All On Four: Everything you need to know about this revolutionary dental implant technique

The loss of one or more teeth is no longer a problem. Thanks to dental implants we can provide a functional and esthetic solution and restore the smile of most people. But what happens if you have lost all your teeth or if it is necessary to extract them because they have lost their function or esthetics? This is where we have the All on Four technique that allows you to enjoy fixed teeth from day one.
In addition to reducing waiting times, the All On Four technique reduces surgical interventions and offers an effective, reliable and safe restoration. If you still do not know this technique and want to know what it consists of and what are all its advantages, keep reading!

What is the All On Four technique and why is it called this way?

The All On Four technique, All-on-4, or even All-in-4, is an advanced implantology technique that consists of placing a prosthesis on four osseointegrated dental implants for each of the two arches. These 4 implants are placed two in parallel in the center and two more perpendicular (inclined up to 45º) at the ends.
In this way, a fixed dental prosthesis with 4 implants is achieved without the need to make a full mouth. Grafts are not necessary either, since the implants placed at an angle at the ends allow to save those posterior sectors where bone is normally lacking.
This technique, invented in the 1990s, was called All On Four, which literally means that all the teeth are supported by four dental implants. Today, the technique has been perfected allowing the patient to leave the clinic with a fixed and complete set of teeth in a single intervention.

What does the All in 4 technique consist of? How is it performed?

Do you want to know how the All on Four technique is performed in our dental clinic in Torremolinos?
The first step is to plan the All on Four technique by performing a panoramic X-ray to have a first look at the bone. In this way we can assess whether the person is a good candidate for the All on Four system or if, on the contrary, it is advisable to perform a conventional implant technique.
Once we have performed a 3D study of the jawbone to be treated and we have made sure that this technique is the most suitable, we proceed to the following All on Four protocol in a single surgical session:
– We perform the extractions of the remaining dental pieces, but that due to their functionality or aesthetics are of no use.
– Next, we carry out a correct preparation of the area that will house the dental implants.
– Once we have the area prepared, we place the 4 implants in the most optimal position. To do this, we have previously planned their placement by means of an implantological study and 3D radiography. The usual All on Four technique is to place two implants parallel in the center and the other two perpendicularly at the ends.
– Once the implants are in place, we take the measurements of the mouth and design the new smile digitally. All this digital information is sent to the laboratory so that they can make the fixed dental prosthesis that we place on the four implants on the same day.
As you can see, the application of the all-on-4 dental implant technique allows you to live a practically normal life from the same day of the intervention. In addition, the definitive All on Four prosthesis surpasses the esthetics and functionality of the previous denture, improving the patient’s quality of life and self-esteem.

When is the All four technique used or recommended?

Originally this technique was only indicated for patients who had no bone in the posterior maxilla or mandible and did not want to undergo bone regeneration.
Nowadays, the range of patients who can be fitted with a prosthesis on four implants is very wide. Above all, it is a very useful technique for those who have been wearing a full prosthesis for a long time and are tired of the inconveniences and limitations that this causes them. It is also a technique indicated for patients with severe periodontal disease.
In short, it is an optimal technique for those people who want to replace all the teeth of the upper or lower jaw with the smallest number of implants possible, in the shortest possible time.

Is it a reliable technique and does it work over time?

If you are thinking of having the All on Four technique performed, you may be wondering if this technique is effective and long-lasting.
To answer this question, we must consider that it is a technique that has been developed since the late 90s, so the experience in the thousands of cases performed supports its safety and lasting effectiveness.
However, as is logical, the fact that the prosthesis on four implants will last for many years will depend on good maintenance. This requires proper hygiene on the part of the patient and a visit to the dental clinic at least once a year so that the dentist can lift the prosthesis and clean it properly.

How is the rehabilitation after this procedure?

As with traditional implants, your dentist will recommend a series of care for rehabilitation after All on Four. These recommendations include following a soft diet hours after surgery, as well as taking antibiotics and painkillers under medical prescription to avoid possible infections and pain.
It is also necessary to stop drinking alcohol and smoking, and to undergo the periodic check-ups indicated by the professional in order to be able to assess how the fixation or osseointegration process is going.

Types of all on four implants

In order to achieve the adequate adaptation of the treatment to each patient, there are different modalities of All on Four:
– Standard All on Four. This is the appropriate technique for those patients who have a normalized situation and have sufficient bone in the upper jaw. In this case 4 standard implants are placed.
– Hybrid All on Four. In the case of bone loss in the posterior part of the maxilla, it is recommended to place two standard implants in the frontal part and two zigoma implants in the posterior part.
– All on Four Zigoma: If the maxillary bone is totally lost, we can proceed with the placement of 4 zigoma implants. In this way, with this type of All on Four system, the most complex cases can be rehabilitated without the need to resort to bone grafts.

How much do all four implants cost?

We know that price is always something that matters when making certain decisions. However, it is a more affordable treatment than other types of dental implant procedures.
This is because the all-on-4 technique is based on a minimal amount of implants, which allows you to save time and also money.
However, the final price must be adjusted to each case, so it is best to make a customized estimate.

What are the advantages and disadvantages of the All in 4 technique?

The All on Four benefits are multiple and varied:
-It is a graftless procedure. By tilting the posterior implants using the available bone, we reduce the need for bone grafts. In addition, it allows anchorage in better quality bone, which makes the use of longer implants possible.
-It allows to rehabilitate complete arches immediately, in a single intervention and dispensing with other surgical interventions.
-It avoids waiting times ranging from 3 to 6 months to get a prosthesis with fixed teeth, depending on whether you have to wait for bone grafting.
-You will be able to enjoy fixed teeth from day one. This will allow you to forget about the uncomfortable situation of being without teeth. You will see how this new situation allows you to improve your self-esteem and your social and work relationships.
But besides knowing its enormous benefits, you should also take into account the disadvantages of All on Four:
-Possibility of prosthesis breakage. Since part of the posterior implants are angled, this causes the prosthesis in the molar area to remain without any support. This overhang that remains, with the passage of time, use and poor hygiene, can end up breaking.
-As it is only a fixed prosthesis on 4 implants, if any of the implants fail, you will have to undergo a new surgery to place the dental implants.

Summary and conclusions

As you can see, if you are missing most of your teeth and you have little bone and you have been told that you cannot have implants, the All on Four technique offers you the possibility of having fixed teeth in a single surgery.
This advanced technique of implantology is based on only 4 implants in each arch on which the dental prosthesis is placed with your new teeth digitally designed to the millimeter for you. And all in a single surgical intervention, which saves time and costs.
If you have any doubts and want to find out if the All-on-4 system is for you, now is the time to find out. At Medident we are specialists in cases with little maxillary bone and we can help you determine which is the most appropriate dental treatment for your particular case. Contact us and we will answer all your questions without obligation!



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Álex V. Cutilla
Álex V. Cutilla
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Ivan Moreno
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Julia m
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José Manuel Martín
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Esther Moya Moyano
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