What is All-on-4?

All-on-4 is a unique dental implant procedure for replacing teeth. Traditional dental implant dentures use between four and six implant abutments distributed across the jaw and attached to the denture. Unfortunately, many patients with advanced tooth loss are not good candidates for dental implants because they have reduced bone density in their jaw due to tooth loss. All-on-4 allows these patients to receive a dental implant denture. Rather than spacing the implants along the jaw, the All-on-4 procedure maximizes the bone density at the front of the jaw to support the entire denture.

What are the advantages and disadvantages of All-on-4 treatment?

Advantages of All-on-4

No dental treatment is right for everyone, but if you opt for All-on-4 treatment, you will benefit from certain advantages:

• 93-98% successful implant placement rate;
• Reduced need for advanced preparatory procedures like bone and soft tissue grafting;
• Faster healing and implant placement so that full dentures can be permanently fixed sooner;
• A more natural look and feel than traditional removable dentures and better denture stability;

Potential Disadvantages of All-on-4

All-on-4 dentures allow dentists the ability to replace teeth with implants in more patients, but many dentists opt to immediately place these dentures. While All-on-4 implants heal and fuse to the jawbone faster, immediately placing a denture increases the risk of implant failure. If the All-on-4 dental implants are allowed to fuse to the gum and bone tissue before the denture is attached, these patients typically have a 95% implant success rate, comparable to traditional implant placements.

How to Determine if You Are a Good Candidate for All-on-4 Treatment

Have You Lost Teeth?

If you have lost one tooth, several teeth, or almost all of your teeth, you may be a candidate for implants. For the All-on-4 treatment concept, you will need to have lost most of your teeth or have most of your teeth in very poor condition. Those who still have a few healthy teeth are typically better candidates for implant bridges or individual replacement teeth.

Are You in Good Health?

If you suffer from a serious illness or medical condition, it is best to postpone your implant surgery. In some cases, individuals with chronic illnesses may not be good candidates. Undergoing surgery while your body is already weak or fighting off an infection or illness can put it under unnecessary stress. This increases the risk of something going wrong during the procedure, and we never want to put you at unnecessary risk.

It is also important that you are in good oral health. If you suffer from gum disease or other problems, the oral surgeon will work with you to eliminate any infections and resolve any other issues first. This way, the risk of infection at your implant sites is less.

Is Bone Loss a Factor to Consider?

For other types of dental implants, patients need to have a good amount of jawbone to support the implanted abutment. But with the All-on-4 treatment concept, this is not a necessity. The four abutments can be placed in certain locations so that even if one area does not have a good amount of bone, another area might. As a rule, even people who have had fairly advanced gum disease can still have implants placed with all-on-4 treatment.

Are There Age Limits for All-on-4 Treatment?

In most cases, age plays no role in determining whether a person is a good candidate for the All-on-4 treatment concept.

All-on-4 Dental Implant Placement

Most dental implants are made of titanium. The titanium is inserted into the jawbone where it bonds to the bone, creating a strong structure. The titanium fuses to the bone, much like a traditional tooth root bonds to the bone. Implants are placed and a natural-looking prosthesis will be fixed to an abutment on the implant stem. The protocol uses four implants in the anterior part of completely edentulous jaws to support an immediate-loading, fixed provisional prosthesis. The two most anterior implants are placed axially, while the two posterior implants are placed distally and angled to minimize cantilever length.

It is important for patients missing teeth to understand that the longer they wait to receive treatment, the greater the risk of developing problems such as gum recession, bone loss, and other oral health issues that can become very serious if left untreated. By taking early steps to replace missing teeth, you are investing in your overall health and well-being and avoiding these potential problems in the future.

The All-on-4 treatment concept was developed to maximize the use of available residual bone in atrophic jaws, allowing immediate function and avoiding regenerative procedures that increase treatment costs and patient morbidity, as well as complications inherent to such procedures.