COMPARISON BETWEEN THE ALL-ON-FOUR TECHNIQUE AND COMPLETE DENTURES IN THE REHABILITATION OF PATIENTS WITH ATROPHIC JAWS

Abstract

This study evaluated the viability of the All-on-Four technique for the rehabilitation of completely edentulous patients, particularly those with atrophic maxilla, by comparing its outcomes with those of conventional complete dentures. Total edentulism adversely affects mastication, esthetics, and self-esteem, thereby diminishing quality of life. A systematic review of the MEDLINE and SciELO databases identified studies published between 2021 and 2025 that addressed the use of the All-on-Four technique in completely edentulous patients, including those with atrophic maxilla, compared with conventional complete dentures. Studies lacking full-text availability or published outside the predefined period were excluded. The qualitative synthesis considered functional, esthetic, and psychosocial outcomes, as well as implant- and prosthesis-level success rates. Twenty studies met the inclusion criteria, reporting high success rates for the All-on-Four technique (94% to 98%) over follow-up periods of up to ten years and demonstrating effectiveness in atrophic maxilla. The combination of axially and distally tilted implants optimized load distribution, reduced the need for bone grafting, and accelerated rehabilitation. The technique was associated with significant improvements in masticatory performance—including increased bite force and chewing efficiency—surpassing outcomes achieved with conventional complete dentures. These gains favored dietary adaptation and overall health. Beyond functional advantages, esthetic and psychosocial benefits were observed, with improvements in self-esteem and patient satisfaction. The use of digital surgical guides enhanced placement accuracy and procedural safety, thereby minimizing prosthetic complications. In conclusion, the All-on-Four technique is a safe and effective option for the rehabilitation of completely edentulous patients, particularly those with atrophic maxilla, yielding superior functional, esthetic, and psychosocial outcomes compared with conventional dentures. Further high-quality research with extended follow-up is warranted to consolidate the long-term evidence base.