Progressive clinicians demand progressive solutions. That’s why clinicians looking to improve treatment outcomes and grow their practice are using the All-on-4® treatment concept. Today backed by almost 20 years of clinical success, this established and proven1 approach for restoring full arches continues to evolve. Thanks to Nobel Biocare’s latest innovations, the All-on-4® treatment concept is more life-changing than ever, both for patients and dental professionals.

The new Multi-unit Alignment Instrument makes it easy to identify the angulation of the most-suitable Multi-unit Abutment and the rotational position of the implant; and the broad assortment of Titanium Multi-unit Healing Caps makes individualized treatment possible.

The key principle of the All-on-4® treatment concept is well known—it makes the full, graftless rehabilitation of an edentulous mandibular or maxillary arch possible with just four implants and allows a provisional restoration to be placed on the day of surgery.*

With the latest innovations from Nobel Biocare, the next generation of this well-documented2 treatment protocol has arrived. New versions of implants and abutments plus versatile restorative options mean that even more patients and practices can benefit from the proven benefits of the All-on-4® treatment concept.

The right implant

Today, Nobel Biocare offers more implant options than ever before for the All-on-4® treatment concept, providing clinicians with the right implant for every case.

The NobelSpeedy implant system, the original and widely documented option for the All-on-4®treatment concept, is available in more lengths and diameters for increased surgical flexibility. Shorter, longer and wider versions have been added to an expanded NobelSpeedy Groovy range. All are designed to further help clinicians utilize a graftless approach and achieve cortical anchorage, even where bone quality and quantity are limited. These new options will allow even more patients to benefit from the proven advantages of the All-on-4® treatment concept.3

In cases where maxillary bone is severely resorbed, the placement of zygomatic implants can nonetheless make graftless restoration of the full arch on four implants possible. Building on 25 years of success with Nobel Biocare’s zygomatic implants, the newest NobelZygoma 0° and 45° implants provide greater surgical and prosthetic flexibility than previous options. They have an unthreaded implant body designed to interface with soft tissue and, depending on the anatomical situation, parts of the implant body can be located outside of the maxillary sinus. A new tapered apex design has been designed to support high primary stability for Immediate Function.

All these options are intended to make it possible for clinicians to utilize the proven benefits of the All-on-4® treatment concept in more cases, helping them build a reputation for rapidly restoring quality of life for patients who are experiencing the problems associated with dentures or a failing dentition.

Reduce restorative chair time

In order for a clinician to be able to offer the benefits of the All-on-4® treatment concept to more patients, treatment efficiency is also a key consideration. If patients spend less time in the chair, they will be more comfortable during treatment, and clinicians will consequently have the chance to successfully treat more patients in a day.

With this in mind, Nobel Biocare has introduced the Multi-unit Abutment Plus. The successor to the company’s original, and extremely popular, Multi-unit Abutment, this updated version is designed to significantly reduce the chair time required to perform provisionalization processes such as a denture conversion— a procedure commonly used in the All-on-4® treatment concept.

By introducing a snap-fit function between the temporary cylinders and the abutment, screws are no longer required during the try-in process. This means the common practice of removing the temporary cylinders and the denture several times during the conversion process can be done in a few snaps—with no need to tighten and loosen four screws each time— saving valuable time for the clinician and lab technician.

For further ease, speed and efficiency in choosing the correct Multi-unit Abutment rotational position and angulation, the Multi-unit Aligning Instrument is now available for conical connection and Tri-Lobe. This latest innovation makes it easy to identify the angulation of the most-suitable Multi-unit Abutment and the rotational position of the implant, helping to optimize the final abutment position and prosthetic design.

In addition, the Titanium Multi-unit Healing Cap assortment (see below) facilitates the placement of the provisional prosthesis. Designed to help individualize treatment, this newly expanded portfolio of healing caps provides clinicians with a choice of dimensions and designs to suit the thickness of the soft tissue. These one-piece components are made of titanium to provide ease of placement, and are single-use to prevent the deformity that can be caused by repeated sterilization.

When it comes to the final restoration, NobelProcera offers a wide variety of precision-milled CAD/CAM restorations offering easy handling, long-term predictability and a precise fit.4

The All-on-4® treatment concept – the key to practice progression?

For a dental office to be at the fore- front of the profession, it has to stand out from the competition. If the practice team wants to build a strong reputation, they need to offer effective treatment that leaves patients satisfied to the extent that they are willing to share their positive experiences with others. In this regard, few treatment options come close to the proven success of the All-on-4® treatment concept.

According to research, 95% of All-on-4® treatment concept patients were satisfied with their new teeth, and fully 88% said they would definitely recommend similar treatment to friends and colleagues.5

There’s no reason this positive patient response won’t last, with long-term success documented for All-on-4® in both the edentulous maxilla and mandible. Long-term follow-up shows high cumulative survival rates of 94.8% in the mandible after ten years and 98.0% in the maxilla after five years.6

Becoming known for such success can help significantly increase patient flow. In fact, 24% of those that attended a Nobel Biocare All-on-4® treatment concept course grew the number of implants they placed by 50% the following year.7

Importantly, this new generation of componentry is just the next step in the continuous evolution of the All-on-4® treatment concept. As the company behind the original concept, Nobel Biocare is committed to further enhancing the componentry and workflow for All-on-4®.

Thanks to this commitment, clinicians who take advantage of the treatment concept’s proven benefits will find themselves firmly at the forefront of their profession not just today, but for the foreseeable future.

* For patients meeting criteria for the immediate loading of implants.

More to explore

References

  1. Patzelt SB, Bahat O, Reynolds MA, Strub JR (2014) The all-on-four treatment concept: a systematic review. Clin Implant Dent Relat Res 16(6):836-55

    Lopes A, Maló P, de Araújo Nobre M, Sanchez-Fernández E(2015) The NobelGuide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Prospective Report on Medium- and Long-Term Outcomes. Clin Implant Dent Relat Res. doi: 10.1111/cid.12260

    Maló P, de Araújo Nobre M, Lopes A, Ferro A, Gravito I (2016) All-on-4® Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7-Year Clinical and 5-Year Radiographic Retrospective Case Series with Risk Assessment for Implant Failure and Marginal Bone Level. Clin Implant Dent Relat Res. doi: 10.1111/cid.12282

    Mozzati M, Arata V, Gallesio G, Mussano F, Carossa S. Immediate postextractive dental implant placement with immediate loading on four implants for mandibular full-arch rehabilitation: a retrospective analysis. Clin Implant Dent Relat Res 2013;15:332-40

    Weinstein R, Agliardi E, Fabbro MD, Romeo D, Francetti L. Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants. Clin Implant Dent Relat Res 2012;14:434-41

    Maló P, de Araújo Nobre M, Lopes A, Ferro A, Gravito I (2016) Complete Edentulous Rehabilitation Using an Immediate Function Protocol and an Implant Design Featuring a Straight Body, Anodically Oxidized Surface, and Narrow Tip with Engaging Threads Extending to the Apex of the Implant: A 5-year Retrospective Clinical Study. Int J Oral Maxillofac Implants 31 (1) 153-61

  2. Patzelt SB, Bahat O, Reynolds MA, Strub JR (2014) The all-on-four treatment concept: a systematic review. Clin Implant Dent Relat Res 16(6):836-55

    Lopes A, Maló P, de Araújo Nobre M, Sanchez-Fernández E(2015) The NobelGuide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Prospective Report on Medium- and Long-Term Outcomes. Clin Implant Dent Relat Res. doi: 10.1111/cid.12260

    Maló P, de Araújo Nobre M, Lopes A, Ferro A, Gravito I (2016) All-on-4® Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7-Year Clinical and 5-Year Radiographic Retrospective Case Series with Risk Assessment for Implant Failure and Marginal Bone Level. Clin Implant Dent Relat Res. doi: 10.1111/cid.12282

    Mozzati M, Arata V, Gallesio G, Mussano F, Carossa S. Immediate postextractive dental implant placement with immediate loading on four implants for mandibular full-arch rehabilitation: a retrospective analysis. Clin Implant Dent Relat Res 2013;15:332-40

    Weinstein R, Agliardi E, Fabbro MD, Romeo D, Francetti L. Immediate rehabilitation of the extremely atrophic mandible with fixed full-prosthesis supported by four implants. Clin Implant Dent Relat Res 2012;14:434-41

    Maló P, de Araújo Nobre M, Lopes A, Ferro A, Gravito I (2016) Complete Edentulous Rehabilitation Using an Immediate Function Protocol and an Implant Design Featuring a Straight Body, Anodically Oxidized Surface, and Narrow Tip with Engaging Threads Extending to the Apex of the Implant: A 5-year Retrospective Clinical Study. Int J Oral Maxillofac Implants 31 (1) 153-61

  3. Malo P, de Araujo Nobre MA, Lopes AV, Rodrigues R. Immediate loading short implants inserted on low bone quantity for the rehabilitation of the edentulous maxilla using an All-on-4 design. J Oral Rehabil epub ahead 2015

    Vicent et al. (2016), Clinical outcome of extra-long tilted for the rehabilitation of complete edentulous atrophic maxilla using the all-on-four concept. Implant Therapy Outcomes, Surgical Aspects. Clin. Oral Impl. Res., 27: 269. doi:10.1111/clr.267_12958

  4. Pozzi A, Tallarico M, Barlattani A. Monolithic Lithium Disilicate Full-Contour Crowns Bonded on CAD/CAM Zirconia Complete-Arch Implant Bridges With 3 to 5 Years of Follow-Up. J Oral Implantol. 2015 Aug;41(4):450-8. doi: 10.1563/AAID-JOI-D-13-00133. Epub 2013 Nov 4

    Pozzi A, Holst S, Fabbri G, Tallarico M. Clinical reliability of CAD/CAM cross-arch zirconia bridges on immediately loaded implants placed with computer-assisted/template-guided surgery: a retrospective study with a follow-up between 3 and 5 years. Clin Implant Dent Relat Res. 2015 Jan;17 Suppl 1:e86-96. doi: 10.1111/cid.12132

    Örtorp A, Jemt T. CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 10-year comparative clinical study. Clin Implant Dent Relat Res. 2012 Mar;14(1):88-99. doi: 10.1111/j.1708-8208.2009.00232.x. Epub 2009 Aug 17

    Maló P, Nobre Md, Lopes A, Francischone C, Rigolizzo M. Three-year outcome of a retrospective cohort study on the rehabilitation of completely edentulous atrophic maxillae with immediately loaded extra-maxillary zygomatic implants. Eur J Oral Implantol. 2012 Spring;5(1):37-46

    Maló P, de Araújo Nobre M, Lopes A, Ferro A, Moss S. Extramaxillary surgical technique: clinical outcome of 352 patients rehabilitated with 747 zygomatic implants with a follow-up between 6 months and 7 years. Clin Implant Dent Relat Res. 2015 Jan;17 Suppl 1:e153-62. doi: 10.1111/cid.12147

    Hjalmarsson L, Örtorp A, Smedberg J, Jemt T. Precision of fit to implants: a comparison of Cresco™ and Procera® implant bridge frameworks. Clin Implant Dent Relat Res. 2010 Dec;12(4):271-80. doi: 10.1111/j.1708-8208.2009.00171.x

    Pozzi A, Holst S, Fabbri G, Tallarico M. Clinical reliability of CAD/CAM cross-arch zirconia bridges on immediately loaded implants placed with computer-assisted/template-guided surgery: a retrospective study with a follow-up between 3 and 5 years. Clin Implant Dent Relat Res. 2015 Jan;17 Suppl 1:e86-96. doi: 10.1111/cid.12132

  5. Babbush CA, Kanawati A, Kotsakis GA, Hinrichs JE. Patient-related and financial outcomes analysis of conventional full-arch rehabilitation versus the All-on-4 concept: A cohort study. Implant Dent 2014;23:218–24

  6. Maló P, de Araújo Nobre M, Lopes A, Francischone C, Rigolizzo M. “All-on-4” immediate-function concept for completely edentulous maxillae: a clinical report on the medium (3 years) and long-term (5 years) outcomes. Clin Implant Dent Relat Res. 2012 May;14 Suppl 1:e139-50. doi: 10.1111/j.1708-8208.2011.00395.x. Epub 2011 Oct 18. PubMed PMID: 22008153

    Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011 Mar;142(3):310-20. PubMed PMID: 21357865

  7. Data on file: Comparing annual increase in customer net sales (2013-2014)

Posted by Nuria Serra