Objectives: The treatment plan is responsible for the design, number and position of the implants so the purpose of this study was to radiographically evaluate the success of two treatment options to overcome anatomical obstacles in resorbed mandible involving installing distal short implants versus All on 4 concept. Materials and Methods: Fourteen completely edentulous patients were selected according to certain criteria, and they were randomly allocated into two equal groups, Group I: patients had guided surgical installation of four implants following “All on 4 “concept and Group II: patients had guided surgical installation of two straight interforaminal implants (3.5x11 mm) and two distal short implants(4 x4mm). The implants in the two groups were monitored using cone beam computed tomography on loading ,6 month and one year later. Results: In this study, at the end of follow up period, there was statistically significant difference in the marginal bone height loss between the two group. The least bone loss was reported around the implants in group II. Conclusion: Within the limitation of the number of patients and the follow-up periods enrolled in this study, it was concluded that widely spread of implants is much better than limiting the spread of implants even for the same number of implants. Recommendation: The authors recommend further investigation on All on 4 concept with longer follow up periods
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