All-on-4 dental implants

Immediate Function Implants Hybrid Bridge

Immediate function implants hybrid bridge is a dental implant treatment option used to replace all missing teeth with a hybrid fixed bridge. There are several implant systems using the concept Immediate function implants hybrid including:

  1. All-on-4
  2. ProArch
  3. NeoArch


All-on-4 dental implants

All-on-4 treatment provides a fixed prosthetic and immediate function. For cases with sufficient bone at the anterior area, the All-on-4 implants are a graftless procedure solution that provides patients with full-jaw hybrid bridge during the same one trip.

The All-on-4 treatment uses 4 implants, 2 at the anterior bone area and 2 tilted at the posterior bone area. Because the 2 posterior implants are tilted, the bone-to-implant contact is enhanced to allow optimized bone support even with minimum bone volume and in general an improved anchorage due to better anterior quality bone.


Benefits of All-on-4

– immediate implants possibly using four implants consisting of two straight anterior implants and two implants tilted up to 45 degrees in the posterior

– there is shorter time-to-teeth treatment that provides for a fixed provisional bridge immediately for use after implant post surgery

– Bone grafting is avoided by tilting the posterior implants and using the available anterior bone for individuals that meets criteria

– for patients that are soon-to-be edentulous and ultimately requires the removal or loss of all teeth in jaw, the All-on-4 provides new immediate function teeth for a smoother transition


All-on-4 procedure and Malo protocols

In 1998, Dr. Paulo Malo successfully treated the first patient with the All-on-4 treatment concept. There is a difference between the All-on-4 concept and the Malo protocol. The All-on-4 is a concept refers to the surgical portion that uses 4 implants, 2 placed conventional at the front area and 2 placed titled at posterior area.

The Malo protocol entails 2 sets of practices

  1. surgical protocol –what & how to place the implant posts using All-on-4 concept or otherwise
  2. bridge protocol –what & how to build to prosthetics fitted over the implant posts by an hybrid all acrylic bridge, hybrid acrylic bridge or hybrid ceramic bridge

The Malo protocol is normally done in 2 stages or at least 2 trips:

Stage 1 : Implant post placement with immediate function provisional acrylic bridge

Stage 2 : Conversion of provisional bridge to long-term acrylic or ceramic bridge

For selective All-on-4 concept cases, patients may opt not to follow Malo protocols and may possibly have their treatment completed in 1 stage or 1 trip:

One Stage : Implant post placement with long-term acrylic bridge

The All-on-4 concept is a trademark by Nobel Biocare. Since then, this concept has been sometimes referred by patients as All-on-1 (All-on-one implants) or Four-on-one (4-on-1 implants) with various adaptations.

Nobel Biocare All-on-4® treatment concept eBook and Dr Alex Chung, DDS., MS., Taiwan


ProArch dental implants

ProArch dental implants

The edentulous practice for a fixed final prosthetic with 4 or more implants (placing it straight or tilted) developed by Malo has become a popular procedure worldwide and has influenced developments in shortening time to teeth.

Pro Arch is Swiss base Straumann’s new generation of full-arch fixed restorations, on either straight or tilted implants, provide an immediate screw retained fixed hybrid bridge solution. Pro Arch utilizes Strauman patented SLActive® surface and Roxolid® technologies combining several treatment steps aimed to reduce complexity without compromising the outcome.


NeoArch dental implants

NeoArch dental implants

NeoArch is NeoDent implants’ immediate fixed edentulous solutions based on proven edentulous concepts at an affordable cost.


Implant Costs