Total tooth loss is no longer a problem: All-on-4 treatment concept

The All-on-4 treatment concept is the life-changing solution for edentulous and soon-to-be edentulous patients who, instead of a removable denture, want a comfortable and ‘chew-safe’ full-arch rehabilitation.

Tooth loss in adulthood is an unpleasant condition in many ways. Without strong and healthy teeth, it is impossible to chew properly which have long-term health risks. If you are missing teeth, you are unable to eat certain foods or you might swallow a bite without chewing. As a consequence, such unhealthy eating habits put a strain on the digestive system. Moreover, living with missing teeth is a social taboo. So, people who have lost teeth might feel intimidated smiling and laughing freely in public, which can negatively affect their mental health. Replacing missing teeth with a traditional removable denture cannot always provide a perfect result. We believe in unremovable dental implants, and for edentulous patients, the special All-on-4 treatment concept.

History of the All-on-4 treatment concept

The name All-on-4 suggests that all the full fixed bridge rely on only 4 implants. This unique treatment was developed by a Portuguese dentist, Dr. Paulo Malo in the 1990s. In 1998, Dr. Paulo Malo successfully treated the first patient with the All-on-4 treatment concept. Since then, the treatment concept has become more and more successful. The Swiss implant manufacturer Nobel Biocare provides the impeccable quality implants for the All-on-4 treatment concept.

The uniqueness of the All-on-4 treatment concept

The most important feature of the concept developed by Dr. Malo is that it does not require bone grafting even in the case of significant bone loss. This can be achieved by placing the implants, tilted 17° and 30°, into the most stable part of the jawbone with screws. The exact angle and length of the screws can be varied to make the implants perfectly suited to individual cases (details below).

The advantages of the All-on-4 treatment concept

• The All-on-4 treatment concept is less expensive than replacing the missing teeth one by one with dental implants or a surgery combined with bone grafting. It means that even less affluent people can enjoy the benefits of a fixed dental implant. According to a study, 98% of patients undergone the All-on-4 treatment concept recommend it because of its cost.
• Dr. Malo’s treatment is fast as it does not require bone grafting. In addition, the fixed denture can be used immediately after the treatment.
• The All-on-4 treatment concept is also available for patients who do not have adequate jawbone but want to avoid the expensive and long bone grafting procedure.
• There are several advantages of the All-on-4 treatment concept over removable dentures:
  • First of all, the full bridge is fixed so there are no inconveniencies dentures might cause such as being wobbly when talking or eating.
  • It is important to note that the palate is uncovered which allows to eat freely.
  • In addition, with the All-on-4 full fixed bridge biting is stronger and more stable compared to traditional removable dentures.
  • Evidently, since the implants are fixed into the jawbone, the full bridge does not need to be glued and taken out overnight, making the daily oral care routine easy.

The benefits of the All-on-4 treatment concept

The All-on-4 treatment concept is a cost-efficient, graftless solution that provides patients with a fixed full-arch prosthesis on the day of surgery.

How is it possible?

By tilting the two posterior implants, the bone-to-implant contact is enhanced, providing optimized bone support even with minimum bone volume. Additionally, tilting of implants in the maxilla allows for improved anchorage in better quality anterior bone. Furthermore, the implant design from Nobel Biocare allows bicortical anchorage in the cortical bone of the sinus wall and the nasal fossa.

Tilting of the posterior implants also helps avoid vital structures and results in a better distribution of implants along the alveolar crest, which optimizes load distribution and allows for a final prosthesis with up to 12 teeth.

Nobel Biocare offers straight as well as 17° and 30° angled Multi-unit Abutments for all Nobel Biocare implants. The abutments are available with various collar heights to match the thickness of the soft tissue.

With the All-on-4 treatment concept, patients that meet the criteria for immediate loading can also benefit from an immediate implant- supported all-acrylic restoration, as a provisional prosthesis is screwed onto the implants right after surgery. Final solutions include both fixed and fixed-removable prostheses.