What is the All-on-4®? Dental Implants


This information given below is intended to explain in general terms the All-on-4 technique pioneered by Dr. Palo Malo of the famous Palo Clinic in Lisbon, Portugal.It is amazing that by employing this technique, you do not have to wait a long time to complete your implant procedure. In most cases, the implants and the prosthesis can be delivered within the SAME day ! I have just returned from my second mini residency course in this technique which was conducted by the man himself. I have been doing dental implants since 1991. But because this dental implant is technology driven , it is mandatory that I should attend courses periodically to keep abreast of developments in this field of dentistry. Only by doing so can I be in a position to provide first rate service to all my patients. For patient specific information, please drop by at my clinic for consultation.–Dr. Kamsiah G. Haider.

All-on-4® Frequently Asked Questions

FAQ: What is the All-on-4®?


The All-on-4® is a dental implant technique that can be used to provide patients with a new set of fixed (non-removable), highly aesthetic and immediately functional teeth in as little as a single appointment. These patients are typically edentulous (have lost all of their original adult teeth), near-edentulous or are suffering from a failing dentition as a result of advanced periodontal (gum) disease. Many have existing loose or failing bridgework and others are denture or partial denture wearers.

FAQ: How does the All-on-4® dental implant technique differ from dentures?

The All-on-4® dental implant technique provides patients with fixed (non-removable) teeth and because of this, they:

  • Are cleaned and maintained in the same way as natural teeth and do not need to be removed after meals or at night time.
  • Enable you to bite down with close to a natural bite, thus allowing you to enjoy the foods you love, but couldn’t manage with uncomfortable dentures.
  • Do not shift around and cannot fall out, saving patients much discomfort and social embarrassment.
  • Do not rest solely on the gums, as is the case with dentures, and therefore seldom cause irritation, inflammation and the development of sores in the mouth.
  • Dental implants promote better jaw bone health by channeling the functional stimulation associated with eating into the supporting hard tissue.
  • Can halt the progression of bone loss in the jaw and so do not require one’s bridgework to be redone every few years or so (as a result of the changing shape of the jaw).
  • Do not incur repeated expenses such as messy adhesives, soaking solutions, anesthetic gels and other hygienic and storage products typically needed for dentures

The All-on-4® MALO CLINIC bridge is far slimmer than traditional bulky dentures and doesn’t cover the hard palate. Consequently, it does not tend to trigger the gag reflex or impede your ability to taste and sense the temperature of your food properly.

My second mini-residency course with Dr. Palo Malo

My second mini-residency course with Dr. Palo Malo

FAQ: What is the difference between the All-on-4® and conventional dental implant techniques?

The All-on-4® technique is a breakthrough in the field of fixed oral rehabilitation as it enables our skilled team of dental implant professionals to achieve unprecedented results in an unprecedentedly quick treatment time. The key differences between this incredible innovation and older dental implant methods for the treatment of a failing dentition are:

  • The All-on-4® only requires four dental implants to provide patients with new teeth. Older techniques could require as many as six, eight or even ten dental implants to be placed per jaw! This means that for full mouth reconstruction, a patient could be looking at having as many as 20 dental implants placed, which frequently worked out to be prohibitively expensive. Additionally, the use of more implants means more surgery, incurring a longer recovery period with greater post-operative pain. If spaced too close together, the risks of complications and implant failure could be greater.
  • The All-on-4® typically only requires a single surgery to give patients new teeth. With only four dental implants needed per jaw, full arch replacement can quite easily and safely be completed within the space of a single procedure. Older techniques could see a patient coming in for treatment for up to 18 months, as the greater number of implants and “necessary” bone grafting would have to be performed in sessions. This means lengthier treatment, greater discomfort, multiple recovery periods, more time off from work, inconvenience and, of course, expense!
  • The All-on-4® typically avoids the need for bone grafting surgery. The oral diseases that cause tooth loss also deteriorate jawbone health. This combined with atrophy (caused by the loss of functional stimulation of the jawbone via the tooth roots) used to necessitate the augmentation of the jawbone before the surgeon could consider treatment using dental implants. However, owing to the strategic arrangement of implants utilizing the All-on-4® technique, we can almost always find enough support from the existing bone volume for a new set of prosthetic teeth. This saves patients significant discomfort, money and time AND it almost always enables patients to receive new and immediately functional teeth in as little as a single day.
Dr. Kam with Dr. Palo Malo, her mentor on this technique.

Dr. Kam with Dr. Palo Malo, her mentor on this technique.

FAQ: What is the success rate of the All-on-4® procedure? What influences failure?

The All-on-4® has an extremely high success rate over 10 years, which means that almost all patients who have received treatment will still be enjoying their new teeth after a period of 10 years. Here at MALO SMILES, we perform the All-on-4® The MALO CLINIC Way – the way it was researched and innovated – while making use of only the highest quality prosthetics and dental implant products. As such, like them, we enjoy an incredible success rate in treating patients who have lost most or all of their teeth.

There are a number of factors that may lead to implant failure, but luckily, most of these are in the hands of the patient. Smoking, heavy drinking and not following post operative instructions or dietary restrictions can significantly affect the chances of success. There are also certain medical conditions, such as diabetes, that can affect the success and lifespan of your All-on-4® implants; however all of these risk factors will be discussed in detail with you at the time of your consultation.

FAQ: Who is a candidate for All-on-4® implants?

Almost every patient is a candidate for the All-on-4® implant procedure. During your initial consultation, we will assess your current state of oral health (looking for signs of periodontal disease and jaw bone deterioration), your medical history (making special note of diabetes, respiratory disease, heart disease and bleeding tendencies that may render surgery risky) and age-related diseases, such as osteoporosis. Age itself is never considered a problem. The team here at MALO SMILES has given patients in their nineties beautiful new teeth with the All-on-4®!

Follow the link to read a more detailed explanation of Patient Candidacy for the All-on-4®.

FAQ: What does the All-on-4® procedure involve?

Getting new teeth with the All-on-4® dental implant technique typically involves one or more initial consultations with one of our experienced and compassionate dental implant team members. You will then come back to MALO SMILES for your actual surgery and the fitting of your new rigid prosthetic dental bridge by our prosthodontist. This is followed by a schedule of follow-up appointments during which we ensure that your implants are healing properly and your new teeth are functioning optimally.

For a more detailed, step-by-step explanation of the All-on-4® procedure and what you can expect from the various stages along your journey to oral rehabilitation, Click here (we at DrKam adopt the same protocol)

FAQ: How much time should I take off from work?

We typically recommend that you take a few days off to relax and see your recovery off to as good a start as possible. Having said this, many patients return to work the very day after the surgery! It all depends on your schedule, your constitution and how strong you feel.

FAQ: Is the All-on-4® procedure painful?

The use of sedative medications and local anesthetics ensure that you are kept entirely comfortable and pain and anxiety-free during the All-on-4® procedure. As with any surgery, you can expect some post-operative discomfort, but we will send you home with prescription analgesics (pain-killers) to help manage this. In any case, this discomfort is typically minimal and seldom persists for more than a few days.

FAQ: Will I need to return to the MALO Advanced Rehabilitation Facility after the procedure?

Yes. We do require that you return to us between 10 and 14 days after your surgery so that we can make sure your implants are healing well and that there are no signs of infection or complications. We may also clean and reattach your temporary bridge. In a consequential appointment, after your implants have fully bonded to the bone, you will receive your customized final bridge. Thereafter, you need only come to MALO SMILES or your dentist for the standard scheduled professional cleanings and check-ups.

FAQ: Can I get both my bottom and upper teeth replaced with All-on-4® implants?

Yes! The All-on-4® dental implant technique can be used to replace your upper or lower set of teeth, or both. Should you require full mouth reconstruction, our experienced dental implants surgeons can replace both dental arches on the same day if recommended and desirable. This can sometimes achieve better results and, of course, enables you to leave MALO SMILES with fully restored smile and bite.

FAQ: Will the results look natural?

Absolutely! The prosthetic dental bridge attached to the All-on-4® dental implants is expertly fabricated by highly trained MALO CLINIC lab technicians to be virtually indistinguishable from a set of natural, healthy teeth. Using molds or impressions that are taken of your teeth during your initial consultation with us, the bridge will be custom made to perfectly fit the natural contours of your jaw, thus making it look and feel very natural.