All-On-Four Implants

A fixed prosthesis with 10-14 teeth is placed on four implants, which is used immediately, generally within 24 hours of surgery.

The term all-on-4, also known as all-on-four, refers to "all" teeth that are worn "on four" dental implants. It is a surgical and technical prosthetic procedure for the complete rehabilitation of toothless ( toothless ) patients or of patients with severely broken teeth, carious teeth, or teeth affected by gum disease. It consists of the rehabilitation of the toothless or toothless upper and/or lower jaw with fixed dentures by inserting four implants in the front upper jaw, where the bone density is higher. A fixed prosthesis with 10-14 teeth is placed on four implants, which is used immediately, generally within 24 hours of surgery.

The implant manufacturer Nobel Biocare AB from Gothenburg, Sweden, was one of the first to recognize the development of all-on-4 technology as a potentially valid and cost-effective alternative to conventional implantation techniques.

All-on-4 is not an invention, but rather a treatment technique that has evolved and has the following features:

four dental implants to support a fixed full bridge

the use of angled implants in the rear area to compensate for bony deficits or anatomical structures



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The all-on-4 treatment concept is a prosthetic procedure ( d. H. Replacement of missing teeth ), which enables a permanent, screwed replacement for the entire upper and/or lower teeth with a bridge or prosthesis on the same day. This process is best suited for patients with severe tooth loss or caries, as well as for those who are unable to perform traditional (vertical) dental implants due to bone loss in the lower jaw area. Dental loss is often accompanied by a loss of the jawbone, which poses the problem of rebuilding the jawbone, which requires bone transplantation. During All-on-4-Procedures, the dense bone, which is still present in the front part of the lower jaw, is used to place the two rear implants at a certain angle, so that the jaw cavity of the upper jaw and the nerve tube of the lower jaw are bypassed. The cost of the all-on-4 process varies depending on the final prosthetic material. Acrylic resin teeth above a titanium bridge are much cheaper than in European countries.

A successful operation requires careful analysis of the bone structure. The ideal method for assessing the bone is cone beam computer tomography ( CBCT ). The all-on-4 protocol provides that at least four implants are placed in a jaw. The rear implants are usually placed at an angle of approximately 30 to 45 degrees to the occlusion ( bite level ).

The implant is placed before the maxillary sinus and the mandible before the mental nerve. The head of the implant emerges approximately in the position of the second premolar. This allows a molar tooth to be tilted backward, which leads to a prosthesis or bridge with about twelve teeth.


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