All-On-4 Dental Implant – Evolution

1993 : All-on-4™ standard protocol pilot study

1998 : All-on-4™ mandible retrospective study

1998 : NobelSpeedy™ implant development

1999 : Malo Clinic Ceramic Bridge clinical studies- initial phase

2001 : All-on-4™ maxilla retrospective study

2002 : NobelSpeedy™ implant clinical studies – initial phase

2003: All-on-4™ mandible retrospective study publication

2004: Technical viability study of zygomatic and pterygoid anchorage

2005 : NobelGuide™ adaptation to the concept

2005 : All-on-4™ maxilla retrospective study publication

2005 : Study of the hybrid and extra-maxilla, with zygomatic and pterygoid anchorage – Initial phase.

2006 : Study of the All-on-4™ extra-maxilla new design order to use it with NobelGuide™

2007 : Study of the technique with zygomatic and pterygoid anchorage accepted for publication

2008 : All-on-4™ with extramaxillary anchorage: study publication

2011 : Study of the 10 years follow-up the All-on-4™ technique in the mandible

All-On-4 Dental Implant – Scientific Evidence


16 centers /  524  patients / 2148 implants / 1 – 5 years  follow up


Brånemark System TiUnite implants, NobelSpeedy Groovy and Brånemark System MK III Groovy implants


CSR (Cumulative survival rate) short term2,6,7,10      (1 year)  97.6% – 100%

CSR  mid-term7,8                  ( 3-4 years ) 96,9% – 100%

CSR mid-term8,9                  ( 4 –5 years) 99.73% – 98.36%

High CSR in both fully edentulous mandible and maxilla1-10, also with NobelGuide

Favorable marginal bone levels 2, 7,9 and soft tissue parameters 3, 6,8

Evidence-based, predictable , cost-effective, graftless solution for full arch rehabilitations

1.Malò P et al CIDRR (Clinical Implant Dentistry and Related Research) 2003,

2.Malo P et al CIDRR 2005,

3.Malo P et al CIDRR 2006,

4/5.Malo P et al JPD 2007 (2 papers) ,

6.Francetti L et al. CIDRR 2008,

7.Francetti L. et al JOMI 2009

8. Pomares C  Eur J Oral  Implantol  2009,

9. Agliardi E. Int.Quintessence 2010.

10. J Am Dent Assoc 2011;142;310-320 Lopes, Steve M. Moss and Guillermo J. Molina

All-On-4 Dental Implant – Scientific Documentation

Malo P, Rangert B, de Araujo, Nobre M. “AII-on-Four” immediate-function concept with Branemark System implants for completely edentulous mandibles: A retrospective clinical study. Clin Implant Dent Relat Res 2003; 5
(Suppl 1): 2-9.

Malo P, Rangert B, de AraLljo, Nobre M. AII-on-4 immediate-function concept with Branemark System”) implants for completely edentulous maxillae: A 1-year retrospective clinical study. Clin Implant Dent Relat Res 2005; 7
(Suppl 1): 88-94.

Malo P, de Araujo, Nobre M, Petersson U, Wigren S. A pilot study of complete edentulous rehabilitation with immediate function using a new implant design: Case series. Clin Implant Dent Relat Res 2006; 8:223-232

Malo P, de Araujo, Nobre M, Lopes A. The use of computer-guided flapless implant surgery and 4 implants placed in immediate function to support a fixed denture: Preliminary results after a mean follow-up period of 13 months. J Prosthet Dent 2007. Suppl: In press.

Davo Rodriguez, Malevez C and Rojas J. Immediate Function’” in atrophic upper jaw using Zygoma implants. J Prosthet Dent 2007 (Submitted)

Tulasne J F. Osseointegrated fixtures in the pterygoid region. in: Advanced osseointegration surgery. Applications in the maxillofacial region. Worthington P; Branemark PI.- Chicago, USA: Quintessence Publ. Co, Inc.
1992.- p. 182-188.

Graves SL. The pterygoid plate implant: a solution for restoring the posterior maxilla. Int J Periodontics Restorative
Dent, 1994; 4: 512-523.

Parel S, Branemark PI, Ohrnell LO, Svensson B. Remote implant anchorage for the rehabilitation of maxillary
defects. J Prosthet Dent 2001; 86: 377-381.

Vrielinck L, Politis C, Schepers S, Pauwels M, Naert I. Image-based planning and clinical validation of zygoma and pterygoid implant placement in patients with severe bone atrophy using customized drill guides. Preliminary results from a prospective clinical follow-up study. Int. J Oral Maxillofac Surg 2003; 32:7-14.

Hirsch J-M, Henry P, Andreasson L et al. A clinical Evaluation of the Zygoma Fixture. One-year follow-up at 16 clinics.
J Oral Maxillofac Surg 2004; 9 (Suppl): 22-29.

Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants of
improved prosthesis support. Int J Oral Maxillofac Implants 2000; 15: 405-414

Aparicio C, Perales P, Rangert B. Tilted implants as an alternative to maxillary sinus grafting: A c1incal, radiologic, and periotest study. Clin Implant Dent Relat Res 2001; 3: 39-49.

Fortin Y, Sullivan R, Rangert B. The Marius implant bridge: surgical and prosthetic rehabilitation for the completely edentulous upper jaw with moderate to severe resorption: A 5-year retrospective clinical study. Clin Implant
Dent Relat Res 2002; 4: 69-77.

Aparicio C, Arevalo X, Ouzzani W, Granados C. A retrospective clinical and radiographic evaluation of tilted
implants used in the treatment of severely resorbed edentulous maxilla. Appl Osseointegrat Res 2003; 1: 17-21