These days, we live in a world of wonders, so much so that we begin to take not only the technologies themselves for granted, but also the inventors of those technologies. After the device is made, the discovery seems so obvious and the process so easy that we fail to appreciate how truly revolutionary it was at the time.
A Heartbreaking Need
Maló began his quest, as many inventors do, when he was confronted by a patient whose suffering could not be relieved by treatments that were currently available. The patient was an older man who had lost all his teeth, but who had difficulty dealing with his dentures. They were fitted as well as could be managed, but they still weren’t secure and they didn’t give him the chewing force he needed to live a normal life. Unfortunately, the man wasn’t a good candidate for dental implants. He didn’t have enough bone, and wasn’t a good candidate for a bone graft procedure.
That’s when Maló began searching for a dental implant solution that could be used reliably without bone grafts.
Balance of Forces
The secret to achieving a successful, reliable implant denture solution was balancing the forces involved. They needed to be able to put enough teeth in that patients could function adequately, but not use too many dental implants.
More implants is not always better, because each implant requires space in the jawbone, and if too many were required, they would be back to the need for bone grafts again. More implants also weakens the denture, as the denture has to be made to accommodate attachment to the implants.
At first, Maló and his team were only able to manage six to eight teeth on a denture that could be supported by four implants in areas where there was typically enough bone without grafting. More than that would have to be “cantilevered”–not supported directly by implants, but indirectly through the denture itself. To achieve the twelve implants they considered the minimum necessary for quality results, that led to too much force on the denture.
Then they hit on the idea of angling some of the implants. By angling the implants, they not only maximized bone support for the implant, but were also able to locate the implants further back in the mouth without the need for a bone graft. This allowed them to create a 12-tooth denture with a minimum of cantilever.
A Very Effective Solution
Although Maló and his team were working through the problems carefully and addressed all the challenges before they began to test the All-on-4 approach, they had no idea just how successful it would be. They were justifiably excited when they found that they had an almost 100% success rate, and that people receiving these implant dentures were extremely happy with the appearance and function of the restorations. And to this day, we continue to see the amazing benefits of this innovative treatment.