If you’re familiar with various dental implants due to dental issues, you might not have come across ‘All-on-4 dental implants.’ Despite the peculiar name, the concept addresses a common problem. Over 35 million American adults lose all upper and lower teeth annually, favoring conventional implants. While effective for single-tooth gaps, they may be less suitable for multiple missing teeth. Enter All-on-4 dental implants, offering advantages in such cases. Curious? Let’s explore its benefits and how it might be your desired solution.
The ‘All-On-4’ Concept: An Overview
Starting in the ’70s, the concept focused only on the effective restoration of an entire arch of teeth with no specific number of fixtures. However, it started evolving due to typical anatomical limitations in the back of the patient’s upper and lower jaws. The angulation of the back implants helped clinicians avoid the bone-deficient areas while leaving enough room for two more implants in the front. Eventually, a complete set of teeth was supported by four fixtures. This is how today’s ‘All-on-4’ was born. As the term suggests, it is a surgical and prosthodontic procedure in which ‘all’ teeth are supported ‘on four’ dental implants. This offers total and permanent rehabilitation to the edentulous or dentate maxilla and mandible patients and those whose teeth are decayed, compromised (due to gum disease), or broken down badly. (1)
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All-On-4 Dental Implants
The evolution of the basic ‘All-on-4’ concept made it a highly potent alternative to traditional implants, and it was first identified (a registered trademark) by the well-known implant manufacturer ‘Nobel Biocare.’ The conventional technique revolves around the insertion of a small titanium screw into the jawbone for the replacement of the root part of a missing tooth, followed by the attachment of a ‘crown’ (fake tooth) to it. However, this is an individualistic approach in which one implant is necessary for every missing tooth. Advanced technology and materials in All-on-4 help restore the full smile quickly and effectively by placing four implants strategically. They work as a robust and long-lasting foundation for your replaced teeth and give you a youthful facial structure with a realistic appearance.
How Do All-On-4 Dental Implants Work?
Here is how All-on-4 dental implants can replace your missing teeth with a set of new teeth’ that not only looks natural but also usually functions (2)
The implants in the front of the jaw have a higher bone density for supporting a fixed dental prosthesis with at least 12 teeth. As few as four titanium implants are needed for each jaw. Based on the requirements of the patients, they can be used to replace either the top set of teeth, the bottom set of teeth, or even both sets of teeth.
The posterior implants are tilted 30-45 degrees from the biting plane to avoid anatomical structures like sinus cavities (upper jaw) and the nerve canal (lower jaw). This also provides optimal strength to the prosthesis in patients with bone loss by overcoming the need for expensive and time-consuming bone grafting.
Ideal Candidates
The All-on-4 treatment is perfect for anybody who has lost most of their natural teeth. It is also suitable for people with diabetes, osteoporosis, etc., who cannot undergo bone grafting due to low bone volume.
The Procedure
Here are the steps involved in the basic All-on-4 implant procedure (3):
1. It all starts with the initial consultation with an expert dentist, who evaluates your jaw bone structure and density through a CBCT scan. If you are a suitable candidate for implants, the proper treatment is planned, and the new dental bridge is designed for you by taking your dental impressions and X-rays.
2. On the scheduled day of surgical implantation, you will be sedated by administering local or general anesthesia, and your mouth will be prepared for the implants. This involves extracting the remaining failing teeth and the removal of infected and damaged tissue from the gums and jaws.
3. Your mouth will be cleaned thoroughly before the implantation process beginsThen; your dentist will drill four holes in your jaws (two at the front and one angulated at each side of the back) and insert the titanium screws into the jawbone.
4. Once the implants are secured properly, your mouth will again be cleaned, focusing on the surgical sites. The dentist will also suture all the incisions made throughout the procedure with dissolvable stitches.
5. The new teeth are fitted and adjusted the same day or the next day. If your dentist creates a temporary overdenture, you may need it replaced after a few months.
Procedural Time
All-on-4 is a one-time, complete teeth restoration process that can be performed in a single day with immediate placement of implants.
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Post-Procedural Care
It is essential to follow your dentist’s advice for proper care of your implants in the days following surgery. For the first few hours after the procedure, you must gently bite down on gauze packs and change it every 30-45 minutes. If you get persistent bleeding, the gauze packs inside your mouth must be repositioned. Do not touch or rinse the tender areas of your mouth. However, you may experience common post-surgical issues like discomfort, pain, swelling, nausea, discoloration or bruising near the surgical sites, sore throat, dry lips, etc., which usually subsidize within 2-3 days. To counteract the feeling of muscle stiffness, you can stretch your jaw slowly and gently occasionally. You can keep your implants clean by brushing and flossing them once a day, like your regular teeth.
All-On-4 Dental Implants – Before & After
Recovery And Downtime
It takes around six months for the implants to get fused to the natural bone and for the gums to heal fully. But you can return to your regular schedule in less than a week. Until then, rest enough to promote healing, and do not indulge in heavy exercise during this period. Stay on a restricted diet (very soft foods) until you can chew correctly. Also, avoid strenuous activities, lifting heavy objects, smoking, etc.
Risks And Complications
Some of the most common risks associated with All-on-4 dental implants include infection, profuse bleeding, failed osseointegration, failed implants, bulky feeling in the mouth, issues with speaking or spitting, etc.
Lasting Time
The All-on-4 implants can last longer than ten years if everything goes fine. Ensure you care for your ‘new teeth’ according to your dentist’s instructions.
Cost Of Implants
As the procedure needs only fewer implants, it is considered to be a more cost-effective treatment plan than its traditional counterpart. The cost usually varies based on the unique requirements of the patients as well as the material of the implants used. Given below is an average estimate breakdown:
Extracting remaining teeth and placing four implants in one jaw can range from $12,000 to 15,000. For both jaws, it can reach up to $40,000.
Standard acrylic implants cost between $20,000 and $30,000 per jaw, while porcelain ones cost between $25,000 and $35,000.
Summary
The ‘All-on-4’ dental implant concept, introduced in the ’70s, provides a comprehensive solution for individuals with significant tooth loss. It involves strategically placing four implants in each jaw to support a complete set of teeth. Ideal for those unable to undergo extensive procedures, it overcomes anatomical limitations with tilted posterior implants. The procedure, typically completed in a day, offers immediate restoration with minimal downtime. Suitable candidates include those with extensive tooth loss, even with conditions like diabetes. Post-surgery care is crucial, and recovery takes around six months. The cost varies, with estimates ranging from $12,000 to $40,000, based on factors like material choice and individual needs.
References:
1. “All-on-4“, Wikipedia
2. “All-on-4 Dental Implants: Your Guide To Costs, Treatment, and More“, Dentaly
3. “What Are All On Four Dental Implants?” Authority Dental
