All-on-4 Technique: Pros and Cons?


Mike asks:
I am interested in learning more about the All-On-4 Dental Implant technique. More specifically, what are the main pros and cons of this procedure? Do you need a specific type of dentist to do this? Thanks.

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ekusek's picture

This is concept is still up

Answered By: Dr. Edward Kusek - Sioux Falls , SD

This is concept is still up in the air. Some clinicians highly recommend it and some are very skeptical as I am. This procedure places the implants in forces that traditional implants do not do well in the long term. Meaning, implants like forces that are directed to the center, while this procedure places the forces at an obtuse angle. Long term is the question, will the patient have bone loss and develop periimplantisis ( infection of the surrouding tissues of the implant) and those lose the implant(s). Having these few implants could be a major problem to the success of the case.

Good luck

Dr. Edward Kusek

tgrossman's picture

All on 4

Answered By: Dr. Theodore M. Grossman - Aventura , FL

1) Teeth in a Day - A maxillofacial C.T. scan aids the Oral Surgeon, Prosthodontist and Technician to plan & provide the convenience of same day delivery of a fixed detachable prosthesis.
2) It has been used in other countries for many years.
3) It is F.D.A. approved.
4) It circumvents anatomical areas, ie. maxillary sinus, mandibular nerve and may eliminate the need for bone grafting.

1) Can be considerably more expensive than other reconstructive options.
2) The failure of one implant will necessitate replacement and a prosthetic remake.
3) It requires adequate bone volume for the placement of long & angled implant fixtures.
4) It doesn't use as many implants for prosthetic support as more conventional procedures.

Careful consultation is required for all options to be explained pre-operatively.
Good Luck

Theodore M Grossman D.M.D.

Dr. Theodore M. Grossman

smmoss's picture

All-on-4 Technique: Pros and Cons?

Answered By: Dr. Steven M. Moss - Rutherford , NJ

Hi Mike
All-on-4 is not a new concept. It was developed in the early 1990's by Dr. Paulo Malo, MALO CLINIC-Lisbon. Since it's inception, the protocols and components used have been innovated to the point where this technique now rivals success rates of conventional dental implant techniques! Tens of Thousands of patients have had this procedure done. Long term studies done at MALO CLINIC show continued success (over 98% implant survival) with 8 years (upper jaw) and 10 years (lower jaw) follow up. Each study includes over 1,000 patients and more than 4,000 implants! I have performed this technique for a few years now(using MALO CLINIC protocols) and have experienced similar results.

PROS: Almost everyone is a candidate. The esthetics are typically better than with conventional techniques. Bone grafting is almost NEVER needed. Cost is LESS than conventional techniques for full arch implant supported fixed bridge. No need for multiple procedures. Never wear a denture. Implants and provisional fixed bridge placed the same day!

CONS: You need to find a team (surgeon and restorative dentist) that have experience with this technique.

Best of luck to you!

Dr. Steven M. Moss
MALO Advanced Oral Rehabilitation

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