Malo Dental All-on-4™ Protocol Evolution

Malo Dental All-on-4™ Protocol is a revolutionary approach in Full-mouth Rehabilitation which was developed by Dr. Paulo Malo with his medical and clinical research team. It allows the rehabilitation of totally edentulous (and soon to be edentulous) patients with the placement of only 4 titanium dental implants in each jaw, utilizing a quick and minimally invasive surgical technique (the All-on-4 Surgical Protocol). The 4 implants act as a stable foundation for the DENTAL Bridge, which allows the installation of a fixed set of dentition, which closely mimics a set of natural teeth. The technique stabilizes bone levels, thus keeping the jaws healthy. By uniquely tilting the two posterior implants at an angle of 45°, patients with low or even no bone conditions are allowed to have implants without the need for any bone grafting (transplant) procedures. This results to a fixed or non-removable natural-looking set of teeth, which is indistinguishable from a natural dentition.

Malo Dental All-on-4™ Protocol Evolution Timeline


Initial study of the Immediate Loading Protocol for Single Tooth and Small Bridges

1990 to 1993

Problem: Identify Total Edentulism Challenge

Establishment of Immediate Loading Protocol for Single Tooth and Small Bridges

Non-clinical Stage of Development of the All-on-4 Surgical Protocol

Anatomical and Biomechanical Study of the Mandible Rehabilitation Protocol with All-on-4 Surgical Protocol


First Case: All-on-4 Standard Mandible

Development and Improving the All-on-4 Surgical Protocol for the Mandible


First Case: All-on-4 Standard Maxilla

Development and Improving the All-on-4 Surgical Protocol for the Maxilla


Single Tooth and Small Bridges Immediate Load Protocol Article Published
Talk of the Times 1998, December 3(3)

Establishment of the All-on-4 Surgical Protocol (Mandible)

NobelSpeedy® Implant Development


Dental Ceramic Bridge Clinical Studies (Initial Phase)


Immediate Function of Brånemark Implants Retrospective Study


Establishment of the All-on-4 Surgical Protocol (Maxilla)


NobelSpeedy® Implant Clinical Studies (Initial Phase)


All-on-4 Mandible Retrospective Study Publication


Study of the All-on-4 Hybrid and Double Zygoma, with Zygomatic Anchorage (Initial Phase)


NobelGuide™ Adaptation to the All-on-4 Concept

All-on-4 Maxilla Retrospective Study


New Implant Design: Pilot Study


NobelGuide™ with All-on-4 Study Publication

Short Implants: Retrospective Study Publication

All-on-4 with Implants placed in Periodontally Compromised Sites: Study Publication


All-on-4 with Extra-Maxillary Anchorage: Study Publication


3.3 mm diameter Implants for Rehabilitation of Edentulous Posterior Regions: Study Publication


All-on-4 Mandible Study

All-on-4 Maxilla Study

Short Implants Prospective Study

All-on-4 Implant Philosophy Overview

All-on-4 Extra-Maxilla: Case Report

The Rehabilitation of Edentulous Maxilla: Study and New Classification

Half All-on-4 Study


All-on-4 Extra-Maxillary Anchorage Study

All-on-4 in Non-Ideal Conditions Study

Dental Ceramic Bridge Follow-up Study


All-on-4 Maxilla with Trans-Sinus Implants Study

All-on-4 with Longer Tilted Implants (20-25mm) Study

All-on-4 Nobelguide™ in Mandible: Technique Modification: Pilot Study

All-on-4: Extra-Maxillary Surgical Technique

Partial Implant-supported Fixed Dental Prostheses with Cantilevers


The Influence of Rehabilitation Characteristics in the Incidence of Peri-Implant Pathology

Posterior Maxillary Implants inserted with Bicortical Anchorage and placed in Immediate Function for Partial or Complete Edentulous Rehabilitations

All-on-4™ Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible

Individual Lithium Disilicate Crowns in a Full Arch, Implant-supported Rehabilitation

Immediate Loading of Implants placed in Patients with Untreated Periodontal Disease

Rehabilitation of Completely Edentulous Atrophic Maxillae with Immediately-loaded Zygomatic Implants placed Extra-Maxillary

The Nobelguide® All-on-4™ Treatment Concept for Rehabilitation of Edentulous Jaws: A Prospective Report on Medium- & Long- Term Outcomes

Immediate Function Single-Tooth Dental

Double Full Arch versus Single Arch, 4 Implant-supported Rehabilitations: A Retrospective Study


Long-Term Outcome of Implant Rehabilitations in Patients with Systemic Disorders and Smoking Habits

Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques

Axial Implants in Immediate Function for Partial Rehabilitation in the Maxillla and Mandible


Immediate Loading Short Implants inserted on Low Bone Quantity for the Rehabilitation of the Edentulous Maxilla using an All-on-4 Design

Evaluation of Clinical Soft Tissue Parameters for Extramaxillary Zygomatic Implants and Conventional Implants in All-on-4 Hybrid Rehabilitations

Complete Edentulous Rehabilitation Using an Immediate Function Protocol and an Implant Design Featuring a Straight Body, Anodically Oxidized Surface, and Narrow Tip with Engaging Threads Extending to the Apex of the Implant