All-on-4® is a surgical and oral rehabilitation technique
which objective is to replace all teeth (all) on top of four (on-4) implants on
the same day. There are various causes for a patient to lose teeth either on
the upper maxilla or the mandible. Among these we find caries, fractured teeth
and periodontal or gum disease.

By definition the All-on-4 ® technique must have the
following characteristics:

•          It features 4 implants that support a fixed restoration, a restoration that cannot be
removed from the patient mouth.

•          Angled implants especially the most posterior ones to:

- Avoid anatomical structures such as the maxillary sinuses (upper maxilla) and the mental nerve in the mandible.

- To be able to restore the posterior teeth as far as possible (antero-posterior spread)

•          The fixed restoration must be installed the same day that the implants area surgically
placed or within 24 hours. (Immediate load).

This technique was developed by an implant company called
Nobel® although some other companies have modifications and protocols with similar names such as all-on-X, all-on-6, full arch reconstructions, teeth in
day, etc.

What advantages does this technique offer when it is compared to conventionally placed implants?

•          Avoid bone-grafting procedures:  The angled
implants help to avoid anatomical structures such as the maxillary sinus, which is in the upper maxilla on the posterior aspect. When multiple teeth are lost in this zone and with the pass of time, these maxillary sinuses that are empty
spaces lacking good and firm bone will have the tendency of moving inferiorly.
Making implant surgery in these areas difficult unless bone grafting procedures
are done before.  With the All-on-4® Dr. Abril offers to his patients implants without the need of grafting.

•          Shortening the time form the implant surgery to the restoration:  When a dental implant is placed in a bone that has not been grafted, then we will increase the stability of that implant that has recently been placed and the (temporary) restoration can be placed the same day of the surgery.  The conventional technique used in the past was to use bone grafting techniques followed by 3-4 months of healing then an implant was surgically placed and then another 3-4 months before the fixed restoration was installed.