All on Four Dental Implants

The All-On-Four Dental Implants Technique was developed by a dentist in Portugal in cooperation with Nobel Biocare. It is an attempt to allow dentists to place a full arch of teeth in patients with poor bone levels by using highly angled implants in only the anterior portion of the jaw, where there is more bone density. The idea is to provide a shortcut around bone grafting, which has become the standard technique for patients with poor bone levels.

Dr. Chal has taken the course for the All on Four Technique and is fully prepared to use it. In fact, he is personally acquainted with Dr. Palo Malo, the dentist who developed the technique. As a leader with a world-wide reputation for his dental implant treatment and innovations, he is willing to implement any technique like All-on-Four, that has the potential for helping his patients.

But, while there are advantages, there are risks the patient needs to understand.

After taking the training course that is offered, Dr. Chal is very cautious about it. He will use it for you if you wish, but he will candidly discuss all of the pros and cons.

Implant Diagnostics CT His primary concern with this technique is the risk that is involved. He is intent on providing the highest level of predictability for his patients, and wants his patients to know that, if he uses the All-on-Four technique for them, and if one of the dental implants fails, the entire restoration fails and has to be re-done.

Especially considering that this technique is recommended for patients with marginal bone levels, this seems to him a real concern.

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

all on four dental implants - x-ray view
Here is a panographic x-ray of the four angled implants that have been placed.

A second concern when this technique is used is the jaw atrophy that occurs in the posterior region of the jaw. (For more information on this jaw atrophy, please see our page on facial collapse.) This atrophy creates a risk of jaw fracture. Since the all on four technique only places implants in the anterior of the jaw, the bone in the posterior is not stimulated and thus continues to be resorbed by the body. The presence of implants, on the other hand, has a piezoelectric effect that prevents bone resorption.

Please see more information in this web site on dental implant failure.

You also may be interested in seeing Dr. Chal's impressive list of credentials and awards on his main web site, or in seeing his dramatic implant success stories.