All-on-4: Everything you need to know - GO.CARE Blog
All-on-4: Everything you need to know
Author: Chí Hùng
Review Date: June 11, 2019 | Last Modified: August 27, 2019
All-on-4: Everything you need to know

All-on-4 provides the optimal solution for patients with badly broken down teeth, decayed teeth or compromised teeth due to gum disease. The term All-on-4 refers to “all” teeth being supported “on four” dental implants.

Definition

1. What is All-on-4 Dental Implants?

All-on-4 dental implants is a dental restoration procedure for patients who suffer from loss of all teeth in both the upper and the lower jaw. In this procedure, 4 implants, which are 4 titanium screws are placed into the patient’s jawbone.

This is a modern technique where the back implants are placed at 45-degree angles to support the denture above. The tilt of these implants helps avoid the bone-loss area and obviate the need for bone grafting in the implant procedure.

With this technique being deployed, fewer implants are needed compared to other techniques in the past, which results in a higher rate of success. In addition, the process of cleaning and maintenance is also simplified and much easier for all-on-4 dental implants.

2. What is the purpose of all-on-4 dental implants?

The purpose of all-on-4 dental implants is that the implant screws inserted into the jawbone will play the role of the dental roots and stabilize the prosthetic replacement teeth or the dental bridge above.

In full arch rehabilitation, this procedure allows for the placement of only two implants in the front of the jaw, and another two in the back of the jaw at an intended angle (traditional implant techniques require an implant to be placed under every replacement tooth). The leaningly placed implants will help avoid the poor-quality dental bone, which in turn enables patients who suffer from serious bone loss to skip the bone graft procedure. The tilted implant fixtures also contribute to a reliable foundation for the prosthesis.

After the placement of the implants, a permanent dental bridge can be immediately attached to these screws without having to wait until 6 months later as in other technique.

Candidate

1. When is all-on-4 dental implants procedure needed?

This is a total rehabilitation option for patients with their upper or lower jaws, or possibly both jaws, being toothless. Especially, all-on-4 dental implants suit well for patients with soft jawbones. The technique helps avoid the parts of the jawbone that are of typically poor quality and therefore makes bone grafting no longer needed.

2. Who are eligible for all-on-4 dental implants?

Patients who can consider undergoing all-on-4 dental implants include:

  • People who suffer from loss of the entire teeth on one side of their jaws (upper or lower) or on both sides.
  • Those with a soft jawbone, not suitable for placing too many implants on the jaw
  • Patients with serious bone-loss conditions but do not desire bone graft.

Cost

In the US, all-on-4 dental implants may end up costing from $25,000 to $35,000

Meanwhile, the procedure costs much cheaper in India, only varying from only $4,000 to $6,000

Vietnam dental clinics also offer a competitive price for all-on-4 dental implants procedures, with the price falling around $6,000.

all-on-4

Preparation

1. What should I do before an all-on-4 dental implants procedure?

Before an all-on-4 dental implants procedure, patients would need to pay attention to the followings:

  • Inform your dentist of all previous dental treatments
    Provide information about your medical history, especially about diseases like hemophilia

2. What should I do after an all-on-4 dental implants procedure?

After the procedure of all-on-4 dental implants, patients would need to pay attention to the followings:

Hygiene and diet

  • In a short period after surgery, patients may experience bruising, swelling, pain and discomfort. In cases where patients cannot tolerate pain, the doctor may prescribe medications to relieve pain and swelling. If the patient is not in so much pain, no medication is needed. Bridges are permanently fixed into the implant fixtures, so patients do not have to remove them. For cleaning purpose, patients can brush them as if they are real teeth at least 2 times a day.
  • During the first 3 months after the procedure, patients should be going on a soft-foods diet, eating foods such as fish, low-fiber foods (rice, noodles) or eggs. Extreme caution should be exercised when eating hard or chewy foods because they may affect the recovery and healing process, cause bone formation on the Implants or unsettle the implants and eventually cause them to fall out.
  • After 4 months, patients would need a follow-up examination to check whether the implants and bridges are good and compatible with each other or not. If necessary, the bridges can be removed for some adjustment to be made about the gingival surface and other factors (if any).
  • After the follow-up examination and the doctor determines that the jaw has healed completely, patients can eat any normal food no matter if they are fruits, hard nuts or bread.
  • Patients would need to get periodic tooth scaling and dental x-ray as well as go to other follow-up examinations to repair the dental bridges (if scheduled) regularly every 2 years.

Procedure

1. How long is the procedure of all-on-4 dental implantation?

An all-on-4 dental implants procedure can take up to 1 week including time for consultation, getting tooth mold, and placing the implants and bridges into the jaws. Each of them may last from 30 minutes to 60 minutes or longer depending on the patient’s condition.

2. How is the procedure of all-on-4 dental implants?

Patients get general dental examinations, dental x-rays and jaw bone imaging, blood test, CT scanning, etc for diagnosis.

Once the physician has acquired sufficient clinical information and had a well understanding of the patient’s medical history, a treatment plan will be made regarding the treatment stages as well as related costs. Estimated time is from 30 minutes to 60 minutes.

Once the patient has decided to undergo dental restoration using this method, an imprint and photos of the patient teeth will then be taken, and the surgical wafer, as well as other necessary procedures, will be prepared for the surgery. This process will take 2-3 days to complete.

♦ The Implant Placement Process

  • All the teeth that are left on the jaw (if any), as well as the pathogens, will be removed so that the jaw bone is in the best condition for implant placement.
  • Surgery is usually done under general anesthesia or local anesthesia, and the implant will be inserted into the located jaw bone.
  • Shortly afterward, the doctors will proceed to get the imprint of teeth to make a permanent bridge.

♦ Testing the permanent bridge

This section can be performed after a few hours or a few days after surgery. During this appointment, all necessary adjustments related to the aesthetics as well as the function of the new teeth will be adjusted to best fit the patient. At this point, the patient will know what his future teeth will look like after treatment.

♦ Assembling the permanent bridge

The patient will return the next day to attach the permanent bridge to the new implants. This time, the bridge is placed on without using any kind of anesthesia.

3. What happens after the procedure of all-on-4 dental implants?

All-on-4 dental implants is an outpatient procedure so patients do not need to stay in the hospital after the procedure. Patients should go to all follow-up examinations scheduled by the doctors. In addition, patients would also need to pay extra attention to which foods they should and should not eat after the procedure in consideration of the teeth conditions. It is advisable to follow the doctor’s recommendations.

Complications and Side Effects

1. What complications could arise from all-on-4 dental implants?

Complications that could arise from all-on-4 dental implants include:

  • Infection occurred in the implanted area
  • Fracture of the implant screws
  • Implant screws being “drawn” deep into the jaw

2. What are the possible side effects of all-on-4 dental implants?

Possible side effects of all-on-4 dental implants include:

  • Damage to tissues around the mouth
  • Bleeding, swelling, and bruising in the mouth area

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1. Dental Implants https://www.webmd.com/oral-health/guide/dental-implants Accessed on 23/11/2018.

2. Implants https://www.dentalhealth.org/dental-implants Accessed on 23/11/2018.

3. What is All-on-4 Dental Implants? https://www.authoritydental.org/all-on-four-implants Accessed on 23/11/2018.

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