Implantation using the All-on-4 protocol

Surgery using the All-on-4 protocol is most often performed in one stage: on the same day, the surgeon places the implants and a fixed prosthesis. In some cases, a decision may be made to use a two-stage placement method when temporary prosthetic treatment is carried out over 3 days. “All-on-four” prosthetic treatment can be performed using several methods:

• Immediate placement — the implant is placed into the socket of a tooth that has just been extracted.
• Using a template — with the use of computer-assisted 3D technologies. A 3D model is created that replicates the shape of the jaw and includes 4 openings that serve as guides for implant placement.
• With gum flap elevation — the surgeon makes an incision in the gum, moves it aside, creates an opening in the bone tissue, and then places the implant.

Unfortunately, there are cases when surgery may not go according to plan, and the patient should know what risks they are taking and what complications may occur during dental implantation.

Complications may be associated with:

• violation of bone tissue integrity (perforation of the maxillary sinus floor, entry into the mental foramen, fracture of the bony septum, fracture of the alveolar process)
• individual characteristics of the patient’s body (allergic reaction to medications or to the material of the temporary prosthesis)
• other causes (nerve damage, an unstable implant).

To prevent complications, the patient is advised to take a responsible and careful approach to choosing the clinic and doctor, and also to assist the doctor in collecting the medical history during the consultation.

Complications after All-on-4 implantation may occur:

1. Immediately after surgery or in the following days: increasing throbbing pain, bleeding from the wound/wounds, tissue inflammation, high temperature, purulent formations, osteomyelitis, mobility of implants/prosthetic structures.
2. Delayed: peri-implantitis, implant failure, inflammatory processes of the soft tissues.

Complete placement of All-on-4 implants takes up to three hours. The healing process lasts from three to six months. After complete osseointegration, after 6 months, the prosthodontist will make and place a permanent fixed dental prosthesis.

Advantages

• no need for bone augmentation
• short procedure time.

Disadvantages

• requires special surgical skills and specialized equipment in the clinic
• despite the relative universality of the method, contraindications exist
• increased costs, because temporary prostheses will need to be replaced with permanent ones
• limited strength of the temporary structure
• bulkiness of the structure.