All-on-4: Everything About the All-on-4 Dental Implant Technique

Bone Regeneration and Implantology

The latest news in the media about dental implants has been the herald of a dramatic revolution in dentistry with the marketing of a popular new treatment which promises “placement of dental implants without surgery,” and which has sparked heated debate among specialists. Currently numerous opinions can be heard about the technique both pro and con. In the light of all this the specialists at Moria Dental Clinic, a leader in the field of implants and regeneration, have decided to sort out the confusion in the media by offering you all the reliable and up-to-date information currently available about the “All-on-4” treatment technique.
Following are several noteworthy facts to be aware of before making your decision.


What is the All-on-4 technique?                        

The “All-on-4” technique is based on using a minimum number of implants to serve as a foundation for placement of a dental prosthesis. A guiding principle of the technique is to ideally distribute loading between the implants, thereby preserving as much alveolar bone as possible. Owing to its popularity is the fact that in practice, the patient receives the prosthesis all in the same day, after only 4 implants are placed in each jaw, and the prosthesis is then immediately screwed on to them. The technique has received widespread attention with varying degrees of objectivity.        

Before you decide if the technique is for you, the specialists at Moria Dental Clinic present the advantages which have contributed to its popularity, as well as its disadvantages, which the public may be unaware of.


What makes it so popular?

The technique has several clear advantages: chief among them are rapid results and minimal surgical intervention.  This means that treatment with the technique facilitates rapid rehabilitation in a short time frame, and moreover eliminates the need for bone grafts and sinus lifts. At the same time it should be pointed out, however, that the technique does require a surgical procedure for the implant placement. 


What are the disadvantages of the technique?

Firstly, outcomes have been determined only for five years post-operatively, inasmuch as the technique is still in the experimental phase. At present, studies have yet to appear in the literature establishing long-term success rates and complications. Following are the main disadvantages currently known about the technique:


  1. Esthetics: It must be borne in mind that the reconstruction is a large prosthesis. The prosthesis does not answer everyone’s esthetic needs to the same degree, as it also recreates the gingival tissue. Thus, the treatment does not necessarily improve one’s quality of life.
  2. Cost: Although the expenses involved are relatively low, the total cost can be determined only at the end of treatment. For example, costs can mount from additional treatments made necessary from unforeseen complications and failures. 
  3. Initial bone requirements:  A precondition for successful results with the technique is a pre-existing minimal quantity and quality of bone. Patients lacking this basic requirement are not appropriate candidates for this treatment.
  4. Adjunct treatments: The latest techniques of bone grafting and regeneration are incompatible with treatment using this technique.


Risks of the Technique

As with any treatment there are risks involved. Following are the principal risks associated with All-on-4:

  1. Loading: The technique relies on just 4 implants to provide support for 14 teeth. The location and inclination of the implants can be unfavorable for optimal distribution of loads and likewise, loading that is excessive by any standard can sometimes be involved and even lead to implant failure. In addition, the jaws are capable of suddenly exerting enormous forces on newly placed implants which can prove unable to withstand them, eventually resulting in treatment failure.
  2. Interdependence of the implants: In contrast with rehabilitation involving multiple implants which share the loading forces, in this current technique, failure of the entire reconstruction will result from failure of a single implant. In addition, finding a permanent restorative solution will then become impossible.
  3. Professional levels: Because the technique can be performed not only by periodontists, prosthodontists, and oral surgeons, but also by general dentists, the level of professionalism will vary accordingly.
  4. Bone loss: The technique requires bone reduction in order to achieve a uniformly level plane of bone. This loss of valuable bone support is irreversible and it limits the possibilities for future treatment options.


In conclusion, although the technique offers appealing advantages, there are also considerable risks and drawbacks which you should carefully consider prior to making a decision. You are invited to consult with us regarding any questions you may have, and in case you are uncertain, the specialists at Moria are available to offer their personal opinions.