Bone Level Evaluation Around Implants in All on Four Hybrid Restorations With Different Connections (Radiographic Evaluation)

Patient selection:

Fourteen completely edentulous male patients free from any systemic diseases that would affect bone metabolism, had no history of recent administration of chemotherapy or radiotherapy and no history of para-functional habits will be selected from out-patients clinic.

Grouping of patients:

The first group will include seven patients who will be planned to receive screw retained implant supported mandibular prosthesis with multiunit abutments.

The second group will include seven patients who will be planned to receive screw retained implant supported mandibular prosthesis with OT Equator abutments.

Pre-surgical protocol:

For each patient, upper and lower complete dentures will be constructed. Using dual CBCT scan protocol, stereolithographic surgical guide will be constructed according to virtual implant planning in the software.

Surgical protocol:

The 3D surgical guide will be used to insert four implants in mandibular canines and mandibular first molar positions.

For the first group, multiunit abutments will be screwed to the four implants. For the second group, OT EQUATOR abutments will be screwed to the four implants.

Denture conversion for temporization:

Trans-mucosal abutments will be used to convert the denture to a temporary fixed implant supported restoration and will be screwed on multiunit abutments of the first group and on OT EQUATOR abutments for the second group.

Delivery of final prosthesis:

After three months of implant insertion, the final prosthesis will be constructed and then screwed to the multiunit abutments for the first group and to the OT Equator abutments for the second group.

Radiographic Evaluation:

The DIGORA Optime intraoral sensor and a specially built acrylic template for each patient will be used to take intraoral radiographs with the standardized long cone paralleling technique to measure changes of crestal bone level around each implant. Periods of 0 (immediately after delivery of final prosthesis), 3, 6, and 9 months after delivery of final prosthesis for radiographic evaluation.

Statistical analysis:

Bone loss measurements will be tabulated and statistically analyzed.

Inclusion criteria

• completely edentulous patients
• male patients
• free from any systemic diseases
• no history of recent administration of chemotherapy or radiotherapy
• no history of para-functional habits

Exclusion criteria

• female patients
• diabetic patients and patients with bone metabolism diseases
• history of recent administration of chemotherapy or radiotherapy
• history of para-functional habits
• Heavy smokers.
• Heavy consumption of Alcohol