Full-arch fixed implant bridges or the All-on-4 have taken teeth replacement by storm. These hybrid bridges are supported by four specialized dental implants. They are often presented with package pricing. Some practices promote All-on-4 as the best treatment option for their soon-to-be-edentulous (toothless) patients.
Before you start looking around for the best deal to get in on this amazing treatment, ask yourself — do you really know what you’re looking for? Is all on 4 dental implants good for all?
What are All-on-4 Dental Implants?
The “All-on-four” treatment concept was developed by Dr. Paulo Malo to maximize the use of available jawbone.
The protocol uses four implants in the front of jaws to support a provisional, fixed and immediately loaded denture.Journal of Clinical and Experimental Dentistry
The all-on-four treatment concept
“The “all-on-four” treatment concept was developed to maximize the use of available remnant bone in atrophic jaws, allowing immediate function and avoiding regenerative procedures that increase the treatment costs and patient morbidity, as well as the complications inherent to these procedures…”
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The difference from the traditional false teeth on implants is that the back implants in All on 4 are tilted at an angle of 45o.
Advantages of All-on-4 Dental Implants
- immediate function i.e. teeth in a day
- avoids bone grafting that increases the treatment costs.
What are the Common All on Four Problems?
Deciding to get All on 4 treatment may be one of the most important decisions you’ll make. Read to know more about the problems with All-on-4 and what can you do to avoid any possible all on four problems.
What may seem to us to be a minor speech flaw can become an overwhelming concern for the All-on-4 patient. Implant-supported bridges require some bulk for strength. All-on-4 patients need to be made aware of this compromise.
They can often retrain their tongues with time and practice, but it is likely to be a significant source of anxiety for them.
Difficulty adapting to bridge bulk
It may be very difficult for patients to adapt to the different feel of an All-on-4 bridge. In the All-on-4 bridge, patients feel the real soft tissue and then fake soft tissue (the tissue portion of the bridge) prior to the teeth.
Patients are more likely to accept any compromises when they know about any limitations prior to treatment.
Alternatives to All on 4 Dental Implants
There are many implant-supported options to choose from: All on 6, 3 on 6 dental implants, individual teeth on implants.
These fixed bridge options using traditional implants. The advantages are
- More implants mean more support for the entire arch of teeth.
- If one implant fails, you still have 5-7 implants supporting your teeth. Because All on 4 is designed to work with exactly four implants, failure in one means redoing almost the entire procedure.
So while All on 4 dental implants certainly sound like an attractive prospect to many, it’s not always the best tool for the job.
How to find an Experienced All on 4 Dental Implantologist
- Research the Dentist’s credentials: You need to look into the experience of the implantologist performing the procedure.
- Ask how many All on 4 implants they have placed: You want someone who knows the procedure well, and knows how to deal with unexpected surprises during the surgery.
- Make sure they specifically have All on Four dental implant experience: Placement of All on 4 is different from traditional dental implants.
- Does the clinic provide guarantee: A guarantee on a medical procedure is risky for a dentist, so it’s usually a good sign when someone is confident enough to offer one.
Comparison of Various Full-Mouth Rehabs
|All on 4||Crowns on Implants||All on 6/8||Removable Dentures|
|Fixed hybrid denture is supported on 4 implants||Individual crown or a bridge is supported on implants||Fixed bridge is supported by 6/8 implants||Denture has to be taken out every night|
|Graftless procedure||Bone graft may be needed||Bone graft may be needed||No need for bone graft|
|1-3 days||6-12 months||3-6 months||1-2 months|
|Highly stable||Highly stable||Highly stable||Not very stable|
All-on-4 is an extremely technique-sensitive procedure. Research well before you get it done.