Edentulism (having no teeth) and a Revolutionary Treatment: The “All-on-4™ Dental  Implant Procedure”
Dental implants are titanium root replacements that support natural looking, non-removable replacement teeth.
They can also be used to support a dental bridge - replacing a few, several  or even all of the teeth in each jaw.
WHY WE LOSE OUR TEETH Chronic periodontal (gum) disease leads to bone loss. Teeth  eventually then become loose and fall o...
WHY WE LOSE OUR TEETH Tooth loss then leads to further bone loss due to a lack of stimulation or pressure on the bone from...
The gum tissue is also “lost”, becoming diminished when the underlying bone atrophies or disappears.  Traditional implant ...
EDENTULISM <ul><li>By 2025, the global population over age 65 years will double from the 2005 levels, to about 820 million...
<ul><li>Nutritional </li></ul><ul><li>Limited diet </li></ul><ul><li>Systemic effects on health   </li></ul><ul><li>Psycho...
Significant improvements in: <ul><ul><li>Functional Capabilities:  Eat, chew and speak normally again with ease and comfor...
REPLACING ALL THE TEETH Replacing all the teeth using dental implants has historically been a challenge due to the lack of...
REPLACING ALL THE TEETH Traditional implant techniques often call for the placement of 8-10 (or more) implants to replace ...
REPLACING ALL THE TEETH <ul><li>Sinus Lift grafting </li></ul><ul><li>Onlay bone grafts </li></ul>These procedures add add...
COMMON BONE GRAFTING ALTERNATIVES When bone is lacking in the back of the upper jaw, the sinus membrane or lining can be e...
COMMON BONE GRAFTING ALTERNATIVES Bone harvested from the chin of a patient The bone is then “grafted” using small screws ...
MALO CLINIC Headquarters, - Lisbon, Portugal  Dr. Paulo Maló- Innovator  of the “All-on-4”
By placing only four implants at specific angles where the  bone volume remains, a full dental bridge can be placed the sa...
Clinical research over the past decade has shown that more than 4 dental implants to support a full, fixed (non-removable)...
<ul><li>E liminates bone grafting and the need for multiple procedures </li></ul><ul><li>“ Immediate function” and superio...
CLINICAL   CASES All-on-4™ Standard
ALL-ON-4  ™  Case 1
ALL-ON-4  ™  Case 1
ALL-ON-4  ™  Case 1
ALL-ON-4  ™  Case 1
ALL-ON-4  ™  Case 2
ALL-ON-4  ™  Case 2
ALL-ON-4  ™  Case 2
ALL-ON-4  ™  Case 2
ALL-ON-4  ™  Case 3
ALL-ON-4  ™  Case 3
ALL-ON-4  ™  Case 3
ALL-ON-4  ™  Case 3
ALL-ON-4  ™  Case 3
BEFORE   & AFTERS
 
 
 
 
 
 
 
<ul><li>RESEARCH AND DEVELOPMENT </li></ul><ul><li>1993:  All-on-4 TM  standard protocol pilot study </li></ul><ul><li>199...
<ul><li>RESEARCH AND DEVELOPMENT </li></ul><ul><li>2005:  All-on-4 TM  maxilla retrospective study publication **  </li></...
<ul><li>STATISTICS </li></ul>
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Edentulism & Revolutionary Treatment :- The "All-on-4" Dental Implant Procedure

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Edentulism & Revolutionary Treatment :- The "All-on-4" Dental Implant Procedure

  1. 1. Edentulism (having no teeth) and a Revolutionary Treatment: The “All-on-4™ Dental Implant Procedure”
  2. 2. Dental implants are titanium root replacements that support natural looking, non-removable replacement teeth.
  3. 3. They can also be used to support a dental bridge - replacing a few, several or even all of the teeth in each jaw.
  4. 4. WHY WE LOSE OUR TEETH Chronic periodontal (gum) disease leads to bone loss. Teeth eventually then become loose and fall out, or need extraction.
  5. 5. WHY WE LOSE OUR TEETH Tooth loss then leads to further bone loss due to a lack of stimulation or pressure on the bone from the roots during chewing. The bone tends to atrophy, or undergo resorption and disappear after teeth have gone missing.
  6. 6. The gum tissue is also “lost”, becoming diminished when the underlying bone atrophies or disappears. Traditional implant bridges tend to only replace the teeth (not the gum), hence they have to be longer to reach the new level of the gum tissue. This creates the “horse tooth” appearance often seen with implant supported bridge work today. “ TRADITIONAL” IMPLANT BRIDGES”
  7. 7. EDENTULISM <ul><li>By 2025, the global population over age 65 years will double from the 2005 levels, to about 820 million people. </li></ul><ul><li>In the USA, 21% of the population will be over 65 years by 2050. </li></ul><ul><li>CDC /NIH survey results show that approximately 30% of the current US population over age 65 are completely edentulous (have none of their own teeth). </li></ul><ul><li>There are approximately 37 million edentulous Americans today; that’s over 50% more common than Diabetes (estimated at 24 million Americans). </li></ul>Missing Teeth: A Very Common Problem
  8. 8. <ul><li>Nutritional </li></ul><ul><li>Limited diet </li></ul><ul><li>Systemic effects on health </li></ul><ul><li>Psycho-social </li></ul><ul><li>Fear and Anxiety </li></ul><ul><li>Low self-esteem </li></ul>THE IMPACT OF MISSING TEETH <ul><li>Quality of life </li></ul><ul><li>Diminished enjoyment </li></ul><ul><li>Avoidance of social situations </li></ul>
  9. 9. Significant improvements in: <ul><ul><li>Functional Capabilities: Eat, chew and speak normally again with ease and comfort. </li></ul></ul><ul><ul><li>Nutritional Condition: Enjoy more of the foods you love and benefit from a balanced diet and better nutrition. </li></ul></ul><ul><ul><li>Self Confidence: Feel more secure knowing your teeth won’t slip or come out while speaking or eating. </li></ul></ul>EFFECTS OF DENTAL IMPLANTS ON EDENTULISM
  10. 10. REPLACING ALL THE TEETH Replacing all the teeth using dental implants has historically been a challenge due to the lack of bone available for implant placement or the proximity of vital structures that need to be avoided (the sinus cavities in the upper jaw and the nerve canal in the lower jaw). Many patients are told they are not implant candidates or that they will need bone grafting prior to having dental implants placed. Bone grafting can be painful, costly and take several months or longer to heal.
  11. 11. REPLACING ALL THE TEETH Traditional implant techniques often call for the placement of 8-10 (or more) implants to replace an entire set of upper or lower teeth, and because the bridge only replaces teeth (not lost gum tissue) it can look unnatural and have a “horse tooth appearance”.
  12. 12. REPLACING ALL THE TEETH <ul><li>Sinus Lift grafting </li></ul><ul><li>Onlay bone grafts </li></ul>These procedures add additional costs, healing time, and discomfort. The “All-on-4” technique almost always eliminates the need for bone grafting!
  13. 13. COMMON BONE GRAFTING ALTERNATIVES When bone is lacking in the back of the upper jaw, the sinus membrane or lining can be elevated, or “lifted”, and bone graft material can be placed beneath it to increase the amount of bone available for implant placement after healing. Depending on the source of the graft material, complete healing can often take 4-12 months! This means patients must wait even longer before receiving their implants and longer still for their new teeth.
  14. 14. COMMON BONE GRAFTING ALTERNATIVES Bone harvested from the chin of a patient The bone is then “grafted” using small screws to the site where it’s needed “ Onlay” bone grafting is used to widen a deficient area of the jaw where dental implants are planned. Often this involves harvesting the graft from another part of the patient’s body. This significantly can increase cost and post-operative discomfort.
  15. 15. MALO CLINIC Headquarters, - Lisbon, Portugal Dr. Paulo Maló- Innovator of the “All-on-4”
  16. 16. By placing only four implants at specific angles where the bone volume remains, a full dental bridge can be placed the same day….and all almost always without bone grafting!
  17. 17. Clinical research over the past decade has shown that more than 4 dental implants to support a full, fixed (non-removable) bridge is typically not necessary, and that placing more than 4 implants does not increase success rates. Note that some implants in the upper jaw are not even connected to the final bridge in this case!
  18. 18. <ul><li>E liminates bone grafting and the need for multiple procedures </li></ul><ul><li>“ Immediate function” and superior aesthetics with “fixed bridge” (non-removable) within 30 minutes – 3 hours after the implants are placed </li></ul><ul><li>Anchorage in anterior bone of both jaws (higher success rates for dental implants) </li></ul><ul><li>More people eligible for implant supported non-removable bridge </li></ul><ul><li>Less costly and less invasive than traditional alternatives </li></ul><ul><li>High success rates (lower jaw 99.86%; upper jaw 98.50%) </li></ul>ALL-ON-4 ™ | Advantages
  19. 19. CLINICAL CASES All-on-4™ Standard
  20. 20. ALL-ON-4 ™ Case 1
  21. 21. ALL-ON-4 ™ Case 1
  22. 22. ALL-ON-4 ™ Case 1
  23. 23. ALL-ON-4 ™ Case 1
  24. 24. ALL-ON-4 ™ Case 2
  25. 25. ALL-ON-4 ™ Case 2
  26. 26. ALL-ON-4 ™ Case 2
  27. 27. ALL-ON-4 ™ Case 2
  28. 28. ALL-ON-4 ™ Case 3
  29. 29. ALL-ON-4 ™ Case 3
  30. 30. ALL-ON-4 ™ Case 3
  31. 31. ALL-ON-4 ™ Case 3
  32. 32. ALL-ON-4 ™ Case 3
  33. 33. BEFORE & AFTERS
  34. 41. <ul><li>RESEARCH AND DEVELOPMENT </li></ul><ul><li>1993: All-on-4 TM standard protocol pilot study </li></ul><ul><li>1998: All-on-4 TM mandible retrospective study </li></ul><ul><li>1998: NobelSpeedy TM implant development </li></ul><ul><li>1999: MALO CLINIC Ceramic Bridge clinical studies – initial phase </li></ul><ul><li>2001: All-on-4 TM maxilla retrospective study </li></ul><ul><li>2002: NobelSpeedy TM implant clinical studies – initial phase </li></ul><ul><li>2003: All-on-4 TM mandible retrospective study publication * </li></ul><ul><li>2004: Technical viability study of zygomatic, pterygoid and sphenoid anchored implants </li></ul><ul><li>2005: NobelGuide TM adaptation to the All-on-4 TM concept </li></ul>* Malo P, Rangert B, Nobre M. &quot;All-on-Four&quot; immediate-function concept with Branemark System implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res. 2003;5 Suppl 1:2-9. ALL-ON-4™ All-on-4 evolution
  35. 42. <ul><li>RESEARCH AND DEVELOPMENT </li></ul><ul><li>2005: All-on-4 TM maxilla retrospective study publication ** </li></ul><ul><li>2005: Study of the All-on-4 TM hybrid and extra-maxilla, with zygomatic, pterygoid and sphenoid anchorage: initial phase. </li></ul><ul><li>2006: Study of the extra-maxilla new design in order to use it with NobelGuide TM </li></ul><ul><li>2007: Study of the All-on-4 TM technique with zygomatic, pterygoid and sphenoid anchorage: accepted for publication </li></ul><ul><li>2007: NobelGuide TM with All-on-4 TM concept: study publication *** </li></ul><ul><li>2008: All-on-4 TM with extramaxillary anchorage: study publication **** </li></ul>** Malo P, Rangert B, Nobre M. All-on-4 immediate-function concept with Branemark System implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Dent Relat Res. 2005;7 Suppl 1:S88-94. *** Maló P, Nobre M, Lopes A. The use of Computer-Guided flapless implant surgery and 4 implants placed in immediate function to support a fixed denture: Preliminary results after a mean follow-up period of 13 months. J Prosthet Dent 2007; 97: S26-S34. **** Maló P, Nobre M, Lopes I. A new approach to rehabilitate the severely atrophic maxilla using extramaxillary anchored implants in immediate function: A pilot study. J Prosthet Dent 2008; 100: 354-366. ALL-ON-4™ All-on-4 evolution
  36. 43. <ul><li>STATISTICS </li></ul>
  37. 44. <ul><li>Total number of cases: 1014 </li></ul><ul><li>Total number of implants : 4056 </li></ul><ul><li>Total number of failures : 64 </li></ul><ul><li>Success rate – implants: 98.42% </li></ul><ul><li>Success rate – prosthesis: 99.70% </li></ul>Immediate Function of implants for restoration of the totally edentulous upper jaw. ALL-ON-4™ UPDATE (up to 8 years follow-up) ALL-ON-4™ MAXILLA
  38. 45. Immediate Function of implants for restoration of the totally edentulous lower jaw. ALL-ON-4™ UPDATE (up to 10 years follow-up) <ul><li>Total number of cases: 1122 </li></ul><ul><li>Total number of implants : 4488 </li></ul><ul><li>Total number of failures : 56 </li></ul><ul><li>Success rate – implants: 99.75% </li></ul><ul><li>Success rate – prosthesis: 99.50% </li></ul>ALL-ON-4™ MANDIBLE
  39. 46. THANK YOU Visit us at MaloDentalImplants.com for more information Or call (201) 549- 8817 1- 877 MALO USA 
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