What is the Success Rate for "All on Four" Dental Implants?

I read ALOT. I've also restored ALOT of All-on-4 cases myself. The answer must be based on science!! The doctor that invented the procedure (Dr. Malo) published many papers on longterm followup, with good results. The All-on-4 was originally designed to replace the lower teeth, since lower conventional dentures are very poorly accepted by patients. There is more data on lower All-on-4 treatments...He will have 15 year data on these patients soon. Since there was good results on the lower, they started tracking the upper treatment outcomes, which they only have 5 year followup (soon 10yr). He looked at a couple of different things--- 1. Teeth vs. No teeth? Do success rates differ if the patient has teeth currently that need to be extracted, compared to a patient that needs the All-on-4 with no teeth at all?? Or in other words: Does the patient currently have a few missing teeth (partial edentulism) or are they already missing ALL of their teeth (full edentulism)... Does it matter?2. Upper Arch (Maxilla) vs. Lower arch (Mandible)? Bone is typically more dense in the lower mandible compared to the upper maxilla. Does it matter?Actual Success Rates for "All-on-4" implants:Lower Arch: 5 year followup: 94.8 percent (for people that had the procedure and started with full edentulism; no teeth at all) and 98.1 percent (for partial edentulism)10 year followup: 93.8 percent (started with full edentulism) and 94.8 percent (for partial edentulism)Upper Arch:5 year followup: 93 percent (full edentulism)Generally speaking, longterm success depends on many factors: patient compliance, hygiene, use of night guards, overall systemic health of patient, grinding of teeth (bruxism), general wear and tear from usage of bridges, trauma, smoking, etc.Overall, the procedure has some of the highest success rates for ANY dental procedure. However, there is a trend that the lower treatment is slightly more successful than the upper, nonetheless, BOTH are in the ++90%. The above information is for educational purposes only. You should have a consultation with your Prosthodontist and Oral Surgeon prior to any treatment.

While you may read that the success rate for implants is quite high nowadays (e.g. 99% or even higher), it all depends on a variety of factors. The brand and material of the implants is key, because scientific tests have shown certain materials such as Titanium to be most compatible with human bone and therefore have greater chances of integration. Many top tier companies have patented their own designs of implants which are also recognized for achieving greater torque, etc. The patient's set of circumstances will also affect the chances of implant survival. Will patients comply with post-op instruction during the healing period? Are they smokers? Do they suffer from diabetes or other health conditions that may compromise or slow down integration? Lastly and most importantly, the skill and experience of the implantologist is crucial, as is the approach used in installing the implants. All-on-Four implants tend to have higher chances of success because implants are splinted together with the provisional denture during the healing period. This distributes chewing pressure more evenly, preventing undue strain on any single implant.

Full arch implant treatments have a very high success rate overall, but there are different outcomes depending on how the case is planned out. When a patient presents to our office wanting full arch implant treatment, I do not stop with 4 implants. I place as many implants as the bone will allow.  The reason for this is more implants more foundation. This basic building principle applies to building houses and also dental implants because if there are 8 implants and 1 fails, it is not a big catastrophic deal. If there are  4 implants and 1 fails, the whole structure fails.