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Video Details
All-On-Four Implant Protocol - Fad or Phenomena

Description:
The All-on-Four protocol uses fewer implants, generally four or five, that are placed at mechanical inclinations to maximize support in the fabrication of fixed implant supported prosthetics in fully edentulous patients. The use of angled implant placement allows the clinician to avoid encroachment of anatomic structures such as the sinus, nasal floor or mandibular canal that may make vertical placement difficult or impossible without significant grafting of deficient sites. This webinar with Dr. George Duello and Dr. Maurice Salma will discuss the various treatment options available today for this patient segment and emphasize when and where the All-On-Four protocol can be successfully utilized to eliminate the need for costly augmentation procedures and months of healing time.

Date Added:
8/30/2011

Author(s):

George V. Duello, DDS, MS George V. Duello, DDS, MS
George V. Duello, DDS, MS has been in private practice in St. Louis since 1983 after serving as Chief of Periodontics, MacDill AFB, Tampa, Florida. Dr. Duello was born in St....
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Online Videos / Surgery / Implant / All-On-Four Implant Protocol - Fad or Phenomena




Questions & Comments
mladen petranović - (2/7/2012 2:02 PM)

That is it, simple, and clear !

George Duello - (9/18/2011 11:26 AM)

Dr. Pate, The malleable guide is available through Nobel Biocare. Dr. Duello

George Duello - (9/18/2011 11:25 AM)

Dr. Murphy, Both arches were included but the majority of the implants were not tilted. Dr. Duello

K Michael Murphy - (9/12/2011 8:43 PM)

Great Video course. When Dr. Branmark placed all on four 10mm implants in his patients did that include the upper arch or just the lower arch. smiledds@aol.com Dr. Murphy

raymond pate - (9/11/2011 5:31 PM)

Dr Duello,

What ce do you recommend to learn more about this specific protocol. Also, where can I purchase the pilot hole malleable implant guide you featured on this video.

Thanks

Dr Pate

George Duello - (9/7/2011 8:51 AM)

To Webinar Attendees, Someone asked what to you do if you have an implant failure under an All-on-Four. Remove the prosthesis, remove the implant, graft-delayed implant placement, and keep the prosthesis on the remaining three implants until the new implant has healed. Then you have two choices--remake the entire prosthesis or section the prosthesis where the previous implant has failed and now healed, section the bar and prosthesis, argon laser weld a new section to fit the new implant and replace the fixed All-on-Four prosthesis on the implants. If any one has any other thoughts I would be glad to review them. Dr. Duello

George Duello - (9/7/2011 8:46 AM)

Dear Dr. Smith, I agree with your clinical observations. This is why good diagnosis, adequate alveoloplasty, and excellent laboratory support is necessary to attempt to achieve a prosthesis the has convex or flat anatomy on the intaglio surface so that oral hygiene is possible. However, I also find that overdenture prosthesis can be problematic with gingival hyperplasia under bars that many times leads to psuedo pocketing around abutments/implants. Occasionally I have had patient who can't seat their overdenture due to tissue impingments. I think all prosthesis require constant observation/monitoring with appropriate intervention when tissue problems arise. Thank you for your comments. Dr. Duello

George Duello - (9/7/2011 8:40 AM)

Dear Dr. Kozy, I don't have any cases over 6 years old that meet the definition of "All-On-Four" that was discussed in the webinar on DentalXP as I started using the Malo technique in 2005. However, I have numerous other cases using four implants in the maxilla and mandible. Most of these cases on overdentures with bar and various attachments. As I stated in the webinar, I have modified my philosophy and now use All-on-Four to provide patients with a fixed prosthetic treatment. I hope this answers your question.

George Duello - (9/7/2011 8:40 AM)

Dear Dr. Kozy, I don't have any cases over 6 years old that meet the definition of "All-On-Four" that was discussed in the webinar on DentalXP as I started using the Malo technique in 2005. However, I have numerous other cases using four implants in the maxilla and mandible. Most of these cases on overdentures with bar and various attachments. As I stated in the webinar, I have modified my philosophy and now use All-on-Four to provide patients with a fixed prosthetic treatment. I hope this answers your question.

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