Key takeaways
- In one mandibular series followed 10 to 18 years, cumulative prosthetic survival was 98.8% and implant survival was 93%.
- 149 of 471 patients, 31.6%, were lost to follow-up. Read the 93% next to that.
- Mean marginal bone loss was 1.72 mm at 10 years and 2.32 mm at 15 years.
- A separate review put mean implant survival between 94% and 98% at 72 to 132 months, and asked for larger trials.
| Figure | What limits it |
|---|---|
| Prosthesis survival 98.8% | One clinic's lower jaws, immediate function, 10 to 18 years |
| Implant survival 93% and success 91.7% | 149 of 471 patients (31.6%) were lost to follow-up |
| Mean bone loss 1.72 mm at 10 years and 2.32 mm at 15 years | Means with confidence intervals, not your radiograph |
| Mechanical complications 36.7% | Counted in that series, not a first-week symptom list |
- Cumulative implant survival up to 18 years, mandibular All-on-4, with 31.6% of patients lost to follow-up
- 93%
Mean marginal bone loss in that series was 1.72 mm at 10 years (95% CI 1.59 to 1.85) and 2.32 mm at 15 years (95% CI 1.98 to 2.66).[1]
Not sure which option fits your mouth? Nine questions, no obligation, and a personalized next step.
See if All-on-4 is the question to askWhat did 10 to 18 years of follow-up show?
Maló, de Araújo Nobre, Lopes, Ferro, and Botto reported on 471 patients (286 women and 185 men, mean age 57.7 years), 1,884 implants, and 471 fixed full-arch mandibular prostheses placed with immediate function. Follow-up was 10 to 18 years. Twenty-seven patients had died (5.7%). One hundred forty-nine (31.6%) were lost to follow-up. Cumulative prosthetic survival was 98.8%. Implant cumulative survival was 93% and success was 91.7% up to 18 years.[1]
Previous biological complications had a hazard ratio of 4.43 for implant failure. Biological complications were 11.8% at implant level. Mechanical complications were 36.7%. For marginal bone loss greater than 3 mm, the odds ratios they reported included smoking 2.72, previous failure of a contiguous implant 3.89, and a biological complication 8.11.[1]
A systematic review of the All-on-4 concept found mean cumulative implant survival of 94% to 98% between 72 and 132 months, and prosthesis survival of 99% to 100% at 12 months. The authors did not find a significant difference between axial and tilted implants or between maxilla and mandible. The major prosthetic complication they name is fracture of an acrylic prosthesis. They ask for larger randomized trials with long follow-up.[2]
Why one clinic's series is not your forecast?
The 93% figure is a cumulative survival estimate from one group's lower-jaw patients, after dropping a large share of people from later visits. It does not tell you how long your bridge will last. It does not include a price, and it is not a personal success rate.
People comparing the idea of All-on-4 with staying in dentures can read why people choose All-on-4. The treatment hub is All-on-4 dental implants.
What does maintenance change?
The Maló series linked biological complications with later failure, and linked smoking and prior implant trouble with more bone loss.[1] This page will not turn those associations into a rule for your chart. Smoking and diabetes, as separate pooled analyses, are in dental implants with diabetes or smoking.
Tom Szarski, DD, is the denturist who plans the teeth with the team. The implant surgeon places the implants. How long a prosthesis stays in service is a clinical follow-up question, reviewed against your own radiographs, not against a headline percentage.
Sources
- The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: a longitudinal study with 10 to 18 years of follow-up — Clinical Implant Dentistry and Related Research
- Survival rates of axial and tilted implants in the rehabilitation of edentulous jaws using the All-on-four concept: a systematic review — Journal of Indian Prosthodontic Society
Frequently asked questions
How long did All-on-4 implants last in the longest cited study?
Maló and colleagues followed 471 mandibular All-on-4 patients for 10 to 18 years. Cumulative prosthetic survival was 98.8%. Cumulative implant survival was 93% and implant success was 91.7%. Almost a third of patients were lost to follow-up.
Does 93% apply to me?
No. It is one group's retrospective series of lower jaws, with immediate function. It is not a personal prediction, and it is not an upper-jaw figure.
What complications showed up over those years?
In that series, biological complications were 11.8% at implant level and mechanical complications were 36.7%. Previous biological complications were associated with later implant failure.
