Often patients will ask us what All On 4 is and how it differs from the traditional implant procedure.
All On 4 is a dental implant technique in which the upper or lower set of teeth is replaced with only four implants. These four Implants act as a support mechanism for the placement of a new set of fixed teeth.
With the All On 4 dental implant procedure, posterior implants are tilted 45° towards the back of the mouth and placed in the anterior maxilla, an area of the jaw with higher bone density. Compared to other implant methods, the All On 4 technique does not require the same bone density to fix the implant.
The dental implant itself is a small titanium screw that is inserted into the jawbone and then supports a single tooth or a dental bridge. The titanium implant forms the basis on which the replacement teeth are attached.
For the traditional dental implant procedure, a full arch rehabilitation required 6-8 implants to support a full fixed bridge.
In contrast, with only two implants placed at the front of the mouth and two angled implants placed at the back, only four implants are needed to provide support for the full arch.
The main limitation of the traditional full-arch tooth replacement method arises when screwing posterior implants into areas with low bone density. The introduction of the 45° angled implant meant that bone-deficient areas in the jaw could be avoided.
The less invasive nature of All On 4 also means that the healing and rehabilitation period is significantly shorter, and because fewer implant fixtures are used, there is greater flexibility for designing and fitting optimal replacement teeth.
Oral Bone Health Problems
The All On 4 technique offered a better option to patients with oral bone health problems. In the past, the absence of maxillary bone (often caused by sinus problems or bone loss) was a major concern for implant candidates, often required bone grafts to form enough jaws to support the 6-8 implants that the old methods required.
But the All On 4 technique made a big difference. And that’s great news for patients with Osteoporosis or a jawbone deficiency.
Patients suffering from osteoporosis often think that they are not candidates for dental implants because of their poor quality bones. And in the past, that was absolutely true. However, because All On 4 eliminates the need for bone grafting, patients suffering from osteoporosis can often undergo the All on 4 procedure.
The same applies to patients whose upper jaws are severely resorbed. Zygomatic implants are a great option. These longer implants are fixed to the underside of the cheekbones via the sinus cavity, eliminating the need to rely on the jawbone as the sole source of support.
Together, these innovative options can typically eliminate the need for invasive bone graft procedures.
Is There Anything Going Wrong With All On 4?
Undoubtedly one of the biggest concerns of patients considering any implant procedure is what could go wrong.
While the success rates of the All On 4 procedure are very high as with any surgical procedure, there are some factors to consider when deciding on dental implant surgery.
A dental implant can fail, which you can read more about here. However, there are two additional factors to consider when considering the All On 4 procedure;
Poor Positioning of Implants
The biggest mistake in All On 4 treatment occurs when the implants are poorly positioned. Poorly placed implants can compromise the cosmetic results of the treatment.
When implants are placed too far from the mouth, they cause the gums to recede, and the dark gray metal of the implant may become visible around the gums.
When implants are placed too far back, the shape of the replacement teeth can appear thick and bulky, making it difficult to speak.
When implants are placed too close to the bite surface, this means that replacement teeth can appear short, stunted, and this can feel unnatural.
Correcting misplaced implants can be a difficult process. So ideally, the dentist performing your All On 4 will be equally skilled in both the surgical and cosmetic aspects of the procedure.
Cosmetically Trained Dentists and Surgery Trained Dentists
There are generally two types of dentists who perform the All On 4 treatment. One is surgically trained and the other is cosmetic dentistry trained.
Dentists who focus more on cosmetic results may be less experienced with the surgical aspects of the procedure. If complications arise and the dentist is not competent enough to deal with it, the implants can eventually come out and cause an infection in the gums.
The other type of dentist who practices All On 4 is the surgically trained dentist. A surgically trained dentist does a great job of placing the implant in the nearest bone available, but does not always consider the aesthetic effects of the implant.
The best All on 4 dentists are experienced and knowledgeable in both surgical and aesthetic dentistry, enabling them to position implants correctly and use their experience in cosmetic dentistry to achieve a beautiful result for the patient.
It will be more difficult to find a dentist who combines these skills, but in doing so you will minimize the risk of anything going wrong.
