All-on-4 Dental Implants

What are All-on-4 Dental Implants?

All-on-Four uses only four dental implants to securely support a complete arch of teeth. Because only four implants are needed, the All-on-4 dental implants cost is more affordable, providing a cost-effective solution for complete tooth loss.

Sometimes we may recommend using six dental implants instead, a technique called All-on-Six, for example, when restoring an upper arch of teeth where the upper jawbone is generally thinner and weaker. This is to provide additional support and strength when required.

How is All-on-Four Different from Traditional Implant Treatments?

When replacing an entire arch of teeth, it’s often necessary to use six or more dental implants with support. These are evenly spaced throughout the jawline. With All-on-Four, all four implants are inserted at the front of the mouth.

This is because the jawbone is stronger and thicker in this area. Using the front of the mouth for support helps provide a strong foundation for the implants while reducing the need for bone grafting.

In comparison, dental bone grafting is often needed when using more traditional techniques; the jawbone tends to be weaker toward the back of the mouth, especially in the upper jaw, near the upper back teeth.

This is the area closest to the sinus cavities, which are air-filled spaces on either side of the nose, leaving less room for a thicker jawbone to develop underneath them.

How Does All-on-Four Work?

The way the implants are inserted differs from traditional treatments: instead of being evenly spaced and inserted vertically, two implants are angled backward. The first two implants, right at the front of the jaw, are inserted vertically, but the two remaining implants that are inserted on either side are tilted backward.

There is a very good reason to tilt these implants backward: it allows us to use longer dental implant screws.

The longer screws increase the surface area between the screw and the surrounding bone. The greater surface area strengthens the bond between the bone and the screw and helps build a stronger foundation for these implants, providing greater stability to support the new set of teeth.

Who Is a Good Candidate for All-on-Four?

You might want to consider this option if you have any of the following issues.

• Multiple missing teeth or teeth that are failing.
• Jawbone loss that has made you less suitable for traditional implant treatment without bone grafting.
• You are looking for a fixed and permanent solution for tooth loss.
• You currently wear dentures and find them frustrating and uncomfortable to use.
• You have reasonable dental and general health.
• You are a non-smoker or are prepared to quit smoking during treatment, and we would prefer you quit for good.

The Benefits of Choosing All-on-Four Dental Implants

Treatment can provide many benefits, which include:

• Fixed, nonremovable teeth that remain permanently in place.
• Improved biting and chewing strength that is similar to natural teeth.
• Jawbone loss is prevented around the dental implants.
• Restorations are designed to provide excellent aesthetics and to be fully functional.
• The need for bone grafting is often eliminated.
• Treatment has a very high success rate.

Understanding the All-on-Four Treatment Process

Treatment will take place over several months, as it takes time for the implants to heal once they are inserted into your jawbone. Below is a brief outline of what to expect, but you will receive a custom treatment plan from our All-on-Four dentist.

1. Consultation, Dental Exam, and Diagnostics

You will need a full consultation with our dentist, during which we can discuss treatment further, understand your goals, and answer your questions. We must conduct a full dental exam to ensure your mouth is healthy enough for implants. We also review your dental and medical history to make sure any treatment we plan is appropriate and safe.

Your diagnostics will include a cone beam CT scan, digital dental X-rays, and digital photos.

2. Treatment Planning and Digital Smile Design

We use your cone beam CT scan to assess the quality and quantity of jawbone available for implant placement and to identify exactly where each implant must be inserted for optimal strength and support.

During the planning stage, we also assess if any other treatments are needed, such as the extraction of failing teeth. If so, these can sometimes be removed during a single procedure while inserting your implants. Otherwise, we may suggest they be removed and that your mouth be left to heal before treatment begins.

We can begin designing your permanent teeth, using Digital Smile Design to check they look good and are fully functional. You can preview these images with us to ensure the predicted outcome meets your expectations. It can be quite exciting to see images of your new teeth before we begin, helping ensure you get the right results.

Your finalized treatment plan will identify the location of each implant, and we will create a computer-generated stent or template for use during your surgery.

3. Implant Placement

When someone requires several dental implants, we recommend sedation dentistry to help you relax and feel entirely comfortable during treatment. Once sedation takes effect, we use your surgical stent to place each implant accurately.

4. Temporary Teeth Placement

Usually, it’s possible to fit temporary teeth soon after All-on-Four implant surgery. Temporary teeth can be made before your surgery; they are fitted soon afterward and worn during healing.

These temporary teeth help to splint your implants together, preventing any movement while they heal and fuse in your jawbone.

This is called immediate loading, and if we feel it isn’t appropriate, we will provide another form of restoration for you to use. Another alternative is to use an existing denture and to adapt it to fit during healing.

5. Implant Healing and Osseointegration

Before we send you home to relax and recover after surgery, we will review oral care instructions with you to ensure you know how to keep your mouth clean during healing. We will also provide advice on what to eat during healing, as you will likely need to stick to eating softer foods that require minimal or no chewing while the implants heal and fuse with your jawbone.

This part of the process, called osseointegration, is essential for implant success. It is when new bone is deposited on and around your implants, ensuring they are firmly held in position, strong and stable, and able to support your new set of teeth easily.

Usually, dental implants take between three and six months to heal, but we can advise you on how long to expect based on your dental and medical health.

6. Permanent Implant Teeth

When we are certain your implants are firmly fused in your jawbone, we can begin making your permanent teeth. We take a detailed dental impression of your implants, and this is used to create your new implant teeth.

These teeth will be custom-designed to provide the right support for your cheeks and lips, and to ensure they are the right size, shape, and color for your facial structure, gender, and skin tone. Once ready, they will be permanently fitted onto your implants.

Long-Term Maintenance and Aftercare

Caring for your implants is straightforward, but you need to be dedicated to maintaining a meticulous oral hygiene routine to clean around them thoroughly and to avoid All-on-4 dental implants problems. There is no need to worry, as our hygienist can work with you to ensure you know which tools to use and the right techniques.

When you visit us for your dental exams and hygiene appointments, we can closely monitor your implants and professionally clean them.

To learn more about All-on-4, please contact Dental Pearl Miami to schedule your dental appointment. We’ll answer your questions and determine if All-on-4 is the right fit for you, or if an alternative treatment for multiple tooth loss would better serve your needs.