Titanium Versus Nano-Carbon CAD/CAM Frameworks for All-on-4 Implant Supported Hybrid Prosthesis.

Titanium Versus Nano-Carbon CAD/CAM Frameworks for All-on-4 Implant Supported Hybrid Prosthesis. A Study of Peri-implant Tissue Changes and Prosthetic Complications

This clinical study compares two CAD/CAM framework materials, titanium and nano-carbon fiber-reinforced composite, used in mandibular All-on-4 implant-supported hybrid prostheses. Ten completely edentulous patients are randomly allocated into two equal groups. The study evaluates peri-implant soft tissue health, changes in marginal bone levels,and prosthetic complications over an 12-month follow-up period.

Completely edentulous patients receive four mandibular implants according to the All-on-4 concept, with two anterior axial implants and two posterior tilted implants placed anterior to the mental foramina. Patients are randomly allocated to receive either a CAD/CAM-milled titanium framework or a nano-carbon fiber-reinforced framework. Clinical follow-up includes assessment of modified plaque index, modified gingival index, probing depth, and bleeding index. Marginal bone level changes are assessed radiographically at 6 and 12 months after insertion of the fixed prosthesis. Prosthetic complications are also evaluated.

Inclusion Criteria:

• * Completely edentulous patients requiring mandibular implant-supported rehabilitation.

  • Adequate bone quantity and quality in the mandibular interforaminal region for implant placement.
  • Adequate restorative space for an implant-supported hybrid prosthesis.
  • Healthy oral mucosa and acceptable oral hygiene.
  • Patients medically fit to undergo implant surgery.
  • Ability and willingness to attend the scheduled follow-up visits and provide informed consent.

Exclusion Criteria:

• Systemic conditions or medical contraindications that could interfere with implant surgery or healing.
• History of radiotherapy to the head and neck region.
• Smoking.
• Alcohol abuse.
• Bruxism or clenching habits.
• Any local condition that could compromise implant placement or the planned prosthetic rehabilitation.