To understand what a All-On-4 dental implant is, you first need to know what an implant is. A dental implant is basically a small (usually titanium) screw that’s inserted into your jawbone in the space left by a missing tooth. Once the implant is placed in your mouth, your dentist will attach a fake tooth to the screw.
Now, multiply this idea by four and you get an All-On-4 dental implant. Instead of using an implant for every missing tooth, you can simply use four implants on top and four on the bottom as the main anchors. Then your dentist can attach a denture at those spots.
How is All-on-4 different from traditional dental implants?
All-on-4 dental implants do not require bone grafting and simply require four implants that can support the entire arch of dental restorations. Traditional dental implants may require up to eight single implants to support an entire arch of dental restorations. All-on-4 dental implants only use four implants in total because the two posterior implants are tilted at an angle that allows for longer implant posts. These implants offer the same durability and support of traditional implants but with a faster treatment time.
Surgery is much quicker as most patients are able to have the replacement teeth added the same day as their implant surgery while maintaining regular eating and chewing functions, rather than waiting weeks between surgeries.
With traditional dental implants usually requiring more than four single implants to support a full arch, the cost of treatment is typically higher as more dental implants need to be placed. The jaw bone would also need to have substantial strength in order to support the implants, meaning that many patients would require a bone graft procedure before the implant procedure could even begin. This, again, would increase the cost of the procedure as well as extending the amount of time required for treatment to be complete.
All-On-4 Dental Implant Procedure
It can be scary to get implants for the first time. Most of that fear is probably due to the uncertainty, so here is the step-by-step process for getting an All-On-4 dental implant.
First, your dentist will want to make sure your comfortable, so either local anesthesia will be administered.
Second, the dentist or surgeon will prepare your mouth for the implants, which involves removing your remaining teeth that are failing. They will then remove any diseased or infected tissue from your jaw and gums.
Next, they will begin the implantation process. This means they will insert the titanium screws into your jawbone. Most likely, they will place two implants toward the front of your mouth and two towards the back of your mouth so the “anchors” can evenly bare the force of the denture.
After the implants have been placed, they will thoroughly clean the surgical sites and suturing all the incisions. Then you’ll be taken to a recovery room where you can relax and take time to wake up from the anesthesia.
Full arch Implants Bridge Treatment duration
One trip by required at least 12 days in Bangkok ( 4-5 visits)*
*Please make an appointment in advance
Benefits of All-on-4 and All-on-6 Immediate Function Dental Implants
Suitable for almost all bone quantities. None or very small bone graft required
Flapless and painless procedure
simple and good predictability from a surgical perspective
Well-balanced prosthetic support for an immediate function procedure
Attractive prosthetic solution, Immediate Function & fixed prosthesis
No healing time required prior to functioning
Fast , fixed and cost effective
All-On-4 Dental Implants Recovery Time
The recovery time after getting traditional dentures can range from 3 to 8 months, but after getting an All-On-4 denture, you should be functioning sooner. The reason is that the implants fuse to your bone and promote stability of the denture from the very first day.
Here’s what you can expect the recovery to look like starting the day of the procedure.
First Day Recovery
During the first hour after your recovery or until you stop bleeding, you will have had gauze packs placed over the areas of surgery — you should gently bite down on these to keep them in place. After the first hour, you may be asked to remove the gauze, unless there’s excessive bleeding, in which case your dentist will probably replace them with new gauze. After that, they’ll want you to change the gauze every 30-45 minutes.
When you go home from surgery, make sure you don’t do anything that would disturb the tender areas. Do not rinse or touch the surgical areas, except for gentle brushing with a soft toothbrush. And obviously, smoking afterwards (or in general) is a very bad idea if you want the surgical spots to heal well.
Although you should be extra gentle, it’s also important to keep your mouth as clean as possible. Your doctor will likely prescribe a medicated rinse to keep the bacterial load down in your mouth and help promote healing.
Twenty-four hours after surgery, if there’s minimal bleeding, you can gently rinse your mouth with saltwater. Just mix one tablespoon of salt with about eight ounces of water and rinse gently, allowing the water to drip from your mouth into the sink. You can do this 2-3 times per day.
The Days Following Surgery
In the time following the procedure, the main activities you’ll be doing should involve resting on a couch or bed. Things you shouldn’t be doing include bending over, lifting heavy objects, or any strenuous activities as it could lead to more bleeding and swelling.
Also, when transitioning from a lying down position to standing, it’s best to do so slowly. Otherwise, you could get lightheaded. If you normally exercise, you’ll need to avoid it for 3-4 days after surgery.
Common Post-Surgery Issues And How To Deal With Them
Here are some common issues you may experience in the days following surgery and how to care for your All-On-4 dental implants.
-Persistent Bleeding
If you find that you have bleeding that won’t stop, this usually means you may be biting down on the gauze packs without them covering the surgical areas. Reposition the gauze and see if that helps.
If this does nothing and the bleeding continues, try sitting upright, avoid physical activity, and put ice packs on the outside of your mouth.
Then you can bite down on one for an hour or a moist black tea bag for about 30 minutes.
If this still doesn’t help, call your dentist to schedule an appointment.
-Swelling
Swelling is a normal part of getting surgery, and it will reach its climax about 2-3 days after the procedure. Using ice or a cold pack on your cheek within the 24 hours following the procedure can help control it (20 minutes on and 20 minutes off). Your dentist may prescribe you medication as well.
-Pain
This is something that’s just unavoidable when dealing with surgery. Your dentist will have given you a prescription for pain medicine — take it as directed and it should help decrease the discomfort.
If you feel that you need more medicine to control the pain, call your dentist.
-Restricted Diet
As long as the food you eat doesn’t cause more discomfort, it’s probably okay to eat. Though you should avoid any hard foods or candies or very hot foods, and chewing is not recommended if the sensation in your tongue has not returned. The best-case scenario is to consume only liquids or pureed foods for the first few days after surgery.
Most importantly, make sure your getting nutrition, no matter how inconvenient it may be. It’s crucial to your healing.
-Nausea
You may experience nausea or even vomiting from any accidentally swallowed blood or from any of the medicines you’ll be taking. Usually, a carbonated drink and some crackers can help tone down the sickness. If the nausea persists or gets severe, call your dentist for recommendations.
-Discoloration
About 2-3 days after surgery, you may notice discoloration or bruising near the surgical areas (usually black, blue, and/or yellow). This is normal. After the first 36 hours after the procedure, you can apply moist heat to your cheek.
-Sharp Sensations In Your Mouth
If you start to feel something sharp in your mouth, this could be the bony walls that used to support the now missing teeth. Small pieces of the bone may protrude from the gums after a few days. If it becomes uncomfortable or concerning, you can speak with your dentist.
-Dry Lips
It’s expected that your lips will become dry as your mouth will be slightly stretch from wearing gauze. You can use chapstick or some other hydrating ointment.
-Sore Throat
Because your mouth may be open most of the time because of the gauze, this can lead to a sore throat, making swallowing painful. This is a passing symptom, usually going away after a few days.
-Stiff Muscles
Your jaw muscles may become stiff, again because of the gauze keeping your jaw in the same position for long periods of time. To counteract this, you can gently and slowing stretch your jaw every once in a while.
A: For healthy patient without systemic disease and no pathology of the edentulous site, in some cases implant could be placed immediately and in some cases implant could be place after 6-8 weeks of extraction to allow soft tissue healing
For those with pathology in the bone which cause bone defect or in case of infection in the area of future placement, usually the waiting time is longer, around 3-4 months after extraction.
Please note that timing and treatment planning will be discussed with patient on a case by case basis.
A: It is possible to have implants placed but it might need bone graft to reconstruct the bone for implant placement. Also alternative treatments such as bridges or other types of prostheses can be an option.
Ostoporosis patients who receive Bisphosphonate intravenous more than 3 years
Cancer in craniofacial area which currently has radiotherapy
Heavy smokers especially more than 20 cigarette/day. Smoking cessation should be done before the treatment.
Pregnant patient should delay the treatment
Patients who take anticoagulant or patient who has history of stroke within 6 months- 1 year should consult physician before treatment
Patients who take immune suppressant should consult physician
Patients with liver disease which leads to unstop bleeding should consult physician
Q: Should I have other treatment before placing an implant?
Any infection in the oral cavity should be removed before implant treatment to avoid the risk of infection at the implant site and to failure of the implant
Periodontitis should be treated before placing and implant since patient with history of periodontitis has higher risk of implant failure
Caries : defected tooth structure should be removed to reduce oral cavity germ
Endodontics : root canal treatment should be done since apical infection especially adjacent to the site in the bone can infect the implant site
A:New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks and tongue learn to keep them in place and you get comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase when you first start wearing dentures, but these problems will diminish as the mouth adjusts.
A:Dentures are made to closely resemble your natural teeth so there should be only a small noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
A:Eating with new dentures will take a little practice and may be uncomfortable for some wearers for a few weeks. To get used to the new denture, start with soft foods cut into small pieces. Chew slowly using both sides of your mouth. As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. You should also avoid chewing gum while you wear the denture. Also, don’t use toothpicks while wearing dentures.
A:After getting dentures, you may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures.
If dentures “click” while you’re talking, contact your dentist. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.
A:Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them. During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep. Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, you should remove dentures before going to bed. This allows gum tissues to rest and allows normal stimulation and cleansing by the tongue and saliva. The denture can be put back in the mouth in the morning.
A:A denture adhesive may be considered under the following circumstances:
To enhance satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and an individual’s sense of security.
To assist individuals with dry mouth conditions that lessen denture adherence, such as individuals taking cold medications, those with neurologic disabilities including strokes, and the elderly.
To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.
A:There are situations when denture adhesives should not be used. Those cases include:
When it is used as a “fix” for ill-fitting or poorly constructed dentures. If dentures begin to feel loose, cause discomfort or cause sores to develop, contact your dentist as soon as possible.
When a dentist has not evaluated dentures for a long time. Dentures rest on gum tissue and the jawbone, which shrink and deteriorate, respectively, over time. Therefore, the real problem might be a need for a denture adjustment or new dentures.
When oral hygiene practices cannot be sustained.
When adhesives have been used for a long time, especially when visits to the dentist are infrequent, and when the frequency and volume of the adhesive use increases. These developments may indicate the need for a denture adjustment or new dentures.
When any known allergy exists to the adhesive’s ingredients.
Use the minimum amount necessary to provide the maximum benefit. Apply less than you think you need, and then gradually increase the amount until you feel comfortable.
Distribute the adhesive evenly on the tissue bearing surface of the denture.
Apply or reapply when necessary to provide the desired effect.
Always apply the adhesive to a thoroughly clean denture.
Remember adhesives work best with a well-fitting denture.
21.Paste application. Apply this denture adhesive to a dry or preferably wet denture. Avoid placing adhesive close to the denture borders. If the adhesive oozes, use less of the product. For dentures on the upper jaw, apply three short strips of adhesive — or a series of small dots — along the ridge area and one down the center. For dentures on the lower jaw, apply three short strips of adhesive — or a series of small dots — in the center of the ridge area.
2.Powder application. Sprinkle a thin, uniform layer throughout the tissue-bearing surface of the denture. Shake off excess powder and press the denture into place. Powders may be preferred over pastes because they are easier to clean off the denture and tissue. In addition, they don’t have the same tendency as pastes do to “shim” (keep the denture away from the tissue).
A:Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no ill effects. If adhesives are used excessively to fill voids for an ill-fitting denture, they can be harmful to the underlying soft and hard tissues. Occasionally, in these cases, inflammation of the soft tissues can result. In addition, because of its movement on the soft tissue and underlying bone, an ill-fitting denture can cause bone loss.
