Aesthetic dentistry has evolved throughout the past few decades, specifically in the field of implantology. Patients are preferring endosseous procedures to traditional dentures and other removable prostheses to increase stability and comfort, and to decrease pain.1 Conventional implants require several procedures involving multiple appointments and upwards of a year until completion; although some newer techniques promote a faster completion time. The “All-on-4” technique is an immediate conventional implant procedure in which 4 large-diameter implants (2 in the anterior and 2 in the posterior) are inserted at a 45° angle to take advantage of the available bone and to reduce the need for bone augmentation and/or sinus lift.2
According to Nobel Biocare’s All-on-4 treatment concept manual, a minimum of 5.0 mm in bone width and 8.0 mm in bone height is necessary to begin the procedure.3 (All-On-4 is a registered patent owned by Nobel Biocare developed together with Paulo Malo, DDS, PhD, at the MALO CLINIC.) Though the All-on-4 technique claims to eliminate the need for bone augmentations and sinus lifts, these procedures cannot always be eliminated if the bone quantity does not meet the requirements due to the large diameter of a conventional implant.1-2,4 While the All-on-4 technique offers acceptable support with 4 implants, the endosseous procedure is still invasive and time consuming compared to the immediate and early loading procedures used with mini dental implants.