Surcam Dental Blog

We provides clinical insights and technical resources for implantologists, prosthodontists and dental labs. Our content bridges science, engineering, and clinical application. Helping professional achieve precision, safety and long term success.

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The All-on-4 concept is not defined by implant count alone. It is a system-based full-arch rehabilitation protocol that relies on controlled load distribution, anterior–posterior spread, and rigid prosthetic splinting to function predictably under immediate or early loading conditions. In clinical practice, this approach is commonly executed using either Internal Hex Dental Implants or Conical Connection Dental Implants, depending on connection preference and restorative workflow requirements.

A key biomechanical feature of the protocol is the use of posterior tilted implants. Angulation allows engagement of denser cortical bone while avoiding anatomical limitations such as the maxillary sinus or inferior alveolar nerve. When combined with anterior axial implants, this configuration reduces distal cantilever length and lowers bending moments across the prosthesis. Proper implant selection and positioning at this stage directly influence long-term stability in full-arch cases.

Multi-unit abutments play a central role in translating surgical placement into a restorative platform. By correcting implant angulation and standardizing the prosthetic interface, Screw-Retained Multi-Unit Abutments enable passive, retrievable full-arch restorations while protecting the implant–bone interface during prosthetic handling and long-term maintenance.

Immediate loading, while commonly associated with All-on-4, is conditional rather than automatic. Adequate primary stability, rigid splinting, and controlled occlusion are required to minimize micromovement during early healing. The provisional and definitive prostheses are typically connected using system-matched Prosthetic Screws, where correct preload and interface compatibility play a critical role in maintaining mechanical integrity over time.

From a clinical standpoint, All-on-4 succeeds when viewed as an integrated system rather than a standalone surgical technique. Implant connection design, multi-unit abutment selection, prosthetic fixation, and long-term serviceability must be planned together to support predictable outcomes and ongoing maintenance.

For a detailed, system-based clinical overview, the full article is available here:
All-on-4 Dental Implants