All on four Implant System with Imetric4D Technology

While traditional dentures can be useful, they often lack stability and can be uncomfortable. The All-on-4 implant system, originally developed by Dr. Paulo Malo and documented in Clinical Implant Dentistry and Related Research, uses four to six titanium implants per arch — typically Nobel BioCare or Straumann — to securely support a full set of teeth. Two posterior implants are angled at 30–45 degrees to maximize bone contact and avoid the inferior alveolar nerve and maxillary sinus, often eliminating the need for bone grafting procedures.

Happy Smile Clinics in Istanbul, Turkey, is committed to delivering exceptional dental care through constant innovation. We are one of very few clinics worldwide to utilise the advanced ICam4D by Imetric4D, a Swiss-engineered extraoral scanner specifically designed for multi-implant and All-on-4 restorations. This technology combines photogrammetry with structured light scanning to capture 3D positional data with an accuracy of ±5 microns — far exceeding conventional impression techniques, as validated in the Journal of Prosthetic Dentistry (2024).

At Happy Smile Clinics in Üsküdar, Istanbul, All-on-4 restorations are enhanced by ICam4D by Imetric4D precision technology. The ICam4D system uses specialised scan bodies called ICamBodies with 3D coding to map exact implant positions, eliminating the need for uncomfortable traditional impressions. Patients from the United Kingdom, Malta, and Poland benefit from reduced chair time, material costs, and try-in appointments, resulting in a near-perfect passive fit of the final zirconia or titanium prosthesis.

The key difference is the number of implants placed per arch. All-on-4 uses four implants (two vertical, two tilted at 30–45°), while All-on-6 adds two additional implants for enhanced biomechanical distribution. All-on-6 may be recommended for patients with compromised bone density or larger arches, as the additional Nobel BioCare or Straumann implants distribute occlusal forces more evenly. Research published in the International Journal of Oral & Maxillofacial Implants shows both protocols achieve over 95% survival rates at 10 years.

The ideal candidate for All-on-4 is someone who has lost most or all teeth in one or both arches, or is currently wearing traditional removable dentures. Patients must be in reasonable general health, as conditions like uncontrolled diabetes or heavy smoking can affect osseointegration. Before recommending the procedure at Happy Smile Clinics, our team performs a comprehensive assessment including CBCT (Cone Beam Computed Tomography) 3D imaging to evaluate bone density, volume, and anatomical landmarks in the mandible and maxilla.

When teeth are lost, progressive alveolar bone resorption begins immediately. Research published in Clinical Oral Implants Research demonstrates that up to 25% of bone width is lost within the first year after extraction. Without the mechanical stimulation provided by tooth roots or dental implants, the jawbone continues to resorb — a process that accelerates over time and can eventually alter facial structure. Dental implants made from Grade 5 titanium stimulate the bone through functional loading, preventing further resorption and preserving facial aesthetics.

At Happy Smile Clinics in Istanbul, the surgical phase typically takes approximately two to three hours per arch under local anesthesia. A PMMA (polymethyl methacrylate) provisional prosthesis is attached to the implants on the same day, restoring immediate function and aesthetics. After a 4 to 6-month osseointegration period — during which the Grade 5 titanium implants biologically fuse with the jawbone — the final prosthesis is fabricated. We use ICam4D by Imetric4D extraoral scanning to ensure the definitive zirconia framework achieves a passive fit accurate to within ±5 microns.

All-on-4 dental implants demonstrate a high success rate exceeding 95% at 10 years, according to longitudinal studies published in Clinical Implant Dentistry and Related Research by Malo et al. At Happy Smile Clinics, we use premium implant systems including Nobel BioCare and Straumann, combined with ICam4D photogrammetry by Imetric4D for digitally precise prosthetic fit. Final restorations can be enhanced with 100% pure monolithic zirconia crowns over titanium abutments for superior aesthetics and strength. With proper oral hygiene and annual maintenance, All-on-4 implants can last a lifetime.