Implant Dentures: All-on-4®

Implant Dentures: All-on-4®

Teeth can be removed for a variety of reasons, but without teeth, eating and talking can prove to be very difficult, not to mention the embarrassment of having unsightly gaps in their smile.

Some people can have bridges to replace the missing teeth, but this can result in a great deal of natural tooth substance being removed, or even worse, cutting into teeth that have no previous restorations. Other options for replacing teeth can be by way of removable dentures, but these too can harm adjacent teeth where they clip on to try to aid their stability.

The gold standard for tooth replacement these days is dental implants and they are thought the best solution to replace missing teeth.

There are some patients that have numerous missing teeth with limited bone, that would require significant bone grafting procedures to have traditional dental implants.

New techniques are now available that allow placement of only 4 titanium dental implants in each jaw, without grafting. Often the teeth can be removed, 4 implants placed and new set of teeth can be provided for you all in the same day. Known as All-on-4TM this is a revolutionary approach developed by Dr Paulo Malo Portugal.  He successfully treated his first patient in1998, with this treatment concept and since then, hundreds of thousands of patients have been treated with his technique. Dr Kate has visited and trained with Dr Malo’s at his clinic in Portugal on two occasions and now successfully treats many cases, from the very simple to the highly complex, double (or Quad) Zygoma cases.

Characteristics include:

 Complete oral rehabilitation with only four implants (per jaw)
Two straight implants at the front and two implants tilted up to 45º at the back

 Immediate Function

For patients meeting criteria a new set of teeth can be screwed in on the day of surgery. This is a temporary bridge that helps to stabilise and splint the newly inserted implants. (A bit like putting a broken arm in a plaster cast)

Graftless procedure
Bone grafting is avoided by tilting the posterior implants, utilising available bone


Why is it so popular?

Rapid improvement in quality of life

In most cases you will be a fitted with a new set of teeth on the day of surgery! This will allow you to return to function and will improve things like your speech, your  looks, and thus your  self-esteem.

Shorter treatment times

using tilted implants at the back allows Dr Kate to place the implants where the bone is, avoiding major bone grafting that would have otherwise been needed. Because of this, the treatment is simplified and the treatment times are much faster.

Lower costs

When compared to conventional methods, this concept is the least expensive option for those who have already lost there teeth or who are  soon-to loosing all their teeth.

Why is this procedure so popular?

Many of our patients come to see Dr Kate because they are unhappy with their existing bridgework or denture and are seeking a solution that is not dentures!

Some patients are simply fed up with constantly having fillings and single extractions, I call them “dentally exhausted” and would like a “once and for all” type solution.

Some patients have been discouraged from implants because they lack sufficient bone volume or suffer from some health problems that conventional surgery with bone grafting is contraindicated. For all these cases, even patients with severe bone loss, All-on-4TM may be the right solution for them.

This procedure is well tolerated and of a short duration – typically takes about 1 to 2 hours for the surgery, with minimal bruising and pain post operatively. Dr Kate generally  performs these procedures at the hospital as a day stay, but there is overnight facilities available for those who live out of town, or for those who live alone.

Dr Kate ca usually be performed in patients with diabetes, osteoporosis or other health conditions that can some time be contraindications for bone grafting.

This procedure is done in a single day – with the surgery in the morning and the placement of the fixed (non-removable) teeth later in the day. Traditional techniques often involve multiple surgeries and can take over a year to complete.

The result is natural-looking teeth that feel and work like your natural dentition that are easy to maintain and clean.

This is a cost saving procedure, typically about half the cost of alternative techniques (bone grafting and the placement of more than 4 implants).


Patients with terminal dentition

A significant number of cases treated with the All-on-4® treatment concept are patients with failing dentition.


Insert photos of before and after from Brian falisconi here

also photo of Karen dennison showing crappy teeth


Patients with no teeth (known as edentulism) are also often eligible for the All-on-4® treatment concept. A thorough evaluation of any patient is necessary in order to choose the right treatment and to establish a predictable treatment outcome.


will this be successful??


Proven long-term solution with high survival rates

The All-on-4® treatment concept is a proven long-term solution with

up to 10 years follow-up in the mandible and 5 years in the maxilla.5,6

Cumulative survival rates are high in both the edentulous

maxilla and mandible.2,3,5,6,7,8,9,10

Mid-term 3–4 years: 96.3–100%3,9,10

Long-term 5–10 years: 94.8–98.0%5,

What is All-on-4TM ?

Total Oral Rehabilitation

All-on-4TM advantages

Success rates higher than traditional implant techniques– 98%;

Virtually eliminates the need for bone grafting, which is invasive, costly, and uncomfortable for patients;

Is All-on-4TM the right solution for me?

Total Oral Rehabilitation

At MALO CLINIC we do a first appointment with the purpose to evaluate your current dental health. In this appointment we will advise you the best treatment options to fulfill your needs, answering all your questions.

What to expect

Total Oral Rehabilitation

Placing a dental implant is a quick, minimally invasive procedure. At MALO CLINIC a dental practitioner will do a careful initial evaluation to determinate the best treatment plan for your dental condition. The initial evaluation consists in a comprehensive examination and diagnostic imaging. With the help of a specific computer software program is created a 3 dimensional image of your jaw. “Virtual implants” are placed in the 3D image to ensure accuracy at the time of your surgery. To facilitate the procedure and ensure quality, the fixed bridge is manufactured before the surgery.

All information provided by us or any representatives of the practice, including (without limitations) reference to procedure, treatment, estimated cost will be subject to comprehensive oral exam by the dentist. Treatment will vary from patient to patient. Any surgery or invasive procedure carries risk. Before proceeding, you should seek second opinion from an appropriate health professional.


All-on-4 Zygomatic Implants*


Depending on the outcome of your diagnostic x-rays, extra long dental implants may be offered in cases where the amount of bone available in the upper jaw is insufficient.

These implants are called all-on-4 Zygomatic implants and are anchored into the check bone, providing an alternative to grafting procedures in the upper jaw.

The procedure to insert Zygomatic dental implants is performed under a general anaesthetic and placed by a specialist oral and maxillofacial surgeon. As with the All-on-4 technique, new teeth can be connected to them within three days of the surgery.

Quad Zygoma

In some cases the upper jaw may be very deficient in bone even in the anterior region. For these cases double zygoma implants may be inserted into both sides of the available check bone to support a full upper set of replacement teeth.

As with single zygoma this procedure is performed under general anaesthetic together with a specialist oral and maxillofacial surgeon. A full set of immediate teeth can be connected to the implants after 1-3 days.

Patient benefits using Zygoma and Quad Zygoma implant solutions

  • Improved appearance
  • Normal looking teeth and gums
  • Freedom to eat what you like
  • Confidence to laugh
  • Teeth that do not come out
  • No more denture sore spots
  • Long term tooth support
  • Faster healing than bone grafting
  • Low maintenance

*Please note: Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion.