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All on 4-6 implants

The All-on-4 implant-restorative method was invented by Dr. Paulo Malo in the 1980s and is also called the Malo clinic protocol.

This method was based on the ideas and principles that were commonly in use for dental implants back in the late 1950s and early 1960s.

Dr. Malo established a work protocol that was characterized by convenience and clarity, thus significantly improving and refining operating technique.

Since the 1980s, some upgrades have been made to Dr. Malo’s original protocol (All-on-4-6 for instance).

 All-on-4-6 – how does it work?

The beginning is creating a complete surgical guide according to x-ray and CT images, for precise placement of 4-6 implants. This results in a three-dimensional trapeze-shape being formed, on which we can build a fixed bridge of 12 teeth.
Effectively implementing the All-on-4 method requires careful planning, a high performance level and great surgical experience.
In order for us to be able to place implants and restore teeth in a single day, we must be extremely precise in all stages of the process. 
Dr. Malo developed his method in order to treat complete denture components and patients who were scheduled to have extractions of all of their teeth in a jaw. When we encounter cases in which there is not enough bone or the bone is of insufficient quality, we will use the 6 implants method instead of 4, thus distributing the load over a greater number of points.

Advantages of the All-on-4-6 method.

  • Immediacy of loading – patients will chew within a short time.
  • Saving time – patients who cannot take days off work or who just want to get done with the process quickly.
  • A solution for people suffering from dental anxiety – these people find it very difficult to go through lengthy treatments, so this method can be used to reduce this anxiety significantly.
  • Surgical processes – the method significantly simplifies the surgical procedure, thus reducing treatment times and recovery times.
  • Possibility of implanting teeth during extraction – the method allows for implantation and restoration immediately after tooth extraction.
  • New teeth in a single day – patients leave the clinic with a new set of teeth in just one day!
  • Price – the 4-6 method is significantly cheaper than similar prosthetic treatments

Disadvantages of the All-on-4-6 method.

  • Not all treatment candidates are suitable – e.g. if there are health disorders that may complicate the treatment and prevent it from being done safely.
  • Most dentists prefer not to place implants and restorations in one day and not all of them have the necessary experience and knowledge.
  • The process is very complex, so more than one dentist is required to complete the treatment.
  • A sufficient quantity of high quality bone is required to perform the treatment.

Placement of an abutment after insertion of implants

Pictures courtesy of Nobel Biocare

Alignment and fitting
of the temporary bridge.

The temporary bridge
was prepared in advance.

Positioning the implants
in the lower jaw

Positioning the implants
in the upper jaw

Connection of the temporary bridge to the implants

Upper jaw without implants