5-Points Protocol in All-on-4 surgical planning: an alternative to zygomatic implants

The rehabilitation of edentulous patients with severe maxillary atrophy has always represented a challenging frontier for implant dentistry. 3D imaging exams and surgical software have brought precision to procedures, enabling prior planning of implant anchorage sites. Good planning, based on widely accepted protocols, can provide more assertive procedures, with safe and long-lasting results. In this sense, this study aims to present a preliminary evaluation of the 5-Point Protocol for planning and executing oral rehabilitation of edentulous patients with maxillary atrophy, in the All-on-4 concept and with immediate loading. Methodologically, this is an exploratory study evaluating clinical cases, carried out over four years, aiming to gather the opinions of experts. As a result, it was found that the 5-Point Protocol aims to standardize the search for better implant anchorage structures, indicating sites with sufficient bone quantity to enable immediate loading. Of the five suggested points, four are in zone 2, representing an alternative to zygomatic implants. Experts conclude that the 5-Point Protocol offers more assertive planning for implant anchorage, supporting immediate load in oral rehabilitation procedures in the All-on-4 concept, reducing planning and surgery times, associated risks and providing another alternative for zygomatic implant surgery.