The term All on 4 implants, also called All on Four implants and All on Four implantation, refers to the temporary placement of all of the teeth surrounding an impacted or missing tooth. The procedure is a prosthodontic procedure and a crown lengthening/bridge work that takes the teeth surrounding that missing tooth and supports them with four new teeth in their place. The procedure can be used to support either only one tooth or all of the teeth in a row. It is a cosmetic dental procedure that can be used to realign teeth that have been affected by trauma or decay, as well as those that are misaligned or positioned improperly. A crown lengthening/bridge is typically done in response to a tooth that was removed or that has become malnourished or shortened.
During the procedure, the patient will go through preparation steps, including: numbing the mouth and gums, sealing the mouth and gums, filling the implant with a custom-made filling, and placing the custom-made prosthesis. The procedure will be administered by a periodontist or orthodontist who has completed a thorough training in periodontology, bone anatomy, dentistry, oral surgery, and the application of dental implants. The new teeth will be secured in place using the procedures used during the placement of all on 4 implants. The dental implants are then cemented into the bone.
All on 4 implants require six dental implant treatment visits over a period of one year. These visits are spaced apart by six weeks in order to allow for healing and set (filling) of the prosthetic. This healing time frame is critical because it will determine how long it will take for the prosthesis to assume the proper position. Additionally, the time frame will determine how well the implants integrate with the remaining tissue and bone around the tooth or teeth that they are replacing.
There are some advantages and disadvantages to the All on 4 implant procedure. One benefit is that this type of procedure can be done on patients that have minor missing teeth. Typically, dentists will not perform All on 4 implants in patients that have more than one tooth that needs to be replaced. Similarly, an All on 4 procedure should not be used as an option for patients who have severely decayed teeth due to root canal treatment.
Another advantage of this procedure is that the procedure can be performed under general anesthesia since the implants are secured directly to the bones during the procedure. Unlike braces or metal crowns that are secured to the front of the teeth, the procedure does not require the placement of brackets or cups around the teeth. In addition, there is no need for a long recovery period since the procedure only requires approximately three to four hours in the dental office and the dentist will place the implants directly on the bone. Furthermore, the procedure can be completed in one office visit since the procedure only requires one visit for the placement of the prosthetic teeth and an additional visit for the healing process.
If the patient has healthy gums and the jawbone is flexible, then the dentist will place All on 4 implants in the jaw. Usually, the dentist will place them on the upper jaw first and then to the lower jaw second. The prosthetic crown will then be placed directly over the prosthetic tooth. The jaw will be closed during the procedure and the dentist will make sure that the jawbone and gum is flexible prior to placing the final crown on top of the All on 4 implant. The new teeth will then be attached to the new crowns with the help of the All on 4 adhesive.
Patients that are interested in this type of procedure but do not want to undergo extensive bone grafting should consider using All on 4 braces or a partial denture. This is a viable option since the All on 4 prosthetic will be secured to the bones. Since the bone grafting can sometimes become a failure, it is advisable that the patients go through the bone grafting procedure prior to the All on 4 implants. However, this should be done after consulting the dentist since there are some cases where the bone grafting fails.
One thing that patients need to be aware of is that due to the complexity of the All on 4 implants procedure, it can take weeks or even months before the entire procedure is completed. This is because it is usually required that the patient go through several bone grafting procedures before they are able to get their teeth back. Patients who want to get back their teeth in a quick and less complicated manner should consider consulting a cosmetic dentist or a surgeon with extensive training in the use of dentistry equipment. These dentists and surgeons will be able to provide patients with advice on which procedure is best for them since every patient is different.