Clinical evidence and Science 41 KEY TAKE OUTS: FIXED RESTORATIONS ON FOUR IMPLANTS The restoration of the edentulous mandible with four implants supporting fixed distal cantilevered prostheses showed very high survival and success rates up to five years follow-up irrespective of the time of implant placement and the implant direction in the jaw (axial, tilted). With appropriate hygienic measures and regular follow-up visits these restorations may be successful also for the long-term. Lastly, the same study team evaluated patient specific risk factors affecting the peri-implant marginal bone loss in full-arch restorations supported by four implants in the mandible (16). They found a time- depending reduction of the bone and additionally, a significant correlation between smoking, underlying cardiovascular disease or rheumatic disorder, presence of plaque and alterations of peri-implant marginal bone. Other factors like age, gender, diabetes, position of implants, etc. showed no influence. The survival rate of implants and prostheses was 100% after three years in situ. COMFOUR® System: Occlusally screw-retained prosthetics The COMFOUR® System is indicated for several treatment options as a multivaried concept with options for occlusal screw-retained bar, single tooth, and bridge restorations on straight and angled bar abutments. It offers the possibility for immediate and comfortable dentures. Beretta et al. (2021) and Schnutenhaus et al. (2018) described in their overview work including case reports the use of the system in combination with the digital workflow in complete edentulous situations (17, 18). Both authors planned the implant positions using CBCT scans and a software and printed surgical guides to place CONELOG® SCREW-LINE implants guided. Berretta et al. used a cast-free process with intraoral scanning to plan and produce the provisional restoration with CAD/CAM while Schnutenhaus chose to use casts for scanning the oral situation. After guided placement of four or six implants in both jaws the straight or angled bar abutments were immediately placed and provisionally restored only few hours later. After a standard healing period of three to six months the definitive restoration was placed. Both reports confirmed a successful immediate restoration of the patients with the COMFOUR® System which increases the patients’ comfort and quality of life. Ongoing clinical studies may further confirm the success with the COMFOUR® System. KEY TAKE OUTS: COMFOUR® System The COMFOUR® System especially in combination with a digital workflow allowed a successful immediate restoration of the patients and increased the patients’ quality of life in case reports. PROSTHETIC RESTORATIONS: SCIENTIFICALLY BASED TREATMENT OPTIONS
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