The “all-on-4” treatment concept was developed to maximize the use of available remnant bone in atrophic jaws, allowing immediate function and avoiding regenerative procedures that increase the treatment costs and patient morbidity, as well as the complications inherent to these procedures. The protocol uses four implants in the anterior part of complete edentulous jaws to support a provisional, fixed and immediately loaded prosthesis.
The All-on-4® treatment concept provides edentulous and soon-to-be edentulous patients with an efficient and effective restoration using four implants to support an immediately delivered full-arch prosthesis.
The two most anterior implants are placed axially, whereas the two posterior implants are placed distally and angled to minimize the cantilever length, and to allow the application of prostheses with up to 12 teeth, thereby enhancing masticatory efficiency.
Up to 10 years follow-up in the mandible and 5 years in the maxilla.1,2
High cumulative survival rates (CSR) in both edentulous maxilla and mandible.1–8
Mid-term 3–4 years 96.3–100% 4–6
Long-term 5–10 years 94.8–98.0% 1,2
Stable marginal bone levels4–8 and healthy soft tissue5 both for tilted and axial implants.
Two key elements of the All-on-4® treatment concept significantly reduce treatment complexity, the number of surgeries, and the overall treatment time: tilting of the posterior implants avoids the need for time-consuming bone grafting procedures and reduces prosthetic cantile- vers, while immediate loading shortens time to teeth.
The All-on-4® treatment concept is not only the least time-consuming treatment option in comparison with conventional implant treatment modalities of the edentulous and soon-to-be edentulous jaw, but also the least costly.10
The All-on-4® treatment concept is successful in healed and extraction sites,8 also in combination with the treatment concept NobelGuide with guided drilling and implant insertion.12,13
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