The All-on-4 clinical solution has been developed to maximize the use of available bone and to allow for Immediate Function™. When planning an All-on-4 treatment using a flap technique, be sure to consider the following factors:
General Considerations: • Ability to achieve primary implant stability (35 – 45 Ncm insertion torque). • No severe parafunctions. • Indicated for totally edentulous maxilla with a minimum bone width of 5 mm and a minimum bone height of 10 mm from canine to canine. • Indicated for totally edentulous mandible with a minimum bone width of 5 mm and minimum bone height of 8 mm in between the mental foramina. • To diminish the cantilever, tilt the posterior implants to a maximum of 45°.
If the angulation is 30° or more, it is necessary to splint the tilted implants. • For tilted posterior implants, plan the distal screw access holes to be located at the occlusal face of the 1st molar, 2nd pre-molar or 1st pre-molar. • The All-on-4 treatment does not require a wider opening of the mouth than a normal straight position of the implants due to the angulation of the posterior implants. • If there are extraction sites, clean them thoroughly. It is advisable to place implants between extraction sockets.
