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Home » All-on-4 Dental Implants: What Are They?

All-on-4 Dental Implants: What Are They?

All-on-4 dental implants combine the security of implants with the cost-effectiveness of dentures. They are excellent for replacing either the top or lower arches, resulting in a genuine smile. They are also ideal for toothless patients or individuals with badly damaged teeth. Are they safe? Yes, even if you have bone loss. Traditional implants generally do not allow for that. 

What Are All-on-4 Dental Implants?

All-on-4 is a revolutionary dental treatment method that replaces the top or lower teeth with only four implants. These four implants serve as a foundation for installing a new set of fixed teeth.

Four implants surgically placed into your bone anchor your prosthetic teeth. The implant posts bond to your bone. They give a long-term solution for securing your new artificial teeth.

In the all-on-4 dental implant surgery, the posterior implants are angled 45° towards the back of the mouth. They are put in the anterior maxilla. It is an area of the jaw that has higher bone density. Compared to other implant procedures, the all-on-4 requires less bone density.

Video: The all-on-4® treatment concept is a minimally invasive solution with a fixed full-arch restoration. Video courtesy of Nobel Biocare.

What Are All-on-4 Dental Implants Made Of?

All-on-4 implants use titanium. Titanium implants imitate the function of natural teeth root. They are made to last a lifetime, but you need to have good oral hygiene. They are biocompatible. That means they are not toxic to living tissues. Bodily fluid cannot damage them.

The artificial teeth are made of resin or porcelain. Resin teeth last up to 10 years. But they are not as strong as your natural teeth. However, they cause you no harm.

Dental technicians use porcelain to create biocompatible lifelike restorations, such as bridges, crowns, and veneers. Porcelain resists resist stains and discoloration. It is harder than tooth enamel.

Types of implants used for All on 4

  • NobelSpeedy Groovy
  • NobelSpeedy Replace
  • Branemark System Mk III Groovy
  • NobelReplace Tapered Groovy
  • Replace Select Tapered
  • NobelReplace Straight Groovy
  • Branemark System Mk III, TiUnite
  • Branemark System Mk IV TiUnite
  • Replace Select Straight

Ref: The New Alternative to Conventional Dentures – All-on-4 Dental Implant Treatment Concept: A Review Article, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), Volume 20, Issue 3 Ser.11 (March. 2021), PP 26-37

Is All-on-4 Suitable for You?

At the first consultation meeting with your dentist, the dentist will evaluate several aspects of your dental health to see if the all-on-4 procedure is right for you. The recommended steps, according to a research paper published in the Journal of Dental and Medical Sciences in March 2021, are the following:

  • Your dentist will evaluate your medical history.
  • They will want to know in detail your expectation from the treatment procedure. Your conversation will be recorded.
  • Your dental history is very important. Did you have a surgical failure before? Are you into clenching, bruxism?
  • They will make a radiographical analysis of your full mouth.
  • An intra and extra oral examination of your hard and soft tissue will help the dentist to make a final decision about your case.

Prof Paulo Malo’s Contribution

With financial support from Nobel Biocare, Prof Paulo Malo conducted a series of dental experiments in the 1990s. Among them was to check the effectiveness of this unique technique. Prof Malo was the first person to use the all-on-4 procedure on a patient in 1998. Today, it is recognized as the best alternative for replacing a whole arch of teeth.

Over the decades, Prof Malo has established himself as a world authority in advanced oral rehabilitation. He developed some unique approaches to assist patients with challenging cosmetic treatments. Apart from writing some leading books on cosmetic dentistry, he has also published many scientific articles and lectured on oral hygiene worldwide.

Alongside these accomplishments, he has established the Malo Clinic Education of Lisbon, Portugal. He taught many cosmetic dental professionals to expand their knowledge on all-on-4 dentistry.

By reducing the number of implants to four, each implant can be placed without coming into conflict with adjacent implants.

Open Access Journal

Benefits of All-on-4 Dental Treatment

There are various benefits to getting all-on-4 dental implants rather than traditional implants treatment. Traditionally, you need an implant for each tooth. In all-on-4, you need only four titanium posts surgically implanted into your jawbones. They will hold your permanent dentures in place for a unified appearance across your mouth.

Every case is unique. Your dentist will discuss with you both the advantages and disadvantages of all-on-4 in your case. However, the following are the general benefits of all-on-4 treatment:

  • Stability. With just four implants, the process can restore your whole set of teeth.
  • Durability. Implants are permanently attached to your mouth. They will not come loose or move like dentures.
  • Comfort. You may have your entire set of lost teeth replaced in a single day with just one surgical procedure. You do not need to undergo a complex surgery.
  • There are no dietary requirements.
  • Relatively less invasive. In most cases, you will not need bone grafting.
  • Cost. When compared to the expense of replacing each tooth separately, all-on-4 implants are less expensive.
  • There are no sticky denture adhesives to deal with.
  • All-on-4 allows you to anchor longer implants in high-quality bones.
  • They look both natural and appealing.
  • Simple to take care of and maintain.
  • High success rates.

All-on-4: Treatment Procedure

First of all, your dentist will remove your decayed or rotting teeth and include them in the replacement plan.

Then they will treat your gums if you have any gum disease. This will eliminate the risk of infection from recurring.

Your dentist will create an impression of your teeth.

Your dentist will arrange your surgical operation once your mouth is in good condition. They will use a local anesthetic to make you comfortable throughout your session.

Your dentist will place two implants in the front and two in the rear of the mouth. These implants will provide the necessary support for your new dental prosthetics. You may have your new dentures fitted at this appointment.

Disadvantages of All-on-4 Implant

You should be aware of the followings downsides before opting for all-on-4 dental implants.

  • For the implants to be successful, you’ll need a substantial amount of bone accessible.
  • You will not know how sensitive your teeth will be following your surgery.
  • No dental implants may be put in the molar part of the mouth. But that is where you have an enormous amount of biting pressure.

Is All-on-4 Procedure Painful?

It may be painful for you if you disapprove of the use of any local anesthetic. There is something called sedation dentistry or sleep dentistry. It simply means the procedure happens after you go to sleep. Talk to your dentist about your pain endurance capacity and the level of anesthetic that you want to be applied before preparing for the procedure. But, generally speaking, you have several options open to you:

  • Oral Sedation: involves swallowing a pill
  • Minimal Sedation: involves inhaling laughing gas (nitrous oxide)
  • IV-drug Induced Sedation: involves injecting a substance into the vein using a syringe

Choose the method and level you need in consultation with your dentist.

What is the Cost of All-on-4 Dental Treatment?

Depending on the situation, all-on-4 might cost you anywhere from $10,000 to $50,000. The cost might vary depending on where you live. In addition, the level of competition in your internal market and the quality of the materials used will also influence the cost.

You may pay the fee through installments. Talk to your dentist to see how they can help you in this regard. They may even create a custom treatment bundle for you containing other treatments you may need.

Besides, they will be able to tell you if your company has a fund that can be of assistance to you to meet your cost. You can speak to our company pension fund official to see if you can request any withdrawal from your superannuation fund.

  • All-on-4 – Wikipedia
  • The all-on-four concept may be a viable treatment option for edentulous rehabilitation
  • The all-on-four treatment concept: Systematic review
  • All on Four – The Basics
  • Evaluation of the surgical and prosthetic success of All-on-4 restorations: a retrospective cohort study of provisional vs. definitive immediate restorations