Not Every "All-on-4" is a True All-on-4!

How It All Started

 

27 years ago, in 1998, Nobel Biocare and Prof. Paolo Malo introduced a revolutionary therapeutic concept for treating complete edentulism – All-on-4. This was a true breakthrough compared to previous dental practices.

 

The All-on-4 concept is based on just four implants supporting a full arch of 12 teeth. It enabled fixed solutions even in cases where there wasn’t enough bone for 6 or 8 implants, all while reducing costs for the patient.

 

This innovation was preceded by a decade of development in surgical techniques, driven on one side by Dr. Malo and his team, and on the other by the development of implant components made possible by Nobel Biocare. The result fundamentally changed dental implantology.

 

Dental medicine experienced a 180° shift from previous practice:

 

• Only 4 implants required

• Screw-retained bridges

• Immediate function

• Excellent aesthetics

• Outstanding long-term prognosis

• Implant placement possible even with limited bone

• Affordable for patients

 

The biggest beneficiaries were, of course, the patients. All-on-4 quickly became a market bestseller. Nobel Biocare and the Malo Clinic in Lisbon became global leaders in complete edentulism treatment.

 

The Expansion of All-on-4

 

It didn’t take long for other implant companies and dentists worldwide to recognize the potential of All-on-4. Soon, the method entered daily dental practice on a large scale. Unfortunately, some practitioners were motivated primarily by profit, leading to a flood of All-on-4 variations, cheap copies of Nobel Biocare implants, and procedures performed by inexperienced clinicians.

 

What was originally designed and patented as an almost perfect full-arch solution became a source of mistakes, complications, failures, and lawsuits. Thankfully, regulatory and legal systems in developed countries managed to correct these misuses, and the practice returned to proper standards.

 

Where We Are Today

 

All-on-4 is now a globally recognized method for rehabilitating complete edentulism – but only if performed according to the original protocol from 27 years ago, enhanced with today’s digital technologies.

 

A true All-on-4 procedure requires strict adherence to the following:

 

• Surgical precision: Correct position, angulation, tilt, length, and diameter of the implants.

• Experienced surgeon: Proper planning and significant surgical expertise are essential.

• Prosthetic protocol: Original Multi-unit abutments for screw-retained bridges, with proper mechanical and aesthetic characteristics – titanium frameworks covered with artificial gingiva.

• Original implants: Only Nobel Biocare implants qualify as All-on-4®, as this is a registered trademark.

 

If any of these elements are missing, the procedure cannot be called a true All-on-4® treatment.

 

All-on-4 at IMED

 

At IMED Polyclinic and Day Hospital, we have always used only Nobel Biocare implants and original Multi-unit abutments for All-on-4 procedures. Our fully digital IMED laboratory, using CAD-CAM technology, fabricates the titanium framework and covers it with composite or zirconia for optimal aesthetics.

 

Most importantly, implants are placed exclusively by oral surgery specialists with extensive implantology experience, while the prosthetic component is handled by our experienced dental prosthetics specialists. All prosthetic work is produced in our fully digital dental lab.

 

Thanks to this approach, we proudly operate as an All-on-4 Center of Excellence, delivering only original All-on-4® treatments of the highest quality.

 

In Summary

 

"Not all that glitters is gold!" The internet is full of misinformation. Only the original All-on-4 is legitimate – everything else are variations or imitations, some of which can be dangerous.

 

For anyone considering an All-on-4 treatment, it’s crucial to verify:

 

• What implants will be used

• How the procedure will be performed

• Who will perform it

 

Because in All-on-4, there are no small mistakes – errors are costly and can have lifelong consequences. In developed countries, this knowledge is already established; elsewhere, it is still learning by experience.

 

Author: Mr.sc. Marko Krmpotić, dr.med.dent., Specialist in Oral Surgery and Director of IMED Polyclinic and Day Hospital