Four implants are inserted into the patient’s jaw, on which a fixed prosthesis is then fixed. The method is suitable for the treatment of complete adentia in the upper and lower jaw.
Special feature of the All-on-4 technology
A special feature of All-on-4 is the different position of the implants in the jaw. In the anterior region they are placed straight, and in the lateral region they are placed at an angle. The dentist chooses the angle depending on the clinical picture. Usually it is 30 or 45 degrees. This arrangement provides two tasks:
- Good stabilization of the prosthesis.
- The possibility of placing implants when there is a lack of bone tissue, since a longer implant can be placed at an angle.
In the anterior area, implants are placed straight, so it is not possible to use long rods in case of bone deficiency. If the atrophy is pronounced and the bone volume is not sufficient for primary stabilization of the implant, zygomatic implants can be placed in the anterior region of the jaw.
Indications
- Completely edentulous jaw.
- Partial adentia, but the own teeth are severely decayed and cannot support a prosthesis.
- Bone atrophy, contraindication to osteoplasty.
- Critically close proximity of the maxillary sinuses.
Contraindications
- Periodontal disease. In this case, the All-on-6 protocol, in which six implants are used, is suitable.
- Cardiovascular diseases, weakened immunity, diabetes mellitus.
- Poor blood clotting.
Implants should not be placed during pregnancy or breastfeeding.
Advantages of All-on-4
All-on-4 has advantages over the classic two-stage implant placement:
- With All-on-4, four implants are inserted into the jaw. For the fixation of a fixed prosthesis on implants using the classic technique, 6-10 implants will need to be placed.
- The acrylic fixed prosthesis is fitted immediately after surgery. Such a prosthesis can last about three years. In the classical technique, the prosthesis is only fitted after the implants have fully osseointegrated. During this period, removable prostheses can be fitted.
- All-on-4 allows implants to be implanted without osteoplasty. The classic protocol requires mandatory bone grafting, otherwise it is impossible to ensure normal primary stabilization of the rod in the gum.
- Short treatment time. The preparatory period can take a long time, but the implant placement itself is about 2-3 hours. After that, a temporary denture can be placed.
Dentures on implants also differ favorably from removable dentures. The fixed prosthesis is securely fixed, does not shift, does not rub the gum. After installation, the patient quickly gets used to the design. You can chew any food, including hard food.
However, if the bone tissue is loose, All-on-4 may not always be used, as there is a risk that the structure will not stabilize well. In this case, there are several options for solving the problem:
- All-on-6 implant placement. It is characterized by a large number of implants implanted, so the system is more stable. The same method can be used in patients with pronounced bone resorption and contraindications to osteoplasty.
- Placement of zygomatic implants. The zygomatic bone is dense, it is not subject to atrophy like the gingival bone tissue. Using these implant systems, the doctor is able to work on an All-on-4 protocol, even if the bone is loose or its loss is significant.
- Later loading. All-on-4 implants are an immediate loading protocol. A lightweight temporary prosthesis is placed immediately after implant placement. In the case of loose tissue, the prosthesis can be placed with a slight time delay. In such cases, the implants are usually loaded on the third day after surgery.
Alternatives to the All-on-4 method
All-on-4 is suitable in many clinical cases, but it has contraindications. Alternative methods are used to treat adentia (complete absence of teeth) in these patients:
- Bridge prosthesis with fixation on own teeth. Suitable if the adentia is partial and there are strong and healthy teeth that can be used as support teeth.
- Removable prostheses. Inexpensive prosthetic constructions. Practically have no contraindications. Minus – aesthetics is lower than that of fixed prostheses, there is a long period of habituation.
- All-on-6 implants. Since six implants are implanted in the jaw, the technique provides better stabilization of the structure, so it is suitable for patients with loose or severely atrophied bone.
- Basal implants. Suitable for patients with a complicated clinical picture.
For the treatment of complete adentia, All-on-4 implants are one of the best methods. Immediately after surgery, the patient leaves with teeth. On the day of surgery, you should refrain from eating for 2-3 hours, and the next day you can eat almost without restrictions.
Brickell Dental Care has highly skilled dentists who perform quality dental implant placement. Call us at (407) 863 6487 to schedule an appointment or leave a request on our website.