Welcome to the 21st century with All on 4. Gone are the days of dentures slipping and sliding around, and falling out of Patient’s mouths unexpectedly. No more glues, adhesives or nightly removals for cleanings are required once a Patient opts for secured prostheses or bridges – ones secured by dental implants.
Dentistry has progressed significantly over the past 2 decades, and nowhere have such significant advances been made as with the prosthetics that can be attached to dental implants. The process of securing a full set of replacement teeth has commonly become known as the All on 4, though in some cases several more implants are needed or used.
All on 4 bridges or prostheses can quickly be taken off to be cleaned, repaired or replaced. Once secured to a Patient’s dental implants, the screws that hold the bridges in place are covered up with composite materials so it is very difficult for other people to know the Patient does not have natural teeth. The quality of these bridges can vary greatly depending upon the material used, the manufacturing process, and the skill of the lab technicians who oversee the production of the bridges in each individual case.
While budgetary constraints prevent many people from enjoying the most durable, and natural looking restorations (usually made of zirconium), acrylic bridges, if made from high-grade materials, look great and natural too.
The All on 4 is usually a bridge or prosthesis comprised of 12-14 teeth, made of acrylic, zirconia or a mixture of materials, and secured semi-permanently to 4 dental implants that are placed in the upper jaw bone (maxilla) or lower jaw bone (mandible). Once a bridge or prosthesis is connected, using an intermediary connector called an “abutment”, the only way the unit can be removed is by a qualified Dental Implant Specialist who has the proper tools to remove the retention screws.
To increase the odds of a perfect fit and a great look, a Prosthodontist or qualified Oral Rehabilitative Specialist needs to prepare the Patient’s mouth properly and connect the bridges in a skillful manner. What seems easy is not, and people who cut corners and have inexperienced Doctors (who are typically much less expensive) place their bridges often live to regret that decision
All on 6s (using 6 dental implants) and All on 8s (using 8 dental implants) are sometimes used, but the most skilled Dental Implant Specialists and Oral Surgeons can now achieve the same stability and strength required using just 4 implants in each arch. One of the big benefits of an All on 4 over doing an All on 6 or 8 in the maxilla is sinus lifts can be avoided. That means less invasive surgery, and less cost for the patient. It also means a quicker healing time and less time in the dental chair both during initial surgery, and moving forward as general maintenance and annual removal for cleaning is required.
Another benefit of placing fewer dental implants in the maxilla and mandible is there is less stress placed upon the bone, and as a result there is a lower chance of fractures occurring. Finally, the fewer implants needed to secure a bridge or prosthesis, the lower the chance of a dental implant failing at some future date. The more dental implants that someone has, the greater chance that one will fail, just considering the law of odds.
Well trained and experienced Dental Implant Specialists and healthy, low risk patients generally achieve success rates of approximately 98%. High risk patients such as diabetics, heavy smokers and cancer or other patients who take particular drugs that effect bone density see slightly lower success rates; but often still are able to achieve great results – though the long-term success will likley be shorter lived than healthy low risk All on 4/6/8 candidates.
Many manufacturers are present in the marketplace, but Nobel Biocare remains a leader in the field of implant dentistry and holds the Patent and Trademark for the All on 4. Companies such as Zimmer are also known to make quality implants which support All on 4 bridges and prosthesis, and Patients would be wise to make sure their chosen Surgeon agrees to place these widely available, top shelf brands. It is important Patients and their chosen Doctors use high quality brands as dental implants and their associated tools are not always interchangeable, and it is smart to have implants placed that can be serviced or replaced just about anywhere (the best brands are available worldwide, lesser brands are not).