• When using NobelGuide™ computer-based planning, a CT scan using a Radiographic Guide is required. Please refer to the NobelGuide™ Concept Manual for details. • 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. • The sites must be fully healed. • 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. However, as with all NobelGuide™ treatments, it is important to compensate for the extra height needed for NobelGuide™ components and instruments.
