All About the All-on-4® Screw-Retained Prosthesis

All-on-4® Screw-Retained Implant

Over 20 years ago, Dr. Paulo Malo, a Portuguese dentist and entrepreneur, developed a breakthrough innovation in dental implantology–the All-on-4® technique.

His groundbreaking idea is now recognized worldwide by the dental industry as one of the leading solutions for full-arch dental prosthetic restorations for edentulous patients. Edentulous patients often present with minimal bone to support conventional implants and dentures. Dr. Malo solved this common problem.


The All-on-4® Method


The All-on-4® method uses four implants–two placed axially in the anterior incisor region and two placed in the posterior and angled distally up to 45o.

Tilting the posterior implants avoids interference with anatomical structures such as maxillary sinuses and inferior alveolar nerve, allows for maximum anterior/posterior spread, and permits the use of longer implants for anchoring. The four implants permanently attach to a screw-retained prosthesis and support up to twelve teeth for maximum restoration of the patient’s masticatory function.


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Using the All-on-4® method, you can customize and seat the dentures on the same day you place the implants. The ability to place either a provisional, fixed, immediately loaded, or full-arch prosthesis on the same day of surgery is a distinct advantage for the patient.

No longer do patients have to wait weeks for healing. You can restore their ability to chew and speak with confidence in just one visit to your office.

The All-on-4® procedure maximizes your ability to place implants in patients with atrophic jaws, poor bone quality, and minimal remaining bone structures. In the past, those patients represented the most difficult cases–providing dentures with minimal support while avoiding the common causes of patient dissatisfaction including pain, poor stability, difficulty eating, loss of control of the tongue, reduced bite force, and diminished taste function.

Using the All-on-4® method, even those hard-to-please patients can walk away happy.


Implant Results of All-on-4®


Several studies document the success of the All-on-4® technique.

Published reports show implant survival rates between 92 and 100 percent. A longitudinal study reported in the Journal of the American Dental Association (March 2011) followed 245 patients with 980 implants using the All-on-4® method for 10 years.

They report a 99.2 percent survival rate and conclude, “the results support the conclusion that use of the All-on-4® immediate-function implant concept in completely edentulous mandibles is viable in the long term.”


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The All-on-4® technique is not without risk, though.

As an invasive surgical procedure, potential risks include infection, possible damage to nerve tissue, peri-implantitis, and bleeding during or after surgery. Additionally, some reports document complications with the screw-attached prosthetic devices, such as acrylic fractures and detachments.

The All-on-4® technique, which allows for immediate loading of a stable prosthetic for edentulous patients, has become a favorite of both dentists and their patients. The low incidence of complications and long survival rates make this procedure popular and predictable. The positive impact on the health and satisfaction of edentulous patients includes improved esthetics, speech, function, and overall quality of life. It is a win-win for everyone.

First Choice Dental Lab staff and technicians are happy to help with your treatment plan for patients who might benefit from the All-on-4® procedure. Contact us to discuss this exciting solution for your edentulous patient’s needs.



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