Losing one or more teeth can significantly impact daily life, affecting eating, speaking, and self-confidence. While dentures offer a traditional solution, All-on-4 dental implants and other implant options provide a more permanent and secure alternative. Dental implants are versatile, catering to individuals with single tooth loss, multiple missing teeth, or even full-mouth reconstruction. The ideal implant solution depends on factors such as the number of implants required, their placement, the condition of existing teeth, and overall oral health.
Advantages and Disadvantages of the Different Implants
Removable full dentures come with several drawbacks. For instance, they necessitate multiple visits to the dentist and cannot be permanently fixed, as changes in the shape of the gums and bone over time require frequent adjustments. These adjustments are crucial to prevent the dentures from slipping while chewing or speaking. Additionally, there is a need to pre-cut food into small pieces. In contrast, using implant-supported removable dentures can provide a more stable solution. These dentures are held firmly in place, enhancing confidence during conversations and meals.
Removable Full Dentures
Advantage : Can be easily removed and cleaned.
Disadvantage : There is a chance the dentures will slip out of place, so dentures adhesive may be needed.
Implant-Supported Removable Dentures
Advantage : Stays more securely in place.
Disadvantage : With removable dentures, you must be careful while chewing food.
All-on-4 Dental Implants
Advantages : Uses few implants; dentures can be attached immediately after the implants are in place; and requires less time for the procedure than other methods.
Disadvantages : The first set of dentures immediately after the implant is only temporary and will be replaced later. Caring for All-on-4 includes daily cleaning to ensure that there is no food particle lodged under the dentures, and annual visit to the dentist for complete cleaning.
Crowns and Bridges on Fixed Implants
Advantages : Can replace all the teeth on the jawbone; the implant can firmly and robustly support a ceramic dental bridge and can be cleaned like normal teeth.
Disadvantages : It requires sufficient amount of healthy oral bones.
What is All-on-4 dental implants ?
The All-on-4 dental implant technique is a modern tooth replacement method that helps slow bone loss and maintain facial structure. It typically involves placing four implants in the upper or lower jawbone, although up to six may be used based on the jawbone’s condition and dentist’s assessment. These implants support fixed dentures or bridges, securely attached with small screws, providing a stable and effective alternative to traditional removable dentures.
All-on-4 Dental Implants Procedure
- Diagnosis : Before the procedure, your dentist will check the patient’s medical history, evaluate the conditions of the gum and jawbone, assess the patient’s readiness for the implants – bone density, related vital organs and locations of various relevant nerves for the dental implant – through the use of oral X-ray, Panoramic Radiograph, or CT scan.
- Dental Implant : Directed by CT guided surgery technique, the dentist will insert the implants into place. Using Smile Design software to simulate in 2D and 3D the patient’s normal smile, the dentist will determine the implant locations. Small holes will then be drilled through the gums deep into the jawbones, to create a base for the All-on-4 implants: 2 in front of the maxillary sinus, and 2 in the back of lower jaw tilted at 45 degrees to support the innermost part of the dentures while enabling balance and strength for chewing food.
- Fitting Dentures or Bridges on Implant : After the implants are completely fitted, the dentist will secure dentures or bridges onto the implants on the same day. The prostheses are made of acrylic and will be adjusted to properly fit the mouth and the bite. After 6 months following the procedure, when the wounds are properly healed, the dentist will schedule a follow-up for re-evaluation. Patients may request stronger materials for their prostheses, such as acrylic mixed with titanium or zirconia. For each case, the dentist will determine the suitable material for usage along with the patient’s dental health. It should be noted that, during the fitting, if the patient is worried or afraid of pain, the hospital provides a number of options – such as general anesthesia, intravenous drug administration, etc. under close supervision of an anesthesiologist – to help allay the patient’s concerns.
Types of Prosthesis for All-on-4 Implants
The All-on-4 dental implant technique supports various types of prostheses, which can be tailored to meet the specific needs and preferences of each patient. Here are the primary types of prosthesis used in All-on-4 implants
- Fixed Acrylic Denture : This is a popular choice for All-on-4 implants. The prosthesis consists of a metal framework that is covered with acrylic, with teeth that are also made from acrylic. It is permanently attached to the implants, offering a stable and aesthetic solution.
- Fixed Hybrid Denture : Hybrid dentures combine acrylic teeth with a titanium or metal framework. This type is also permanently fixed to the implants and is known for its durability and strength, making it ideal for patients with significant dental needs.
- Fixed Zirconia Bridge : Zirconia bridges for All-on-4 implants are highly durable and offer excellent aesthetic results. Zirconia is a strong ceramic material that can mimic the look of natural teeth and is resistant to wear and staining.
- Removable Implant-Retained Overdentures : While not as common in All-on-4 treatments, some patients opt for overdentures that can be removed for cleaning. These are still supported by implants, which provide more stability than traditional removable dentures.
Advantages Of All-on-4 dental implants
- Requires a smaller number of implants for permanent dentures.
- Replaces natural teeth and can be used immediately on the same day as the procedure where appropriate. This will depend on the dentist’s recommendation based on the patient’s oral health, jawbones, and other factors.
- Requires less time for surgery and recovery, with fewer number of dental visits.
- Eliminates the problem of loose or slipped dentures, because the dentures are firmly fitted.
- Offers strong construct and natural feel for chewing or talking.
- Simplifies the process of bone grafting.
- Effective way of teeth restoration, to enhance personality and build confidence.
- With proper care, will last a lifetime.
Who Needs All-on-4 implants Procedure?
- People who have fewer teeth or lost most of their teeth – upper as well as lower ones.
- Patients who are required to have all their teeth removed and need permanent dentures.
- People who need multiple dental implants.
- People who cannot have an implant around the back teeth.
- People who have lost their alveolar bone but require less or no additional bone grafting.
- People who have problems with dental crowns or bridges, or loose teeth that must be extracted.
However, All-on-4 procedure is not recommended to people who have severe damage to alveolar bone. The dentist will consider this procedure on a case-by-case basis.
Post-Care for All-on-4 Procedure
Since All-on-4 implants are fixed, they don’t need to be removed for cleaning like removable dentures. Patients should brush normally and clean twice daily using a Waterpik and Superfloss to prevent food debris and bacteria buildup, which can lead to gum inflammation and damage to the bones supporting the implants. Regular dental visits every six months are crucial to check the implants’ stability and perform thorough cleanings.
Conclusion
All-on-4 dental implants provide a quick and effective natural teeth replacement, allowing for the immediate installation of a full set of dentures. This method significantly cuts down treatment time and reduces the need for extensive bone grafting. With proper maintenance, these implants can last over 20 years.
The technique involves placing at least four implants in the jawbone, with the lower two angled at 45 degrees to utilize denser bone areas, enhancing stability. This setup supports fixed dentures installed the same day, improving functions like chewing and speaking and boosting the patient’s confidence. While All-on-4 speeds up the treatment process compared to other implants, its suitability varies by individual and requires a detailed evaluation by a dental specialist.
