All-on-4 Implant Therapy

The All-on-4 is an implant-supported, fixed prosthetic. It is used to restore patients who have already lost or are losing all of their natural upper or lower teeth.

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All-on-4 implants are used to treat patients who have already lost or are about to lose all of their natural upper or lower teeth. Over the past decade, dental implants have become the preferred method of natural tooth replacement. Traditional implants require an implant for every tooth, but All-on-4 Implant Therapy is changing the way teeth are replaced.

What are All-on-4 Implants?

All-on-4 implants are an innovative way of attaching permanent prosthetic teeth with just four dental implants. The procedure is less invasive than traditional implants, and it is much faster too. Patients are fully sedated for the procedure, during which a minimum of four implants are placed into the supporting bone beneath the gum line. Most patients require no bone grafting for this procedure, and a new, unmovable prosthesis can be placed in the same visit.

With all-on-4 implants, patients can expect to resume near normal tooth function, and most will not require dietary changes that are required for denture-wearers. Furthermore, implants are permanent and easy to care for, making caring for them a breeze. 

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ALL-ON-4 FAQ

What is the all-on-4?

The all-on-4 procedure is the best in its class of solutions. This treatment is ideal for patients with failing teeth, edentulous jaws, or are unhappy with their removable prosthetic. The all on four implant technique can utilize four to eight implants depending on the individual’s case. The posterior implants are angulated to take maximum advantage of the support provided by the natural bone structure. By using this method, there is little to no bone grafting involved. Published studies show a 98.2% success rate for the lower jaw and a 98% success rate for the upper jaw.

The all-on-4 has a tremendous amount of benefits. They allow the patient to bite and chew with an increased force of up to 70% percent versus the traditional denture which is around 10% of natural teeth. People who wear dentures are very handicapped in masticatory function. The patient is given back that experience of comfortably eating their favorite foods with no pain or embarrassment. They look and feel like natural teeth and are treated as such.

There is no patient removal and the maintenance is effortless. Placement of the implants stimulates the bone which aides in the restoration of facial features. The procedure ensures a long term result with the potential to last a life time. It best of all, enhances self- confidence and quality of life.

What happens the day of surgery?

On the day of the scheduled surgery, you will take your prescribed medications along with a hearty breakfast. During this procedure, your blood and oxygen levels will be closely monitored. An oral sedative is available for anxiety and often recommended. If extractions are needed, this is done first. At this time, an incision is made on the ridge and the bone is leveled to avoid an unbalanced look. The implants are then placed and x-rays are taken to ensure the positions.

When the implants are in the proper locations, the ridge is sutured and the abutments are placed. Impressions are taken to finish your provisional restoration. The doctor and his assistant complete the remaining fabrications needed to secure the prosthetic to the implants.

What are dental implants? Are they safe?

Dental implants are state of the art in modern dentistry. An implant consists of three main parts: implant post, abutment, and the crown or prosthetic. The implant post is a small,
threaded titanium alloy fixture that takes the place of a natural tooth’s root. After being placed in your jaw, this threaded post starts the process of osseointegration (bonding of post and bone.) This allows the implant to become stable and in most cases, the implant is more stable than a natural tooth. There has been research for more than three decades recognizing titanium for its biological compatibility with the human body.

What is the difference between a provisional and a final restoration?

When the surgery is completed, you will be in your provisional restoration. The provisional prosthesis is made entirely of acrylic resin, which places less stress on your healing implants. Acrylic resin is a softer material that will not cause harm or irritation to your jaw or implants but not to worry, it is fully functional. After a year, the gums are healed and implants are completely stable, we start the process of creating your final restoration. The final prosthesis will have a titanium reinforcement bar allowing extra support and long term function. This bar will be hidden internally and you can choose to have acrylic or porcelain teeth.

Am I a candidate?

The ideal candidate is someone who is in good health with a jawbone that can support an implant. There are very few people who may not be candidates. Chronic illnesses, such as
diabetes or leukemia, may interfere with healing post-surgery, as well as drug use. Constant tobacco use can also cause slow healing. However, each patient is thoroughly evaluated before
determining this extensive procedure. Using a 3D CT scan of your jaw, we are able to evaluate bone quality, volume and quantity. This grants the ability to virtually place your implants. Thus, allowing each step to be premeditated and carried out with absolute precision.

History of procedure and success rate

The all on four procedure has been around for fifteen years and has a combined success rate of 97%. In early 2000, Nobel Boicare teamed up with distinguished European Implantologist, Paulo Malo to use computer simulation, biomechanics and clinical research to determine an optimal
use of implants in a full arch restoration. The main objective was to use as few implants as possible, avoid bone grafting, and provide a high quality restoration in a short time period.
Further published studies indicate the all on four success rate for the upper jaw is 98.2% and 98% in the lower jaw.

Recommended follow up?

After the procedure, your first check up will be in about a week. The next post operative check will be about two weeks after that, at this time you will be given a waterpik to help keep food from under the prosthetic. For the next year, you will be seen once a month to ensure healing is successful and home care is being properly executed.

Traditional denture vs. all-on-4

Most people are confused between the difference between a denture and the all-on-4. A traditional denture is worn by a patient who is completely without teeth. It is held in place by suction between your gum, bone ridge, and the acrylic of the denture. This is the most commonly used method and unfortunately the most troublesome. The process of getting your denture to fit comfortably may be a long one. Many patients experience ulcers due to the acrylic rubbing their gums. A denture does not replace the root of the tooth, which in turn takes away the ability bite and chew the way nature intended. Having dentures for an extended amount of time can also cause the bone to deteriorate due to the lack of stimulation causing the patient to eventually lose the option of even wearing a denture. The bone loss can also lead to facial features being sunken in and droopy. During the process of bone loss, many patients are forced to use messy denture adhesives and in most cases, the denture will still fall out.

Many patients report gagging from the palate of the denture and not being able to taste like they used to. The all-on-4, on the other hand, is a firmly fixed prosthetic attached to four or more implants. They do not have to be removed nightly and are brushed just like natural teeth. The look, feel, and functionality of the all-on-4 is just like your natural teeth. This procedure is designed for immediate function and does not sit up against the gums, removing any chance of an ulcer to occur. The implants stimulate the bone, ending regression of bone, restoration of facial features and allow you to bite with full force. Since it is a fixed prosthetic, the palate can be eliminated, giving the patient relief from gagging and allowing the full experience of eating to be restored.

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