Paulo Malo: All-on-4® - state-of-the art concept

It is very important and beneficial to avoid grafting in elderly patients, who often have compromised health conditions such as diabetes and osteoporosis. The All-on-4® treatment concept is a specific surgical procedure developed to avoid grafting procedures in edentulous indications. Other characteristics of the All-on-4® treatment concept include: delivery of full bridges of high quality and esthetics and immediate function for the patients, superior hygiene maintenance capability, low cost for the patient, high success rates. Dr Malo reviews the different variations of the All-on-4® treatment concept, depending on the available bone volume and quality and discusses clinical parameters such as implant angulation, drilling protocols, implant selection, prosthesis and cantilever design. In the soft maxillary bone, in order to achieve sufficient primary stability for immediate loading, it is beneficial to expand the bone using a suitable implant design and to anchor the implant bicortically in crestal and nasal floor cortical bone. It is crucial that the bridge is manufactured from flexible yet resistant material and for precision and passive fit reasons by CAD/CAM technology.