All On Four Implants

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All-on-4

This is an implant restorative technique whereby a fixed prosthesis such as a bridge is supported on four dental implants. It is commonly used in completely edentulous (no teeth at all) cases.

The prosthesis can have 10-14 teeth on it depending on the case. It forms a great cost-effective solution to more conventional dental implant techniques.

Another benefit of this technique is that the teeth can be used within 24 hours of surgery. This is called Immediate Loading. The treatment which includes the implants, abutments and provisional prosthesis, is placed on the day of surgery. So, the patient leaves with their full teeth in place and is able to use the teeth functionally straight away. Although, due to the surgical nature of the treatment the mouth will be sore initially to eat and chew normal foods and so a very soft diet will be recommended. However, proper and full post-operative instructions will be given to you prior to any treatment. Link to: Post-Operative Advice

Four or six implants have been used in the past to support a prosthesis, however, they were placed more near the front of the mouth. This is because of the bone deficiency seen mostly at the back of the upper and lower jaws and highly prevalent in cases where all the teeth have been lost for some time. The advent of “angulated” implant revolutionised this technique and so four implants only, equally spaced in the arch were able to then support the entire prosthesis. This is the “All-on-4” technique.

Angulated implants can be used to overcome structural and anatomical deficiencies. This means that the implants can be placed in the required position based upon the bone quality and quantity. But the prosthesis is placed in a position that is functional and aesthetically correct. Thus, overcoming the differences in orientation and bone deficiency.

It is common to see most of the bone loss that occurs after total tooth loss to occur at the back of the mouth in both upper and lower jaws. Whilst the thickness of bone tends to remain denser at the front. The All-on-4 technique takes advantage of this shortcoming since it uses two angulated dental implants at the back of the mouth.

This angulation also avoids structures such as the sinuses in the maxilla (upper arch) and the nerve canal for the Inferior dental nerve that supplies the mandible (lower arch).

This technique has proven to be highly successful when trialled by numerous clinicians all over the world.

Benefits of the “All-on-4” technique:

• Minimally invasive
• Fixed full arch prosthesis on the day of surgery.
• Reduced need for additional procedures such as bone and gum grafts.
• Prevention of further bone loss.
• Full arch of teeth can be restored in edentulous cases.
• Immediate loading possible so patients can start using their teeth 24 hours after placement of the prosthesis.
• Cost-effective since only four implants are used to restore the whole arch.
• High patient satisfaction due to the quicker ability to start using the teeth compared to traditional implant techniques. Hence, function, aesthetic, confidence and speech is restored sooner rather than later.

See also: Denture Stabilisation |  Implants in a Day

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Before and After photos