In the mid to late 1990s, the All-on-4 procedure, under the guidance of Dr. Paulo Malo, was developed as a way to more efficiently use implants in both jaws. In the early 2000s, implant manufacturer Nobel Biocare collaborated with Dr. Malo and began to use computer simulation, bio-mechanics, and clinical research to determine the optimal use of implants for restoring a full upper or lower arch of teeth. The result was a procedure that uses the fewest implants possible, avoids bone graft surgery, and provides high-quality restorative results in the shortest time possible.
All four titanium implants are placed so that the bone will grow around and secure them in place. With only four implants, there is much less invasive and lengthy surgery.
The All-on-4 procedure uses four implants, with the back implants angulated to take maximum advantage of existing bone and allow for immediate fitting of replacement teeth. This treatment is attractive to those with dentures or in need of full upper and/or lower restorations. With the All-on-4 procedure, four implants are placed along with a full set of new replacement teeth in just one appointment—without bone grafting surgical procedures. The primary advantage is that implants are placed and the patient leaves the same day with non-removable replacement teeth.
Traditional implant reconstruction typically requires bone grafts, six to eight implants, and up to 18 to 24 months of treatment. This may require a patient to wear a removable denture for an unacceptable period of time. Remember, you would always leave with teeth in place!
Once the implants are in place, Dr. Sims attaches abutments to which the new replacement teeth can be secured.
The restorative dentist fits the replacement teeth on the abutments and adjusts the bite for comfort and a beautiful smile.
With the All-on-4 procedure, the patient has treatment consultation and planning appointment to allow Dr. Sims to gather information (e.g., iCAT, impressions, photos). Following this appointment, the patient is scheduled for surgery. During the surgical appointment the patient comes to the office in the morning, and leaves in the afternoon with a beautiful set of fixed, functional teeth.
The patient will return for occasional check-ups over the next several weeks and months. After four to six months, the implants will be integrated to the bone. The restorative dentist will then take new impressions of the patient’s mouth and prepare the final set of teeth. This helps ensure that the teeth will last for decades, and provide maximum support, beauty, and function to the patient.