Developments in dental implantology have facilitated a departure from the early paradigms set by Branemark and his co-workers’ pioneering work. The operational success rate of dental implants is primarily influenced by the mechanical environment in which they function as a separate entity. The size of implants, their design, and their placement are all determined by the patient’s systemic state, the availability of bone, the type of bone, and, finally, the dentist’s treatment plan. While early recovery of 6 months in the upper jaw and 3 months in the mandible was once indicated, advances in biology and technological advancements have allowed for instantaneous implant loading in some clinical conditions.
Because of insufficient availability of residual alveolar bone and nerve proximation, implant-supported fixed prostheses are not viable in some totally edentulous patients. To overcome the problem in these impaired cases, nerve transposition and grafting are required. The All on 4 teeth implant could provide an alternative to the above-mentioned dilemma.
The All on 4 Dental Implants Concept:
Paulo Malo and his co-workers came up with the concept of “All on four” in 2003. Here two implants are inserted vertically in the anterior region and two implants are placed at a 45-degree angle in the posterior edentulous region. The All on 4 Dental Implant is one treatment process that invigorates us for its usage in entirely edentulous patients, leaving behind the normal management option of conventional dentures with successful results in the short to mid-term, long term, period. Also, this method involves tilting the distal most implants on the edentulous arches which allow us to place longer dimension implants, resulting in acceptable support for the prosthesis with a shorter cantilever arm, which improves the inter-implant distance and implant anchorage in the bone.