What is All-on-4?

Implantation method
developed by a Portuguese dentist,
Dr.Paulo Malo

 The All-on-4 treatment concept is a prosthodontic (i.e replacement of missing teeth) that provides a permanent, screw-retained, same-day replacement for the entire upper and / or lower set of teeth with a bridge or denture. The procedure is best for patients with significant tooth loss or decay and for people whose bone loss in the jaw area prevents them from getting conventionally oriented (vertical) dental implants. Often, tooth loss is accompanied by loss of the jaw bone which poses the problem of reconstruction of the jaw bone requiring bone grafting. The All-on-Four technique takes advantage of the dense bone that remains in the front part of the jaws and by placing the two posterior implants on an angle to avoid the sinus cavities in the upper jaw and the nerve canal in the lower jaw. The All-on-4 treatment concept owes its name to the very nature of the method, which consists of applying a dental prosthesis with at least twelve teeth (bridge) fixed in the jaw, based only on four titanium implants. This effectively enables more cost-effective alternative to conventional implant techniques.

(Excerpt from Wikipedia)
  • Use Nobel Biocare's implant ※1
  • Rehabilitation with 4 implants
  • Avoid implantation of the implant body in molar teeth
  • The posterior implant body is inclined by 45 ° (30 to 45 °) and two are implanted
  • Use a standardized surgical guide plate (All-on-4 guide) (now Nobel Guide)
  • If necessary, a cantilever is added, but in principle it is not provided
  • Perform an immediate load
  • Provisional restoration using low cost acrylic bridge
  • There is also a flapless technique

(Except from “The latest All-on-4 Manual for Japanese”
by Dr.Takatsuna Nakamura and Dr.Ryuji Hosokawa)

 Simply put, All-on-4 implant is a technique that can recreate all teeth with bridge using just four implants in a day. Implant treatment not utilizing “Nobel Biocare” is not genuine All-on-4 treatment.
One should recognize the fact there are some illegit clinics which claim to provide All-on-4 treatment. I have analyzed those clinics and found the following commonality.

・Little or no knowledge and experience in immediate loading.
・Lack of equipment or dental technician or technician with limited skill to make temporary bridges within 24 hours.
・Lack of experience in implanting to avoid the maxillary sinus or the mental foramen.
・No experience in guided surgery.

 In other words, there are people who promoted All-on-4 treatment without proper training and experience. Legit dental professional of All-on-4 uses Nobel Biocare implant, and strictly follow the All-on-4 protocol developed by Dr.Paulo Malo.
Implant Sendai is a networked provider of Dr.Paulo Malo’s, and our dental doctor has achieved professional certification from Portugal.