All-on-4 Treatment of Highly Atrophic Mandible With Mandibular V-4: Report of 2 Cases

This report contains a technical note and 2 case reports of the "all-on-4" treatment of the highly resorbed mandible. The use of 4 angled implants directed toward the midline of the mandible at 30 degrees angles provides the advantage of increased implant length and adequate insertion torque for immediate temporization. The technique engages or perforates the inferior border with implants placed in a spaced distribution to avoid fracture of the mandible. The technique is proposed as an alternative to bone graft reconstruction. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1503-1509, 2009