Nobel Biocare awards Dr Paulo Malo for 25 years of the All-on-4 treatment concept

Dr Paulo Malo has been presented a Quarter Century Award from Nobel Biocare, honouring the 25th anniversary of the All-on-4 treatment concept. At a gathering in Nobel Biocare’s Dental Experience Centre in Zurich, Switzerland, Patrik Eriksson, company president, presented the trophy. 

Dr Paulo Malo led the development of this treatment protocol in the early 1990s, with much-valued support from the late Dr Bo Rangert of Nobel Biocare. In 1998, he treated the first patient documented in the first scientific study1, with the final version of the concept that became commercially launched.

The All-on-4 treatment concept is widely recognised as one of the most significant developments in implant dentistry. It brought a revolutionary way of providing patients with a cost-efficient, graftless solution for fixed full-arch prostheses on the day of surgery, on just four implants.

With edentulism estimated to affect over 350 million people globally2, implant-supported restorations are recognised as one of the optimal treatment solutions3.The All-on-4 treatment concept is one of the best-documented restorative solutions for edentulous patients, proven to provide clinically successful long-term outcomes4,5.

Dr Malo said: “In the early years of the All-on-4 treatment concept, very few people believed that it was possible. But I was seeing firsthand how successful the technique was for my patients and became completely dedicated to making it available for more people who suffer from edentulism. Twenty-five years ago, it was beyond my wildest dreams that it would reach the scale that it has today.

“This level of impact is all thanks to Nobel Biocare. They could see its true potential despite scepticism in the industry, and they took it to a global level like no other company would.”

Patrik Eriksson, president of Nobel Biocare, said: “I’m delighted to award Dr Malo in recognition of this milestone. While many companies have tried to copy the All-on-4 treatment concept, Dr Malo and Nobel Biocare have focused on pushing the boundaries to improve the products and further develop the end-to-end workflow.” 

He concluded: “Together, we continue taking the lead for the future of the All-on-4 treatment concept.” 

Throughout 2023, there will be a series of events to mark the 25th anniversary, including training courses, webinars and the continuation of the All-on-4 Centre of Excellence programme, which awards practices that have distinguished experience in, and loyalty to, the genuine All-on-4 treatment concept. 

About the All-on-4 treatment concept

The All-on-4treatment concept from Nobel Biocare is the original graftless full-arch solution on four implants. It provides a fixed full-arch prosthesis on the day of surgery6,7 for patients who meet the criteria for immediate loading. The prosthesis is placed on two straight implants in the anterior and two tilted implants in the posterior. Tilted implants are key to the concept, as they maximise the use of the existing bone to eliminate the need for bone grafting. This enables a shorter treatment time and reduced costs compared to conventional full-arch treatments8.The All-on-4 treatment concept was launched commercially by Nobel Biocare in 2004 and over 250,000 patients have since been treated9.


  1. Malo P, Rangert B, Nobre M. 2003. “”All-on-Four” immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study.” Clin Implant Dent Relat Res 5 (Suppl. 1): 2-9. doi:doi: 10.1111/j.1708-8208.2003.tb00010.x
  2. Weinstein R, Agliardi E, Fabbro MD, et al. 2012. “Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants.” Clin Implant Dent Relat Res 14 (3): 434-441.
  3. Agliardi E, Clericò M, Ciancio P, Massironi D. 2010. “Immediate loading of full-arch fixed prostheses supported by axial and tilted implants for the treatment of edentulous atrophic mandibles.” Quintessence Int 41 (4): 285-293.
  4. Patzelt SB, Bahat O, Reynolds MA, Strub JR. 2014. “The All-on-Four treatment concept: a systematic review.” Clin Implant Dent Relat Res 16 (6): 836-855.
  5. Nobel Biocare. Data on file.. 
  6. Malo P, de Araujo Nobre M, Lopes A, et al. 2019. “The All-on-4 concept for full-arch rehabilitation of the edentulous maxillae: a longitudinal study with 5-13 years of follow-up.” Clin Implant Dent Relat Res 21 (4): 538-549.
  7. Malo P, de Araujo Nobre M, Lopes A, et al. 2019. “The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up.” Clin Implant Dent Relat Res 21 (4): 565-577.
  8. Feine JS, Carlsson GE, Awad MA, et al. 2002. “The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Montreal, Quebec, May 24-25,2002.” Int J Oral Maxillofac Implants 17 (4): 601-602.
  9. World Health Organization, “Global oral health status report: towards universal health coverage for oral health by 2030,” 2022.