A look back on the pioneering All-On-4® treatment concept

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  Posted by: Dental Design      2nd August 2018









Dr Riz Syed, Principal of Leading Dental Implants Ltd, is a highly experienced implant surgeon. He has now been using the All-on-4® treatment concept for more than 12 years, and here he considers how the concept has changed over that time.

My original motivation for introducing the All-on-4® treatment conceptto my treatment offerings was to be able to deliver an effective long-term solution for patients, without the need for extensive bone grafting. The technique also provided a fixed one-day solution, which offered a clear appeal and various benefits for patients.  

When it first entered the dental market, the concept was not as well advertised as it is now, so we initially concentrated on our own patient base. We invited members of the local community to open evenings and produced our own marketing materials to promote the treatment option in-house. The uptake was very good and patients all had a very positive experience, often referring friends and family. The success rates were fantastic because I was very careful to follow the protocols provided by Nobel Biocare.


Over the last 11 years I have seen a huge increase in awareness of the procedure among patients, who have become more educated as to what they wish to achieve and what is available to them. I think this coincides with a greater interest and acceptance of the procedure among the profession – I myself have held various study clubs and events designed to bring colleagues up-to-date with the treatment procedure and give them the information they need to educate their own patients on what is available. In this time, my work in practice has changed from mainly placing single or multiple implants to now providing the All-on-4®treatment conceptacross the nation on a weekly basis.

Since the concept originally reached the market, several new implants have been added to the system including the NobelParallel®, NobelActive®and NobelReplace®implant ranges with a conical connection to suit all bone types. The immediate load protocols have remained unchanged to ensure long-term success rates. For the resorbed maxilla, the zygomatic All-on-4®treatment concepthas evolved to allow patients who were previously refused treatment or advised on large hip and sinus grafts to have a successful one-day fixed solution.

The fabrication of the temporary and final bridge has also evolved during this time with more effective materials being used to achieve better aesthetics and a stronger temporary solution. 

Looking in the crystal ball

In the future, I hope to see more awareness among both patients and professionals so that more people can benefit from the All-on-4®treatment concept. Also, more patients with limited bone – who previously were not suitable or even offered an implant solution – should be informed about this less traumatic, one-day solution when appropriate.


For more information, contact Nobel Biocare on 0208 756 3300, or visit www.nobelbiocare.com



Author bio:


Dr Riz Syed qualified in 1999 at the Royal London Hospital and worked in the Oral Maxillo-Facial surgical department. Riz is both nationally and internationally respected as a lecturer and mentor in Implant Dentistry. He also lectures for Nobel Biocare on a range of advanced implant techniques and is a visiting surgeon to numerous surgeries across London. As a mentor for Nobel Biocare, he has helped to train implant surgeons across the UK and is regularly consulted for treatment planning complex cases. He has trained in Europe and America and placed over a thousand implants. He is a member of the Association of Dental Implantology (ADI), International Congress of Oral Implantologists.



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