All-on-4 Implant Protocol
The All-on-4 protocol enables full arch rehabilitation using just four strategically placed implants with tilted posterior placement. This technique maximizes bone utilization, avoids grafting procedures, and allows immediate loading with same-day provisional delivery. Dental professionals will learn complete surgical planning, guide design, implant placement angles, and prosthetic workflow for predictable full mouth reconstruction.
Protocol Highlights
- Four implants support full arch prosthesis
- 30-45° tilted posterior implants
- Immediate load with PMMA provisional
- Minimizes need for bone grafting
- Single-day teeth delivery possible
- 95%+ success rate at 10 years
- Reduces overall treatment time
- Lower cost than 6-8 implant solutions
- Compatible with all major systems
- Guided surgery improves accuracy
Surgical Workflow
CBCT Planning
Import DICOM data, identify anatomical landmarks, and plan implant positions with 30-45° posterior angulation.
Guide Design
Create stackable or single-piece guide with pilot, intermediate, and final drill sleeves for each position.
Surgical Execution
Place guide, verify seating, drill through sleeves maintaining planned depth and angulation.
Implant Placement
Insert implants to planned depth achieving 35+ Ncm primary stability for immediate loading.
Provisional Delivery
Connect multi-unit abutments, pick up provisional with temporary cylinders, adjust occlusion.
Frequently Asked Questions
What angle are the posterior implants tilted in All-on-4?
Posterior implants are typically tilted 30-45 degrees to maximize anterior-posterior spread while avoiding the maxillary sinus or mental foramen, enabling longer implants in available bone.
Can All-on-4 be done without a surgical guide?
While possible freehand, guided surgery significantly improves accuracy, reduces operative time, and enables immediate loading with pre-fabricated provisionals. Guides are strongly recommended for predictable outcomes.
What is the minimum bone requirement for All-on-4?
Minimum 5mm of bone width and 10mm of bone height anterior to the mental foramen (mandible) or maxillary sinus (maxilla) is typically required for standard diameter implants.
Related Resources