All-on-Four Dental Implants.

All-on-four is a fixed dental prosthesis that employs dental implants and is simpler implemented than alternative fixed prostheses and implant techniques. Many patients choose this procedure because of its low risk, high success rate, and conformability. However, for patients who do not fit the criteria for alternative implant-supported dentures, they have no choice but to settle for all on four.

This treatment uses dental implants that are specially made for All on Four. The procedure's most notable feature is the strong integration achieved by positioning these implants in the densest regions of the patient's jawbone.

The All-on-Four method significantly alters the aesthetics of the patient's jawbone, facial features, and external look while also restoring chewing function. Consequently, these two factors play a role during the entire treatment procedure.

Consultation and Detailed Examination of the Oral Structure

During the pre-treatment consultation, parameters like as the patient's natural dentition, facial morphology, and skin tone are assessed in accordance with the patient's expectations. Next, the patient has a low-dose X-ray 3D bone examination with the assistance of the CBCT device. The analysis's findings guide the inspection of the bone in the implant-insertion regions. Lastly, we surgically improve the areas with low bone density and sluggish cellular recovery to make them suitable for implants before beginning therapy.

Drilling the Implant Holes and Placing the Implants

Upon completion of the preliminary patient assessments and essential bone growth procedures, four implant sites are drilled in each jaw. The All on Four methodology distinguishes itself from other methods here. The procedure employs two implants that are nearly double the length of normal implants (14-15mm) and positions the implant at an angle to the maxillary or mandibular bone. This produces implants that can securely anchor in the most resilient areas of our jaw and deep within.

Upon completion of drilling the holes and positioning the implants, temporary prostheses are installed, and the patient is thereafter discharged.

Fusion Process of Implants to the Jawbone

In All on Four treatment, the duration for the implant to osseointegrate with the bone ranges from 3 to 6 months. This treatment, on the other hand, has the quickest time for the implants to fuse with the bone because the long implants are put at an angle. Studies have shown that implants positioned at an angle facilitate fusion more quickly.

The utilisation of substandard materials in All on Four treatment may result in treatment failure. At Avita Smile, we favour Straumann dental implants, the global leader in the industry, due to their rapid and efficient integration time.

Second Visit; Rehearsals and Installation of Permanent Implants

During the final phase of All on Four therapy, we conduct preparations before fabricating permanent teeth in the laboratory. Following these rehearsals, which can last up to a week, the laboratory fabricates permanent teeth based on the agreed-upon smile design with the patient. Once the tooth fabrication is complete, we extract the temporary teeth and replace them with permanent ones.

Patients experiencing significant tooth loss and impaired chewing function as a result of age-related bone resorption in the jawbone may find All on Four treatment to be a lifesaver. The following are the top 5 advantages of the All on Four treatment:

• It significantly enhances quality of life by reinstating impaired chewing function.
• Because it restores lost chewing function, it significantly improves quality of life.
• Even though the skin on the chin or face receives no cosmetic treatment, it significantly improves appearance and makes the person appear younger.
• Plaques that have built up in the mouth before treatment are removed during the procedure, eliminating a potential source of infection.
• Bone resorption, which accelerates with ageing in the maxilla and mandible, is halted or mitigated. Furthermore, shifts in the implant regions enhance the patient's bone density.
• Treatment restores the patient's confidence in themselves. This is evident in the patients' initial reactions after treatment. Their new look makes them happy, as if they are beginning a new life, and most patients find it difficult to control their tears as they express gratitude.

A scientific study published in the Journal of Oral Implantology demonstrates that the all-on-four approach has been effectively utilised throughout a diverse patient population. Since long implants are used in the All on Four approach to treat the patient's toughest bones, nearly all patients meet the treatment parameters

However, the patient should not have any conditions that would impair the auto immune system, such as diabetes, in order for the implant wounds to heal after therapy. For All on FOur therapy, an optimal HbA1c (glycosylated haemoglobin) level should be below 7%, and a fasting blood glucose level should be between 80-130 mg/dL.

Moreover, patients should maintain a standard blood coagulation time, which is essential for the healing of post-implantation wounds.

Dental Implants for Blood Thinners

Individuals on anticoagulants (blood thinners) should undergo treatment in a multidisciplinary approach in collaboration with a cardiologist.

All-on-four therapy costs vary significantly across different countries and clinics. Although the treatment material significantly influences the cost, the clinic or dentist's charge for the procedure is the primary determinant of the price. Below, you will find a list of all four treatment prices in different countries.

The healing phase of wounds following the placement of implants in an all-on-four treatment typically requires several days. But compared to other implant therapies, all on four has a shorter duration—though it does vary from patient to patient. This procedure utilises the patient's strongest bones, resulting in expedited recuperation.

During the recovery process, the patient is administered antibiotics and painkillers following the treatment. The primary rationale for administering antibiotics is to avert bloodstream infections due to potential microscopic haemorrhaging following therapy. Consequently, the patient must meticulously attend to oral hygiene for several days post-treatment.

Like any other procedure involving a fixed prosthesis or implant, all on four treatment is not without its hazards. On the other hand, in terms of risk evaluation, it is a less hazardous treatment than alternatives. The following are the four main challenges associated with the All on Four treatment.

• Given that four implants are utilised in the All on Four technique, should one implant become dislodged, the patient must promptly notify the dentist to arrange for the replacement of the lost implant. It's not as crucial in the all on six method as it is in the all on four method.
• You run the risk of having the implant fall out if you drink alcohol or smoke after therapy.
• Substandard nickel-containing implants may cause patients to develop metal allergies.
• Ongoing bone resorption in the patient may compromise the integrity of a perfectly placed implant, potentially leading to its failure and subsequent loss.

In a study that followed patients for 10 years, the success rate for All on Four treatments was 94.8%. A special method and treatment-specific implants are used to put them in the hardest parts of the jaw. These are the primary reasons why this therapy has a high success rate with very few dental implants.

The majority of patients report an improvement in their quality of life following All on Four. The treatment enhances the patient's masticatory functions and promotes optimal digestive system performance, while also providing them with a renewed appearance. Furthermore, the visual advantages of the therapy on the jawbone create a revitalising effect on the patients.

All-on-Four implants are often asked about how painful the process is, how long the implants last, and what kind of care they need. The essential enquiries and corresponding responses are presented below.

How long does the All-on-Four procedure take?

The All-on-Four treatment typically takes about an hour to place the implants. However, if more than one tooth extraction is required from the patient, the patient may need to rest for 1 or 2 hours after tooth extraction or sometimes after an extra surgical procedure. In this case, the treatment process is even longer.

Is The All-On-Four Procedure Painful?

Due to the use of local anaesthetics, the All-on-Four procedure is painless. Throughout the procedure, you will experience just the vibrations of the devices. Normally, the healing period for implant wounds post-treatment averages two days. During this period, the patient receives analgesics and antibiotics to mitigate discomfort.

What Is the Success Rate of All-On-Four Implants?

All-on-four implants have a high success rate, typically above 95%. On the other hand, factors that directly affect the success rate include the patient's attention to oral hygiene, regular dental checkups, smoking and alcohol consumption, and proper implant placement.

How Do I Care for My All-On-Four Implants?

Just like regular teeth, All-on-Four implants require regular care. It is advisable to brush your teeth a minimum of twice daily, utilise dental floss or interdental brushes, and attend frequent dental check-ups. Eating less sticky and hard foods can also help your implants last longer.

To clean the fixed prosthesis used in All on Four, patients use brushes designed for the procedure and specialised tooth floss. Alongside routine brushing, dentures must be maintained using specialised brushes, and teeth should be consistently cleaned with mouthwash.

Can I Eat Normally with All-On-Four Implants?

Yes, you may resume your regular diet once the healing process has concluded. It is advisable to have soft foods during the initial weeks; thereafter, hard and crunchy foods can be easily ingested.

Are All-on-Four Implants Removable?

All-on-Four implants are securely anchored in the jawbone and are not removable by the patient. The prosthetic component can be detached by your dentist for maintenance or repair. This rigid framework mitigates the possibility of dentures dislodging and offers a more authentic sensation.

What If I Have Insufficient Bone Density?

Patients with inadequate bone density may still consider the All-on-Four technique as a viable alternative. This approach facilitates the placement of implants in optimal regions and angles where bone volume is sufficient, hence eliminating the necessity for additional bone grafting. In instances of significant bone loss, different therapies or supplementary procedures may be necessary. Research published in Clinical Implant Dentistry and Related Research indicates that this approach can be effective even in individuals with minimal bone density.

How long do All-on-Four Implants Last?

With appropriate maintenance and routine examinations, All-on-Four implants can endure lifetime. The prosthetic component may deteriorate over time and occasionally requires replacement after 10 to 15 years. The durability of the treatment renders it a cost-effective choice over time.

What Alternatives Are There to All-On-Four Implants?

Alternatives to All-on-Four implants include All on Six treatment as well as traditional complete dentures, bridges or multiple dental implants. While traditional dentures are cheaper, they lack aesthetics and stability. Multiple dental implants may require more surgical procedures and costs. It is recommended that you have a thorough evaluation with a dentist to determine the best option for you.

Final Thoughts

All on Four treatment, first applied by Portuguese dentist Dr. Paulo Malo in 1998, has since been successfully used on millions of patients and has been the subject of dozens of scientific studies on the effectiveness of the treatment. The fact that the treatment is the least invasive technique among fixed prosthesis and implant techniques makes All on Four treatment stand out compared to its alternatives, while at the same time, the great change it makes to the aesthetics of the person is very effective.

A successful and trouble-free All on Four treatment is only possible with experienced dentists who analyze with advanced imaging devices. In addition, quality should never be compromised in the choice of brand for implants.

With a team of highly experienced dentists, each bringing 20–30 years of expertise, Avita Smile has been proudly serving patients across Europe for many years. At our state-of-the-art treatment centres, we combine the latest technology with the finest materials to deliver exceptional care. Our commitment to excellence extends beyond the treatment itself, offering comprehensive aftercare and written guarantees to ensure lasting results and patient satisfaction.