Abstract
Introduction: In the context of dental implant methods, the all-on-four technique has proven to be beneficial in reducing stress around dental implants and is a very effective treatment option for edentulous patients. Objective: A systematic review was carried out to present the main characteristics and clinical results of the all-in-four technique in implant dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 82 articles were found, 40 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=55.7%>50%. It was concluded that technical knowledge and anatomical understanding in all-on-four mandibular surgery are essential for predictable and consistent surgical results. The all-on-four configuration proved to be biomechanically superior to parallel implants, considering the radial stresses on the implants and cortical bone. All-on-four treatments are based on the insertion of two anterior implants and two angled ones to cover a larger area. Therefore, implant-supported prostheses may have higher success and survival rates. The cost of treatment can be reduced. Chewing stress can also be minimized to a greater extent. It was observed that the lowest stress was observed in both lateral and vertical loads in the peri-implant region