All On 4 Technique

All-on-Four is a method for permanent reconstruction of the entire jaw. The method is completed within several hours and is built on four implants.

Solutions for rehabilitation of toothless areas can be divided into two types, removable reconstruction (dentures) and a permanent reconstruction. Although the second type incurs higher cost and more extensive treatment, the permanent solution is the more commonly chosen alternative today.

When rehabilitation is needed for a toothless jaw, the only way to reach permanent rehabilitation is by means of implants. The accepted opinion in research conducted on the matter is that at least 6 implants should be located in the bottom jaw, and 8 implants should be located in the upper jaw.


There are many cases wherein the amount of existing bone does not allow the insertion of the minimum necessary implants. In such cases it is necessary to thicken the bone ridge by building bone. This procedure of course lengthens the duration of the treatment by several months and makes it more costly.

Rehabilitation of the Entire Jaw with the All-on-Four Method
This method was developed (by Dr. Paulo Maulo from Portugal) with the intention of making treatment simple, to reconstruct an entire jaw with the support of 4 implants. 

To support a wide as possible arch, some of the implants are placed at an angle. This method has another advantage, the ability to abstain from penetrating other parts of the facial anatomy (such as the maxillary sinus and the nerve in the bottom jaw), and thereby saving additional surgery of bone construction.

A patient who is suitable for rehabilitation by means of this method undergoes an extraction of the lost teeth and installation of the implants. This is performed in one day, under either local or full anesthesia. While the patient rests for a couple of hours, an authorized technician prepares the temporary denture according to the information and measurements he/she receives from the dentist. Upon the completion of the treatment, the temporary denture is attached to the implants.

Keeping to a meticulous hygienic protocol, a soft-food diet, and refraining from putting a heavy load on the new implants, aid the success of the implants.

After 6-8 months, the procedure reaches its end and the final bridge is installed.

Amongst the dental community, there are differing opinions regarding this method. Supporters list the advantages that were mentioned above: short rehabilitation period and cost reduction for the patient. On the other hand, some specialists claim that the load of an entire arch supported by only 4 implants is not optimal. In addition, in the case of a failure of a single implant, the entire rehabilitation is doomed.

The method is indeed daring and saves the patients much time and money, yet it also holds risks that in the end can make the short cut a very long one! Therefore, great caution must be taken and a number of precautions must be followed so as not to near situations of failure. A partial list of the safety precautions kept in Dr. Orrelle's clinic include the following:

An in depth meticulous examination of each case is conducted. Whoever does not meet the necessary criteria will be forced (for his own benefit) to switch to the regular method of rehabilitation so as to prevent the anguish caused by failure of the procedure.

In any case, much effort is invested in planning a greater number of implants than 4, strengthening the supporting construct so that the rehabilitation becomes resistant to failure due to failure of a single implant.

To Summarize
There is no doubt that for those who are not interested in the conventional treatment of bone construction and sinus liftings,  the All-on-Four – Six method (if found personally suited) will improve the patient's quality of living, as compared to a full denture, granting good functionality alongside perfect aesthetics.

Nonetheless, the limitations of the method must be recognized, and above all, each patient's personal biology must be respected! It is imperative to go with your given biological data and never against it.

To assess your situation and the rehabilitation options open to you, make contact.

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