The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

Skip to main content

Full-Arch Implant Immediate Load

Same-day implant rehabilitation for edentulous and failing dentition

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Full-Arch Implant Immediate Load?

Full-arch immediate-load implant rehabilitation has revolutionized treatment of edentulism and terminally compromised dentition. Pioneered by Paulo Maló (All-on-4 protocol), the technique uses 4-6 strategically placed implants (typically two anterior axial and two posterior tilted to avoid sinus or nerve), achieving primary stability of at least 35 N·cm to support immediate loading with a fixed provisional prosthesis fabricated chairside or laboratory-delivered same day.

Indications include edentulous maxilla or mandible, terminally compromised dentition requiring full-arch extraction, failing dentition with active periodontal disease, prior failed conventional implant treatment, severely atrophic ridges where conventional implant placement is impossible without grafting, and patients seeking same-day rehabilitation. Contraindications include severely atrophic ridges with insufficient bone for tilted implants (without zygomatic alternatives), uncontrolled diabetes, smoking, parafunctional habits, and bisphosphonate or denosumab therapy.

Treatment workflow includes virtual surgical planning with CBCT, customized surgical guide fabrication, atraumatic extraction of remaining teeth, implant placement with primary stability verification, immediate temporization with fixed provisional acrylic prosthesis, healing phase 3-6 months, and final prosthesis fabrication with milled titanium frameworks and ceramic or composite dentition. Long-term success rates exceed 95% at 10 years with proper case selection, hygiene, and maintenance.

Symptoms

Edentulism (complete tooth loss)
Terminally compromised dentition
Active periodontal disease with multiple failing teeth
Failed conventional implant treatment
Failed removable prosthesis
Severely atrophic ridge
Failure to retain conventional dentures
Speech and chewing impairment from poor dentition
Esthetic concerns from missing or failing teeth
Quality-of-life impairment from oral function
Patient preference for fixed over removable prosthesis
Same-day rehabilitation desire
Avoidance of multiple staged surgeries
Prior or anticipated bone grafting need
Compromised systemic health limiting multiple surgical procedures
Functional limitations with conventional dentures
Sore spots, ulcerations from dentures
Decreased vertical dimension from worn prosthesis
TMJ pain associated with poor occlusion
Bone resorption progression

Risk Factors

Smoking (significant impact on success)
Uncontrolled diabetes mellitus
Bisphosphonate or denosumab therapy (osteonecrosis risk)
Prior radiation therapy to head and neck
Active untreated periodontal disease
Severe alveolar atrophy
Insufficient bone volume for primary stability
Parafunctional habits (severe bruxism)
Compromised vascularity
Immunosuppressive medications
Older age (relative consideration)
Anatomical limitations (proximity to maxillary sinus, mandibular nerve)
Failed prior implant treatment
Compromised oral hygiene
Limited compliance with maintenance
Poor systemic health
Complex prosthetic requirements
Limited interocclusal space
Coexisting TMJ disease
Active orthodontic treatment

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Multiple failing teeth requiring extraction
  • Edentulism with poor denture function
  • Considering fixed implant rehabilitation
  • Active periodontal disease with terminal dentition
  • Failed conventional implant treatment
  • Severely atrophic ridge
  • Esthetic concerns from missing teeth
  • Functional impairment from dental loss
  • Same-day rehabilitation interest
  • Avoidance of multiple staged surgeries
  • Prior failed bone graft
  • Considering zygomatic implants
  • Comprehensive multidisciplinary planning need

Treatment Methods

01
Comprehensive evaluation by oral and maxillofacial surgeon and prosthodontist with implant expertise
02
Detailed history including periodontal status, prior dental treatment, systemic health, smoking, parafunctional habits
03
Clinical and radiographic examination with CBCT
04
Periodontal evaluation
05
Soft tissue assessment
06
Occlusal analysis
07
Esthetic risk assessment
08
Smoking cessation, glycemic control, periodontal therapy preoperatively
09
Virtual surgical planning with CAD/CAM software
10
Custom surgical guide fabrication for guided implant placement
11
Provisional prosthesis design (chairside acrylic or laboratory milled)
12
All-on-4 (most common): two anterior axial implants and two posterior tilted implants
13
All-on-6 or All-on-X for additional support in atrophic cases
14
Zygomatic implants for severe maxillary atrophy where alveolar bone insufficient
15
Extraction of all remaining teeth atraumatically
16
Bone preparation and implant placement
17
Primary stability verification (insertion torque ≥35 N·cm)
18
Multi-unit abutments placement
19
Immediate provisional prosthesis delivery same day
20
Healing phase 3-6 months on provisional with soft to mechanical soft diet progression
21
Definitive prosthesis fabrication with milled titanium framework and ceramic or composite teeth
22
Final prosthesis delivery and occlusal refinement
23
Lifelong maintenance with biannual professional cleaning
24
Home hygiene with water flosser, interdental brushes, antimicrobial rinses
25
Night guard for parafunctional control
26
Periodic prosthesis evaluation and screw retorquing
27
Repair or replacement of provisional or final prosthesis as needed
28
Treat peri-implant mucositis or peri-implantitis if develops
29
Multidisciplinary care: oral surgery, prosthodontics, hygienist, primary care for systemic health

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.