All on four

The All-on-4® treatment concept is the best solution for the treatment of full arch using inclined implants. This technique requires a complete previous study with orthopantomography and maxillary and mandibular TAC, by means of which the type of implant, the position, the length and the exact place of placement of the implant are designed and decided.

On the same day of the intervention, at the end of the treatment, the patient is given a fixed temporary prosthesis, which will be replaced by the final one after a few months. It is possible to place the upper arch, the lower arch, or both in a fixed manner, so that the patient leaves the operating room with his provisional denture.

In 1998, Dr. Paulo Malo successfully treated the first patient with the All-on-4® treatment concept. Since then, hundreds of thousands of patients have been treated with this concept using Nobel Biocare implants.

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

In Clinica Beltran y Obradors, Platelet-Rich Plasma extracted from the patient’s own blood is usually used, improving the result of osseointegration and presenting less inflammation and post-operative pain.

Its features include:

  • Rehabilitation of a full arch with only four implants: Two straight implants in the anterior part and two inclined up to 45º in the posterior part. In some special cases, according to the assessment of the professional, it can be increased to 6 implants per arch.
  • Immediate function (temporary fixed bridge): For patients who meet the requirements for immediate loaded implants.
  • Procedure without grafts: The bone graft is avoided by tilting the posterior implants using the available bone.

Advantages of the All-on-four system:

Rapid improvement in the quality of life

The fixed full-arch prosthesis on the day of surgery quickly leads to greater patient satisfaction in masticatory, aesthetic, sensory, speech and self-esteem functions.

Shorter treatment times

The inclination of the posterior implants avoids the need for slow procedures of bone grafting, while the immediate loading shortens the time until the placement of the teeth.

Lower cost

The concept is the lowest cost compared to conventional treatment modalities with fully edentulous and potentially edentulous maxillary implants.

Patients with dentition of poor prognosis

A significant number of cases treated with the All-on-4® treatment concept are patients with defective dentition. Two-thirds of patients treated with full-arch restorations are potentially edentulous patients.

Often, fully edentulous patients also meet the requirements for the All-on-4® treatment concept. It is necessary to make a thorough evaluation of each patient to choose the most appropriate treatment and establish a predictable result for the treatment.

The All-on-4® treatment concept is a proven long-term solution with up to 10 years of follow-up in the jaw and 5 years in the maxilla. The survival rates of the accumulated implants are high, both in mandibles and edentulous jaws:

  • Medium term 3-4 years: 96.3 – 100%
  • Long term 5-10 years: 94.8-98.0%

The favorable parameters for bone and soft tissue are: Levels of stable marginal bone and healthy soft tissue both with inclined implants and with straight implants. Degree of patient satisfaction: 98% of patients would recommend this treatment.

In one study, 95% of 250 patients were satisfied with their new teeth. 88% said that they would undoubtedly recommend a similar treatment to their friends and colleagues and 10% would think about the possibility of recommending it.

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