All on Four Dental Implants

A lot of people have heard about the All on Four dental implants technique. Let's explain what's involved in this treatment and why we don't recommend it.

The All-On-Four Dental Implants Technique was designed by Dr. Palo Malo, a dentist in Portugal. It was designed to be a shortcut—to try to replace all a patient's teeth in cases where there is bone atrophy, without resorting to bone grafting.

This technique involves placing four dental implants placed in the anterior region of the jaw. In order to try to provide more stability when there isn't enough bone to support regular implants, these four are highly angled. See the x-ray below for an illustration of this.

The best way to explain our concern with this technique is that it is a shortcut. There is a reason that bone grafting has become the standard of care in cases where there is bone atrophy. Studies seem to show that there is an increased level of risk with All on Four dental implants.

an x-ray of all on four dental implants

Here is an x-ray showing the four angled implants
placed for an All on Four case

Another concern with this technique is bone atrophy.

Whenever teeth are extracted, your body reacts by resorbing the bone that used to be needed to support those teeth. When dental implants are placed, they stimulate the bone and prevent this atrophy. But with the All on Four technique, implants are only placed in the anterior part of the jaw, which leaves the posterior vulnerable to atrophy, weakening, and possible jaw fracture later in life.

Another concern is that there tend to be problems with the bite.

An illustration of placing All-on-Four dental implants
An illustration of the All-on-Four dental implants technique.

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