increasing need to offer a better solution.

An article in the current issue of the Journal of Oral Implantology reports on an alternative treatment to dentures. The "All-on-Four" therapy uses four implants to support a fixed prosthesis, and the patient's new teeth can be put in place the day of surgery.

When compared with patients who have received implant dentals therapy, those with dentures have shown only a marginal improvement in quality of life, according to clinical studies. These patients report pain, discomfort, poor stability, and difficulty eating. Dental clinicians see the need to offer replacements for natural teeth that allow greater satisfaction and improved quality of life for their patients.

The All-on-Four treatment maximizes the use of available bone and allows immediate functionality. Four implants are placed two near the front and two near the back of the dental area. These support a fixed, full-arch prosthesis that is put in place the same day as the surgery. The success of this therapy is judged not only by its comfort and usability for the patient, but also by its longevity.

The authors evaluated the survival of the All-in-Four treatment for a 29-month period using the NobelActive implant from Sweden's Nobel Biocare. This implant dentals features a tapered body and variable thread design. Other All-on-Four implant designs have reported high survival rates between 92 percent and 100 percent.

In this study, 165 patients, with a mean age of 59 years, received 708 implants. No significant difference was found between the survival rates of implants in the maxilla and mandible jaws. Overall, the survival rate was 99.6 percent, with only three implants failing.