What is All On 4?
All On 4 or All On Four is an advanced dental implant procedure that offers a comprehensive solution for individuals who have lost a significant number of teeth or are edentulous (toothless) in one or both jaws. The name itself, “All-on-4,” signifies the foundational principle of the technique: a full arch of prosthetic teeth, which can be an entire upper or lower set, is supported solely on four strategically placed dental implants.
Traditional dental implant solutions might require an implant for each missing tooth, which can be time-consuming, more invasive, and costlier. In contrast, the All-on-4 approach minimizes the number of implants needed.
How does all on 4 work?
Implant Placement
The four titanium implants serve as artificial roots. They are surgically embedded into the jawbone—two near the front and two towards the back. What’s unique about the rear implants is that they are typically angled, allowing them to harness the denser bone available in those regions. This angulation not only maximizes support but also often eliminates the need for bone grafting, even in patients with some bone loss.
Prosthesis Design
The prosthetic arch isn’t just a set of teeth. It’s a meticulously designed unit that mimics the appearance and function of natural teeth while also compensating for some of the gum tissue lost. Its design ensures even distribution of biting forces across the implants and jaw.
Immediate Functionality
One of the standout features of the All-on-4 procedure is the possibility of immediate loading. In many cases, patients can receive a temporary set of teeth on the same day as the implant surgery, restoring their ability to speak, smile, and chew almost immediately. Once the implants have fully integrated with the bone—a process that can take several months—a permanent, more durable prosthesis replaces the temporary one.
Who needs all on 4?
- Individuals with Significant Tooth Loss: Those who have lost a majority or all of their teeth due to various reasons, such as disease, trauma, or age.
- Preference Over Traditional Dentures: People who desire a permanent, non-removable solution as opposed to the traditional removable dentures.
- Bone Density and Health: Candidates have suitable jawbone density for implants or are willing to consider bone grafting for implant viability.
- Aesthetic and Functional Restoration: Patients seeking a restoration that not only functions effectively but also closely resembles the appearance of natural teeth.
Procedure
What is the procedure for getting an all-on-4?
Pre-Procedural Steps:
- Consultation and Diagnosis: Your dentist will first conduct a thorough examination using X-rays, panoramic radiographs, and sometimes CT scans to visualize the jawbone, determine its health, and plan the implant placement. This step is crucial for identifying the best locations for the implants, especially since the All-on-4 method often involves placing the rear implants at an angle to maximize bone-to-implant contact.
- Treatment Planning: Based on the diagnostic information, a comprehensive treatment plan is devised. It will include details about any prerequisite procedures, like tooth extractions or bone grafting (though the need for bone grafting is less common with All-on-4 than with traditional implants due to the implant angulation strategy).
The Procedure:
- Administration of Anesthesia: The procedure is typically done under local anesthesia, but sedation or general anesthesia might be offered depending on the clinic and patient’s needs.
- Preparation: If any remaining teeth need to be extracted in the arch being treated, this is done first. The mouth is then thoroughly cleaned to prevent infection.
- Implant Placement: Four dental implants are strategically placed in the jaw. The back implants are usually placed at an angle to take advantage of available bone and avoid anatomical structures like the sinus in the upper jaw or the nerve in the lower jaw.
- Immediate Load Provisional Prosthesis: In many cases, a provisional (temporary) dental bridge is attached to the implants on the same day. This is one of the distinguishing features of the All-on-4 procedure, as it provides “teeth in a day.” The provisional prosthesis is not as durable as the final one, but it offers aesthetic and functional benefits during the healing period.
Post-Procedure:
- Recovery: There will be a recovery period where the patient might experience swelling, bruising, minor bleeding, and discomfort. Pain management, usually with over-the-counter pain relievers or prescribed medications, will be necessary.
- Osseointegration: This is the phase where the bone grows around the dental implants, anchoring them securely. It’s a critical phase that can last several months. During this time, patients are advised to stick to a soft diet to prevent undue pressure on the implants.
- Final Prosthesis Fabrication: After the mouth has healed and the implants have integrated with the jawbone, the patient returns to the dentist. Impressions or scans of the mouth are taken to design the final dental bridge.
- Attaching the Final Prosthesis: Once fabricated, the provisional prosthesis is removed, and the final, durable prosthesis is fixed onto the implants. This bridge is designed to match the patient’s oral structures and provide a long-lasting solution.
- Follow-Up and Maintenance: Regular check-ups are vital to ensure the health of the implants and surrounding tissues. Proper oral hygiene, including brushing, flossing, and sometimes the use of a water flosser, is essential.
Risks
Are there any risks with getting all-on-4?
Yes, here are the risks of getting all-on-4:
- Infection: At the implant site.
- Sinus problems: Especially with implants in the upper jaw.
- Nerve damage: Can cause pain, numbness, or tingling.
- Implant failure: The bone may not fuse with the implant properly.
- Prosthesis complications: The prosthesis can fracture or wear out over time.
Benefits
What are the benefits of all-on-4?
- Aesthetics: Provides a natural-looking replacement for missing teeth.
- Functionality: Restores nearly full chewing and speaking functionality.
- Bone preservation: Implants help prevent bone loss in the jaw.
- Convenience: Unlike dentures, there’s no need to remove them for cleaning.
- Durability: With proper care, the solution can last for decades.
Which is better, all-on-4, all-on-6 or all-on-8?
The primary differences between All-on-4, All-on-6, and All-on-8 are the number of dental implants used to support the prosthesis and their distribution within the jawbone. Here’s a detailed breakdown:
All-on-4:
- Number of Implants: 4 dental implants.
- Implant Placement: Two implants are placed vertically in the front of the jaw, and two are placed at an angle in the back.
- Main Advantage: Can often be used in patients with some bone loss without the need for bone grafting due to the angled placement of the rear implants.
- Typical Use: Suitable for many patients, especially those with moderate bone loss, who need a full arch restoration.
All-on-6:
- Number of Implants: 6 dental implants.
- Implant Placement: Generally, more evenly distributed across the jaw than All-on-4. The implants may all be placed vertically, or some might be angled depending on the specific patient’s anatomy and bone availability.
- Main Advantage: More implants can provide greater support and stability, potentially leading to a more durable and long-lasting prosthesis.
- Typical Use: Used when there’s ample bone available or after bone grafting. It may be preferred when seeking to distribute biting forces more evenly or in cases with larger jaws.
All-on-8:
- Number of Implants: 8 dental implants.
- Implant Placement: Evenly spread across the jaw for maximum support.
- Main Advantage: Offers the highest amount of support among the three options, distributing the load over more implants, which can increase the longevity of the prosthesis and reduce the strain on individual implants.
- Typical Use: Typically chosen for patients with larger jaws or when maximum support is desired. It’s also more common in cases where the patient’s bone quality and quantity are excellent.
Cost
How much does all-on-4 cost in Ontario?
The cost for All-on-4 in Ontario can range from $20,000 to $30,000 per arch. And up to $50,000 for a full arch. The exact cost depends on various factors, including the type of materials used for the prosthesis, and any additional procedures that may be required (like extractions, bone grafting, etc.).
Dynasty Tower Dental is a certified DIOnavi Full Arch Clinical Center
FAQs
Can I eat normally with All-on-4 implants?
Yes, once the healing process is complete, All-on-4 implants allow patients to eat a wide variety of foods, including those that can be challenging with traditional dentures. However, it’s always recommended to start with softer foods and gradually introduce harder items to ensure comfort and safety.
How is All-on-4 different from traditional dentures?
Unlike traditional removable dentures, All-on-4 is a fixed solution anchored by dental implants. This provides better stability, improved chewing efficiency, and a more natural feel and appearance.
Do I need bone grafting for All-on-4?
One of the advantages of All-on-4 is that, often, bone grafting isn’t necessary. The two posterior implants are angled to utilize available bone. However, individual cases vary, and some patients may still require bone grafting.
How long does the procedure take?
The surgical placement of the implants typically takes a few hours. In many cases, patients can receive a provisional prosthesis on the same day, hence the term “Teeth in a Day“.
How durable is the All-on-4 prosthesis?
With proper care and regular dental check-ups, the All-on-4 prosthesis can last many years. The titanium implants themselves can last a lifetime.
Is All-on-4 procedure painful?
The surgery is typically done under local anesthesia or sedation, so patients shouldn’t feel pain during the procedure. Some post-operative discomfort can be expected, but it’s usually manageable with over-the-counter pain relievers.
What's the recovery time?
Most patients can return to non-strenuous activities within a day or two. However, a soft diet is usually recommended for a few weeks to allow the surgical sites to heal.
How do I care for my All-on-4 teeth?
Even though the prosthesis won’t get cavities, regular oral hygiene is crucial. Brushing, flossing (using special tools like interdental brushes), and regular dental check-ups are essential to maintain gum health and ensure the longevity of the implants.
Is there any age limit for getting All-on-4?
While there’s no strict age limit, it’s essential that the patient’s jawbone has fully developed. This procedure is popular among older adults due to age-related tooth loss, but suitability is determined more by oral health, bone density, and overall health rather than age alone.
Will my All-on-4 teeth look natural?
Absolutely. One of the main advantages of All-on-4 is the aesthetics. The prosthetic teeth are designed to mimic the appearance of natural teeth closely, providing not just functional benefits but also a cosmetically pleasing result.
Regain Confidence with All-on-4 Implants!
Missing multiple teeth? Choose Dynasty Tower Dental Clinic for your All-on-4 or full arch implant needs. Our skilled team in North York, Toronto, Ontario, has over a decade of experience in restoring smiles and confidence. Book your FREE consultation today!