Less Is More: A Case Report on All-on-4 Prosthesis

Abstract

Severe alveolar ridge atrophy following tooth removal poses a common and worsening issue in edentulous jaws, affecting patient comfort and quality of life. The All-on-4 approach involves axially positioning two anterior implants and distally orienting two posterior implants, reducing cantilever length and enabling prostheses with 12 teeth. This less invasive option, utilizing distal tilting of implants at 30°, offers biomechanical advantages and has shown short-term success, though long-term research is limited. Immediate-loading treatments are gaining popularity for their high survival rates. Understanding the biomechanics of implant-supported prostheses is crucial for long-term success, emphasizing the importance of optimal occlusal schemes. Challenges such as bone defects and surgical complexity have led to the exploration of achieving full-arch fixed restorations with fewer implants, building upon Brånemark's early work with four implants. The All-on-4 concept, originating in 1999, proves to be a viable treatment option, providing excellent long-term results and improved load distribution in challenging clinical circumstances. This case report explores the successful rehabilitation of a jaw using the All-on-4 implant prosthesis concept, a technique strategically placing four implants in completely edentulous jaws to support a fixed, immediately loaded prosthesis.