The Ultimate Guide to All-on-4® Implant Restorations

Implants have been one of the most significant advancements in dentistry over the last 40 years. Former dental restorations, like removable dentures, lacked the stability and durability that implant dentistry in Columbus, OH, has to offer, making it a much more appealing option. Among all restorations, All-on-4® implants are one of the most innovative approaches. Not only do they look and feel more natural, but they also help to keep the jawbone and facial structure healthy.  If you’re interested in getting one, here's everything you need to know about the procedure.  

What Are All-on-4® Dental Implants?

The All-on-4® treatment is an installation technique designed by Nobel Biocare®, an implant manufacturer company. It revolutionized restorative dentistry because it allowed patients to get a permanent prosthetic supported on just four implants, saving the patient’s time and money.  Moreover, this full-arch restoration can be done with one surgical procedure, which is why it’s also known as “Teeth-in-a-Day”. The prosthesis is custom-made to fit comfortably in the mouth and, with proper maintenance, can last a lifetime.

What Makes All-on-4® Implants Special?

The ground-breaking aspect of All-on-4® implants lies in their positioning. The implants are angled at 45° instead of vertically, so the full-arch prosthetic doesn’t need as many implants as other methods. Because of that, even patients with smaller amounts of bone material can undergo this without the need for bone augmentation. When someone loses a tooth, the bones in that area go through a process called bone resorption. On it, the jawbone recedes, losing density and making an implant impossible. To fix that, bone augmentation strategies, like bone grafting, help recover the lost mass, but All-on-4®s avoid that by needing less implants for a complete restoration.

Who Can Get All-on-4® Implants?

Nevertheless, full-arch implants also have downsides. For example, they’re only recommended for patients with many missing teeth, as any remaining ones would need to be removed to place the permanent denture.  Moreover, certain people may not be good candidates for All-on-4® dental implants. For example, if you have:

• If you smoke
• Severe diabetes  
• Suffer considerable jawbone loss  
• Went through radiation therapy to the head and neck  
• Have only one tooth needing replacement

On the other hand, you can get this restoration if:

• You suffered extreme tooth decay  
• Lost your teeth due to an injury or accident
• Suffered tooth loss from gum disease
• Had damage to the face and teeth from illnesses like mouth cancer  
• Have multiple unhealthy teeth, so a dentist might recommend removing only the unhealthy ones and replacing them.

Did you know? Traditional dental implants tend to require one small titanium screw per tooth or six to eight screws per jaw. So, needing only four for an All-on-4® restoration was really ground-breaking.

What Are All-on-4® Implants Made of?

Just like any other implant, All-on-4® are made out of three parts, from different technologically advanced restorative materials:

• The fixture, also known as the implant body. This part is surgically inserted into the jawbone and fuses with the bone tissue. Because of that, it needs to be made out of a biocompatible material, like titanium.
• The abutment which attaches to the fixture and supports the crown. To do so, it protrudes slightly from the gum line and needs to be customized to fit your mouth’s unique shape. It is typically made of titanium or zirconia.
• The prosthesis, commonly referred to as the crown. It’s made out of porcelain or ceramic, and designed to match your other natural teeth in color, shape and size.

How Does All-on-4® Work?

The procedure for getting All-on-4® implants is very similar to any other reconstructive surgery. Only one appointment is required, during which your surgeon will insert four dental implant posts and attach a temporary prosthesis. This temporary denture gives you a set of teeth while your implants heal. Once the bone has grown over the titanium post, your dentist will attach the final prosthesis. Here’s what that looks like in more detail:

Before the Implant Surgery

First, you’ll get a consultation with a professional prosthodontist. Your dentist will assess your worries, expectations, and current condition to create a complete treatment plan to restore your smile. They’ll take 3D scans of your mouth to ensure you have appropriate bone heights for treatment, make you conduct full body check-ups to verify you’re good for surgery, and review anesthesia or sedation options. Once everything is well planned, you’ll schedule an appointment for your surgery. Some people are eligible for ‘same-day implants,’ where the entire procedure happens in one visit. If that's not your case, they’ll place temporary teeth in your mouth until the permanent ones are ready. Pro tip: If you consume alcohol frequently, it’s recommended to stop before surgery, as it will slow wound healing and can make coming out of sedation harder for you.

During the Surgery

During the surgery, your dentist will remove any remaining teeth in order to insert the implants. To do so, they’ll make small incisions on your gums where the jawbone is denser and can sustain the metal screws. That’s why this is a procedure that requires, at least, local anesthesia. After the surgery, the bone around the implant must heal, following a process called osseointegration. It can take 3-6 months. Once the implants heal, the dentist will typically place temporary replacement teeth onto special abutments.

After the Surgery

For a seamless recuperation, your dentist will provide appropriate aftercare instructions. They’ll provide you with a specific dietary plan, which roughly indicates:

• Stick to soft foods to avoid placing too much pressure on your new implants, like warm but not too hot soups, scrambled eggs, and oatmeal.  
• Limit citrus, carbonated, and acidic drinks, such as orange juice, as they can irritate the wounds.
• For the first week or so after the implants are placed, your dentist will prescribe you antibiotics. Make sure to take them.
• Maintain good oral hygiene. Your permanent replacement teeth can’t get cavities, but gum disease can still develop.

Benefits of the All-on-4® Treatment

At the end the day, this surgical procedure will be worth it, as the All-on-4® restoration offers many benefits, such as:

• Recovering your ability to eat and speak comfortably  
• Undergoing just one surgery
• Improved recovery time following implant surgery. After three days, patients can typically resume their normal activities.
• Minimizing or eliminating the need for bone grafting.  
• High success rate, with studies showing a patient success rate of approximately 94%.
• Few long-term dietary restrictions.
• Easy hygiene routine. Brushing and flossing twice a day is all that is required to keep your prosthetic teeth and gums healthy.

Downsides of the All-on-4® Treatment

Nevertheless, just like any treatment All-on-4® prosthetics have its downsides. Some of these are:

• Needing to extract remaining teeth in order to undergo it.
• Some patients report speech difficulties with certain words or letters after getting their temporary prosthesis.
• After the treatment, you may experience sensibility in the gums, but it will pass within weeks.
• Poor hygiene can lead to additional health problems around the implants.
• Risk of a failed implant, which only occurs to roughly 5% of patients. The main cause, thought, lies in a patient’s existing health conditions.

Learn About All-on-4® Implant Dentistry in Columbus, OH

For the last century, we’ve been witnesses to some incredible innovations in the field of dentistry. Baby boomers became the generation to maintain their natural teeth during the elderly years, and even if they didn’t, they had many more options for replacement than the previous generations. The real importance of innovative dentistry lies in offering patients more and better options, which is why at Spectrum Dental & Prosthodontics, we commit to offering the latest proven technologies. If you’re interested in hearing more about that, give us a call!