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- The term All-on-4, also known as All‐on‐Four and All‐in‐Four, refers to 'all' teeth being supported 'on four' dental implants, a prosthodontics procedure for total rehabilitation of the edentulous (toothless) patient, or for patients with badly broken down teeth, decayed teeth, or compromised teeth due to gum disease. It consists of the rehabilitation of either edentulous or dentate maxilla and / or mandible with fixed prosthesis by placing four implants in the , where bone density is higher. The four implants support a fixed prosthesis with 10 to 14 teeth, and it is placed immediately, typically within 24 hours of surgery. The All-On-Bar solution, with the latest technology, computer aid design/Mill (cad/cam) the all-on-4 has evolved including the All-on-bar concept. which is adding a milled titanium bar structure to the dental implants which helps keep them working together. Protecting the implants from failures even after the hybrid bridge is broken. this concept helps the clinician provide a better long-lasting solution, instead of a conversion-denture which is a chair side repair and modified denture. The All-On-Bar reduces the appointments, eliminating the Denture Conversion Temporary by replacing it with a long lasting hybrid, some patients keep this option as their final due to a lower budget or because the space is limited for other final solutions. Pmma or Denture teeth over the titanium bar wears out over time and need replacement, this is a controversial topic since the Pmma has the advantage of been shuck absorbent. This helps the implants receive less stress during mastication forces but keeping a solid structure on the inside.many processionals think this is a better solution, keeping in mind that the bridge can be switch to a new one a few years after. Implant manufacturer Nobel Biocare AB of Gothenburg, Sweden, was among the first to identify the evolution of the All-on-4 technique as a potential valid and cost-effective alternative to conventional implant techniques, and funded studies by Portuguese dentist Paulo Maló to determine the efficacy of this approach. During this time, this technique was also used by various other clinicians around the world. All-on-4 is not an invention, but rather a treatment technique that has evolved over time, and has the following features:
* four dental implants to support a full fixed bridge (documented since 1977)
* the use of angulated implants in the back to overcome bony deficiencies or anatomical structures (documented since 1990)
* immediate loading (documented since 1990) The All-on-4 treatment concept is a prosthodontic procedure (i.e replacement of missing teeth) that provides a permanent, screw-retained, same-day replacement for the entire upper and / or lower set of teeth with a bridge or denture. The procedure is best for patients with significant tooth loss or decay, and for people whose bone loss in the jaw area prevents them from getting conventionally oriented (vertical) dental implants. Often, tooth loss is accompanied by loss of the jaw bone, which poses the problem of reconstruction of the jaw bone requiring bone grafting. The All-on-4 technique takes advantage of the dense bone that remains in the front part of the jaws, and by placing the two posterior implants on an angle to avoid the sinus cavities in the upper jaw and the nerve canal in the lower jaw. The cost of the All on 4 procedure varies based on the final prosthetic material. Acrylic resin teeth over titanium bar is substantially cheaper resulting in a total cost of around $30K per arch/jaw in the United States. Premium prosthetic materials like Zirconia can result in a total treatment cost between $36K to $40k per arch/jaw in the United States. For the implementation to be successful a careful analysis of the bone structure needs to be made. The most ideal way to evaluate the bone is by a cone beam computed tomography (CBCT) scan. The All-on-4 protocol is for at least four implants to be placed in a jaw. The back implants are typically angled approximately 30 to 45 degrees from the occlusion (biting plane). The implant is placed in front of the maxillary sinus in the upper jaw (maxilla), and in front of the mental nerve in the lower jaw (mandible). The head of the implant emerges in approximately the second premolar position. This will allow a molar tooth to be cantilevered posterior, resulting in a denture or bridge with approximately twelve teeth. (en)
- Le terme All-on-4, également connu sous le nom de All-on-Four et All-in-Four, fait référence à toutes les Dents soutenues sur quatre implants dentaires, une technique chirurgicale et prothétique pour la réhabilitation totale d'un patient édenté ou pour un patient atteint de parodontite avancée ou ayant les dents très abîmées (par exemple, une carie). Cette procédure consiste en la réhabilitation de l'os maxillaire et/ou de la mandibule avec une prothèse dentaire complète fixe en plaçant quatre implants dans la mâchoire, là où la densité osseuse est plus élevée. Les quatre implants supportent une prothèse fixe de 10 à 14 dents. (fr)
- All-on-4（オールオン4、オールオンフォー）は、インプラント治療法である。 (ja)
- A técnica para reabilitação do desdentado total All-on-4, é um procedimento cirúrgico e protético inventado na década de 1990 pelo médico dentista português Paulo Maló, que consiste na reabilitação da maxila e da mandíbula edêntulas com próteses fixas através da colocação de quatro implantes na região anterior dos maxilares, aquela em que a densidade óssea é maior e a que apresenta a taxa de sucesso mais elevada, permitindo a colocação de uma prótese fixa com 12 a 14 dentes imediatamente no dia da cirurgia. Frequentemente, a perda dos dentes é acompanhada de perda do osso do maxilar o que coloca o problema da reconstituição do osso do maxilar. Para que a implantação seja bem sucedida é necessário transplantar osso de outras partes do corpo, por exemplo, da crista ilíaca ou do crânio e aplicá-lo na(s) zona(s) onde se pretende implantar o (s) dente(s). A transplantação de enxerto ósseo leva entre três e seis meses para que os implantes possam ser colocados. Após a colocação dos implantes, é necessário esperar dois a três meses, prazo após o qual já é possível a colocação das prótese fixas. O tempo total de reabilitação é de doze meses. Muitos pacientes não podem fazer o transplante de osso por razões de saúde geral (diabetes e outras). A reabilitação dos dentes por esta via (transplante de osso), devido a problemas de saúde é impossível em 20% dos pacientes. O processo em apreço, permite obviar os referidos inconvenientes porque consiste na fixação de uma prótese dentária totalmente personalizada (ponte) assente apenas em quatro implantes de titânio. Estes implantes funcionam como "pilares" para a ponte que suporta os dentes protéticos. O processo inventado permite tirar partido do osso existente, mesmo que escasso, evitando ter que se recorrer a enxertos ósseos. Os implantes posteriores são substancialmente angulados, a aproximadamente 45º, para evitar comprometer a cavidade sinusal no maxilar superior e o canal do nervo na mandíbula. A invenção tal como apresentada deve o seu nome à própria natureza do método, que consiste na aplicação de uma prótese dentária com no mínimo doze dentes (ponte) fixa nos maxilares, assente apenas em quatro implantes de titânio. Parte essencial da invenção, são os parafusos de fixação do implante dentário, os quais estão protegidos pela patente WO2004091424. (pt)
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- Le terme All-on-4, également connu sous le nom de All-on-Four et All-in-Four, fait référence à toutes les Dents soutenues sur quatre implants dentaires, une technique chirurgicale et prothétique pour la réhabilitation totale d'un patient édenté ou pour un patient atteint de parodontite avancée ou ayant les dents très abîmées (par exemple, une carie). Cette procédure consiste en la réhabilitation de l'os maxillaire et/ou de la mandibule avec une prothèse dentaire complète fixe en plaçant quatre implants dans la mâchoire, là où la densité osseuse est plus élevée. Les quatre implants supportent une prothèse fixe de 10 à 14 dents. (fr)
- All-on-4（オールオン4、オールオンフォー）は、インプラント治療法である。 (ja)
- The term All-on-4, also known as All‐on‐Four and All‐in‐Four, refers to 'all' teeth being supported 'on four' dental implants, a prosthodontics procedure for total rehabilitation of the edentulous (toothless) patient, or for patients with badly broken down teeth, decayed teeth, or compromised teeth due to gum disease. It consists of the rehabilitation of either edentulous or dentate maxilla and / or mandible with fixed prosthesis by placing four implants in the , where bone density is higher. The four implants support a fixed prosthesis with 10 to 14 teeth, and it is placed immediately, typically within 24 hours of surgery. (en)
- A técnica para reabilitação do desdentado total All-on-4, é um procedimento cirúrgico e protético inventado na década de 1990 pelo médico dentista português Paulo Maló, que consiste na reabilitação da maxila e da mandíbula edêntulas com próteses fixas através da colocação de quatro implantes na região anterior dos maxilares, aquela em que a densidade óssea é maior e a que apresenta a taxa de sucesso mais elevada, permitindo a colocação de uma prótese fixa com 12 a 14 dentes imediatamente no dia da cirurgia. (pt)
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