الفهرس 
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Abstract
Purpose: The aim of this study was the clinical and radiographic evaluation of maxillary implants after rehabilitation of edentulous maxilla complicated with combination syndrome with All On Four® Implant supported fixed prosthesis. Materials and methods: Sex patients with total edentulous maxillary ridges and partially edentulous mandibular ridges (class I Kennedy classification) received maxillary fixed prosthesis supported on four implants placed according to All On Four® concept and mandibular distal extension RPD. Clinical evaluation of maxillary implants was made at in term of plaque index, gingival index, pocket depth and implant stability at time of prosthesis insertion (T0), 6 months (T1) and 12 months later (T2) while radiographic evaluation at T1 and T2 were performed in terms of peri-implant alveolar bone loss using standardized periapical radiographs for anterior and posterior implants. Results: Clinical evaluation showed that plaque scores, pocket depth significantly increased with advance of time for anterior implants and posterior implants. No significant difference in gingival scores between observation times was noted for anterior implants and posterior implants. No significant difference of plaque scores, gingival score, pocket depth and implant stability between anterior and posterior implants was noted at all observation times. (P>.005). For radiographic evaluation vertical bone loss significantly increased at T12 compared to T6 for anterior implants and posterior implants. However vertical bone loss for anterior implants was significantly higher than posterior implants at T6 and T12. (P<.001). Conclusion : Within the limits of this study regarding the small patient sample and the short follow up time frame, it could be concluded that; All On Four® Implant supported fixed prosthesis for rehabilitation of edentulous maxilla complicated with combination syndrome was associated with favorable clinical and radiographic peri-implant tissues responses after one year. However, it should be noted that anterior implants were at higher risk of increased peri-implant bone loss compared to posterior implants.