There is only one proven All-on-4® treatment concept that provides edentulous and soon-to-be edentulous patients with an efficient and effective restoration using four implants to support an immediately delivered full-arch prosthesis.
After the first dental implant patient was treated in 1965, a discussion began around the optimal number of implants needed to anchor a fixed dental prosthesis in edentulous patients. Some clinicians tended to install as many implants as possible, often one per tooth. Others argued that biomechanically, only four or even three were needed. Only long-term clinical data could provide answers.
At the forefront
The records of the early patients of P-I Brånemark allowed for an early retrospective study.1 After a ten-year observation period, the survival rates were demonstrated to be the same for restorations with four and six implants. However, the challenge of advanced resorption remained. Because it is not possible in many cases to insert distal implants without grafting and/or nerve lateralisation, the concept of tilting the two distal implants was introduced.
Immediate results
In 2003, Dr. Paulo Malo and Dr. Bo Rangert introduced the concept of immediate loading of four implants in edentulous lower (and soon after upper as well) jaws with two tilted distal implants. This one-stage procedure substantially reduced the costly and time-consuming bone grafting procedures, number of surgeries and healing time.
The success continues
In his first study, Malo reported a cumulative survival rate of 96.7 per cent for implants and 100 per cent for prostheses at up to three-year follow up. Since then, he and others have repeatedly reproduced high survival rates for both upper and lower jaws – results that come only when Nobel Biocare products are combined.
Today, the All-on-4® treatment concept is used around the world with similar high survival rates and patient satisfaction that is enhanced by limited costs.
1 Brånemark et al. Clin Oral Implants Res. 1995
