{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T07:01:57Z","timestamp":1777014117014,"version":"3.51.4"},"reference-count":53,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This retrospective study analyzed implant survival of immediate implant-supported fixed complete denture (IFCD) treatment options (TOs) based on the level of alveolar atrophy (CC). Records of 882 patients receiving a total of 6042 implants at one private referral clinic between 2004 and 2020 were considered. The mean follow-up period was 3.8 \u00b1 2.7 years. Cumulative implant survival rates (CSRs) were analyzed as a function of CCs and TOs according to Mantel-Haenszel and Mantel-Cox. Hazard risk ratios for implant loss were compared using Cox regression. Confounding factors were identified using mixed Cox regression models. The 2- and 5-year CSRs were 98.2% and 97.9%, respectively. Maxillary 2- and 5-year CSRs were lower (97.7% and 97.3%) compared to mandibular CSRs (99.8% and 98.6%) (p = 0.030 and 0.0020, respectively). The CC did not influence CSRs of IFCDs in the mandible (p = 0.1483 and 0.3014, respectively) but only in the maxilla (p = 0.0147 and 0.0111), where CSRs decreased with increasing atrophy. TOs did not statistically differ in terms of survival rate for a given level of alveolar atrophy. The adaption of IFCD treatments to the level of atrophy and patient-specific risk factors can result in high CSRs, even at different levels of bone atrophy.<\/jats:p>","DOI":"10.3390\/jcm10215167","type":"journal-article","created":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T09:11:32Z","timestamp":1636017092000},"page":"5167","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Implant Survival in Immediately Loaded Full-Arch Rehabilitations Following an Anatomical Classification System\u2014A Retrospective Study in 1200 Edentulous Jaws"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5544-3744","authenticated-orcid":false,"given":"Jo\u00e3o Manuel Mendez","family":"Caram\u00eas","sequence":"first","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal"},{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisbon, Portugal"},{"name":"LIBPhys-FCT UID\/FIS\/04559\/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1966-8281","authenticated-orcid":false,"given":"Duarte Nuno da Silva","family":"Marques","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal"},{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisbon, Portugal"},{"name":"LIBPhys-FCT UID\/FIS\/04559\/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal"}]},{"given":"Gon\u00e7alo Bartolo","family":"Caram\u00eas","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal"}]},{"given":"Helena Cristina Oliveira","family":"Francisco","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal"},{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-237X","authenticated-orcid":false,"given":"Filipe Ara\u00fajo","family":"Vieira","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, 1070-064 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.11607\/jomi.2014suppl.g4.3","article-title":"Implant Loading Protocols for Edentulous Patients with Fixed Prostheses: A Systematic Review and Meta-Analysis","volume":"29","author":"Papaspyridakos","year":"2014","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1111\/j.1600-0501.2010.01915.x","article-title":"Mandibular Implant-Supported Overdentures and Oral Function: Overdentures and Oral Function","volume":"21","author":"Burgers","year":"2010","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1563\/AAID-JOI-D-14-00018","article-title":"Immediate Loading of Dental Implants Inserted in Edentulous Maxillas and Mandibles: 5-Year Results of a Clinical Study","volume":"41","author":"Shigehara","year":"2015","journal-title":"J. Oral Implantol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.ijom.2015.12.001","article-title":"Immediate Loading of Implants Inserted in Edentulous Arches Using Multiple Mucosa-Supported Stereolithographic Surgical Templates: A 10-Year Prospective Cohort Study","volume":"45","author":"Cassetta","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.11607\/ijp.5804","article-title":"Immediate Versus Delayed Loading of Dental Implants Supporting Fixed Full-Arch Maxillary Prostheses: A 10-Year Follow-up Report","volume":"32","author":"Pera","year":"2018","journal-title":"Int. J. Prosthodont."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/clr.13278","article-title":"Immediate Loading vs. Early\/Conventional Loading of Immediately Placed Implants in Partially Edentulous Patients from the Patients\u2019 Perspective: A Systematic Review","volume":"29","author":"Oates","year":"2018","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1111\/j.1600-0501.2009.01741.x","article-title":"Patient-Centered Outcome of Immediately Loaded Implants in the Rehabilitation of Fully Edentulous Jaws","volume":"20","author":"Dierens","year":"2009","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/j.1708-8208.2009.00265.x","article-title":"Immediate Rehabilitation of the Extremely Atrophic Mandible with Fixed Full-Prosthesis Supported by Four Implants: Immediate Implant Therapy for the Atrophic Mandible","volume":"14","author":"Weinstein","year":"2012","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_9","first-page":"162","article-title":"Role of Primary Stability for Successful Osseointegration of Dental Implants: Factors of Influence and Evaluation","volume":"5","author":"Javed","year":"2013","journal-title":"Interv. Med. Appl. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/j.1708-8208.2012.00482.x","article-title":"Immediate Fixed Rehabilitation of the Edentulous Maxilla: A Prospective Clinical and Radiological Study after 3 Years of Loading: Immediate Fixed Maxillary Implant Rehabilitations","volume":"16","author":"Agliardi","year":"2014","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0901-5027(88)80047-X","article-title":"A Classification of the Edentulous Jaws","volume":"17","author":"Cawood","year":"1988","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1563\/AAID-JOI-D-11-00212","article-title":"Implant-Guided Volumetric Analysis of Edentulous Maxillary Bone With Cone-Beam Computerized Tomography Scan. Maxillary Sinus Pneumatization Classification","volume":"38","author":"Tolstunov","year":"2012","journal-title":"J. Oral Implantol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.joms.2009.07.032","article-title":"\u201c13-23-30\u201d Anatomic Approach for Maxillary Full-Arch Implant Reconstruction: A Case Report and Surgical-Prosthetic Considerations","volume":"68","author":"Tolstunov","year":"2010","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"s19","DOI":"10.11607\/jomi.16suppl.g1","article-title":"Bone Augmentation of the Edentulous Maxilla for Implant Placement: A Systematic Review","volume":"31","author":"Aghaloo","year":"2017","journal-title":"Int. J. Oral Maxillofac Implant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/clr.13312","article-title":"Number of Implants Placed for Complete-arch Fixed Prostheses: A Systematic Review and Meta-analysis","volume":"29","author":"Aghaloo","year":"2018","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"29","DOI":"10.7326\/0003-4819-157-1-201207030-00450","article-title":"Effect of Clinical Decision-Support Systems: A Systematic Review","volume":"157","author":"Bright","year":"2012","journal-title":"Ann. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.knosys.2016.04.022","article-title":"Decision Support Systems for Adoption in Dental Clinics: A Survey","volume":"104","author":"Goh","year":"2016","journal-title":"Knowl.-Based Syst."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"375","DOI":"10.17219\/acem\/115083","article-title":"The Ways of Using Machine Learning in Dentistry","volume":"29","author":"Machoy","year":"2020","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_19","first-page":"11","article-title":"Clinical Decision Support System in Dental Implantology","volume":"1","year":"2013","journal-title":"Mefanet J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1532-849X.1999.tb00005.x","article-title":"Classification System for Complete Edentulism","volume":"8","author":"McGarry","year":"1999","journal-title":"J. Prosthodont."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"320","DOI":"10.11607\/ijp.3791","article-title":"Implant-Prosthodontic Classification of the Edentulous Jaw for Treatment Planning with Fixed Rehabilitations","volume":"27","author":"Papadimitriou","year":"2014","journal-title":"Int. J. Prosthodont."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.prosdent.2013.12.023","article-title":"Complete Arch Site Classification for All-on-4 Immediate Function","volume":"112","author":"Jensen","year":"2014","journal-title":"J. Prosthet. Dent."},{"key":"ref_23","first-page":"175","article-title":"A Comprehensive Classification to Full Arch Implant Rehabilitation","volume":"60","year":"2019","journal-title":"Rev. Port. Estomatol. Med. Dent. Cir. Maxilofac."},{"key":"ref_24","first-page":"95","article-title":"Current Interpretations of the Osseointegrated Response: Clinical Significance","volume":"6","author":"Albrektsson","year":"1993","journal-title":"Int. J. Prosthodont."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1111\/jcpe.12890","article-title":"Early and Late Implant Failure of Submerged versus Non-Submerged Implant Healing: A Systematic Review, Meta-Analysis and Trial Sequential Analysis","volume":"45","author":"Troiano","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/cid.12753","article-title":"Implant Failures and Age at the Time of Surgery: A Retrospective Study on Implant Treatments in 4585 Edentulous Jaws","volume":"21","author":"Jemt","year":"2019","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"531","DOI":"10.11607\/ijp.5883","article-title":"Implant Survival in the Edentulous Jaw: 30 Years of Experience. Part II: A Retro-Prospective Multivariate Regression Analysis Related to Treated Arch and Implant Surface Roughness","volume":"31","author":"Jemt","year":"2018","journal-title":"Int. J. Prosthodont."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/clr.12531","article-title":"A Systematic Review and Meta-Analysis of Removable and Fixed Implant-Supported Prostheses in Edentulous Jaws: Post-Loading Implant Loss","volume":"27","author":"Kern","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"s63","DOI":"10.11607\/ijp.7162","article-title":"Different Interventions for Rehabilitation of the Edentulous Maxilla with Implant-Supported Prostheses: An Overview of Systematic Reviews","volume":"34","author":"Messias","year":"2021","journal-title":"Int. J. Prosthodont."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"219","DOI":"10.11607\/ijp.5142","article-title":"Bone Quality and Quantity and Dental Implant Failure: A Systematic Review and Meta-Analysis","volume":"30","author":"Chrcanovic","year":"2017","journal-title":"Int. J. Prosthodont."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/cid.12485","article-title":"Analysis of Risk Factors for Cluster Behavior of Dental Implant Failures: Chrcanovic et Al","volume":"19","author":"Chrcanovic","year":"2017","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"737","DOI":"10.11607\/jomi.7193","article-title":"Immediately Loaded Fixed Full-Arch Implant-Retained Prosthesis: Clinical Analysis When Using a Moderate Insertion Torque","volume":"34","author":"Eckert","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/clr.13600","article-title":"Retrospective Evaluation of Implant-supported Full-arch Fixed Dental Prostheses after a Mean Follow-up of 10 Years","volume":"31","author":"Chrcanovic","year":"2020","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_34","first-page":"693","article-title":"Early Loading of Mandibular Full-Arch Bridges Screw Retained after 1 Week to Four to Five Monotype \u00ae Implants: 3-Year Results from a Prospective Multicentre Study","volume":"19","author":"Arvidson","year":"2008","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1111\/clr.12704","article-title":"Evaluation of Extrashort 4-Mm Implants in Mandibular Edentulous Patients with Reduced Bone Height in Comparison with Standard Implants: A 12-Month Results","volume":"27","author":"Dard","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.bjoms.2016.04.010","article-title":"Does Increasing the Number of Short Implants Reduce Marginal Bone Loss in the Posterior Mandible? A Prospective Study","volume":"54","author":"Tabrizi","year":"2016","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.prosdent.2020.04.013","article-title":"Mandibular Implant-Supported Fixed Complete Dental Prostheses on Implants with Ultrashort and Standard Length: A Pilot Treatment","volume":"126","author":"Schimmel","year":"2021","journal-title":"J. Prosthet. Dent."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/clr.13311","article-title":"Implant Supported Cantilevered Fixed Dental Rehabilitations in Partially Edentulous Patients: Systematic Review of the Literature. Part I","volume":"29","author":"Storelli","year":"2018","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.jdent.2015.03.003","article-title":"Smoking and Dental Implants: A Systematic Review and Meta-Analysis","volume":"43","author":"Chrcanovic","year":"2015","journal-title":"J. Dent."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/jcpe.13257","article-title":"Levels of Smoking and Dental Implants Failure: A Systematic Review and Meta-analysis","volume":"47","author":"Naseri","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1111\/cid.12771","article-title":"The All-on-4 Concept for Full-arch Rehabilitation of the Edentulous Maxillae: A Longitudinal Study with 5-13 Years of Follow-up","volume":"21","author":"Lopes","year":"2019","journal-title":"Clin. Implant. Dent. Relat. Res"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/ID.0000000000000893","article-title":"Distribution of Trabecular Bone Density in the Maxilla and Mandible","volume":"28","author":"Arosio","year":"2019","journal-title":"Implant. Dent."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jcms.2019.01.030","article-title":"Clinical Outcomes of Pterygoid Implants: Systematic Review and Meta-Analysis","volume":"47","author":"Araujo","year":"2019","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_44","first-page":"e531","article-title":"All-on-4\u00ae Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7-Year Clinical and 5-Year Radiographic Retrospective Case Series with Risk Assessment for Implant Failure and Marginal Bone Level: Complete Edentulous Mandible Rehabilitation","volume":"17","author":"Lopes","year":"2015","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1752-7325.1995.tb02355.x","article-title":"Smoking and Oral Health: A Population Survey in Finland","volume":"55","author":"Telivuo","year":"1995","journal-title":"J. Public Health Dent."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"313","DOI":"10.14219\/jada.archive.1998.0205","article-title":"Relationship between tobacco use and self-reported oral hygiene habits","volume":"129","author":"Andrews","year":"1998","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1002\/jbmr.19","article-title":"Uncoupled Angiogenesis and Osteogenesis in Nicotine-Compromised Bone Healing","volume":"25","author":"Ma","year":"2010","journal-title":"J. Bone Min. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/joor.12465","article-title":"Dental Implant Loss in Older versus Younger Patients: A Systematic Review and Meta-Analysis of Prospective Studies","volume":"44","author":"Sendyk","year":"2017","journal-title":"J. Oral Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1111\/clr.12423","article-title":"Bone Formation in Sinus Augmentation Procedures Using Autologous Bone, Porcine Bone, and a 50:50 Mixture: A Human Clinical and Histological Evaluation at 2 Months","volume":"26","author":"Cassetta","year":"2015","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_50","first-page":"S219","article-title":"Augmentation Procedures Using Bone Substitute Materials or Autogenous Bone\u2014A Systematic Review and Meta-Analysis","volume":"7","author":"Schiegnitz","year":"2014","journal-title":"Eur. J. Oral Implant."},{"key":"ref_51","first-page":"787","article-title":"A 10-Year Retrospective Comparative Human Study on Screw-Retained versus Cemented Dental Implant Abutments","volume":"33","author":"Sinjari","year":"2019","journal-title":"J. Biol. Regul. Homeost Agents"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1902\/jop.2017.170238","article-title":"The One Abutment\u2013One Time Protocol: A Systematic Review and Meta-Analysis","volume":"88","author":"Atieh","year":"2017","journal-title":"J. Periodontol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Mangano, C., Mangano, F., Shibli, J., Roth, L., d\u2019Addazio, G., Piattelli, A., and Iezzi, G. (2018). Immunohistochemical Evaluation of Peri-Implant Soft Tissues around Machined and Direct Metal Laser Sintered (DMLS) Healing Abutments in Humans. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15081611"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/21\/5167\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:25:50Z","timestamp":1760167550000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/21\/5167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,4]]},"references-count":53,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["jcm10215167"],"URL":"https:\/\/doi.org\/10.3390\/jcm10215167","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,4]]}}}