All on 4/ Implant SMILES bridge
All on 4 is an implant treatment used to replace a full set of missing teeth using only 4 implants. The implants are placed and a set of teeth fitted on the same day. This means that patients can come in with no teeth and go home the same day with a full set of teeth. The All on 4 procedure (also known as immediate loading, teeth in a day, same day teeth, Fast and Fixed etc) is a very predictable technique that reduces costs and the time needed for treatment.
What is the All on 4 concept
The All on 4 concept is a treatment option designed to deliver fixed teeth in day. It is designed for patients who already have lost all the teeth in a jaw or whose remaining teeth have problems and need to be removed.
It differs from other options in a number of ways:-
- Only four implants are used towards the front of your jaw. This reduces costs and can also avoid the need for bone grafting.
- A temporary bridge can be fitted that day provided stability of the implants is sufficient.
- The goal of the All on 4 concept is to provide quicker results, at lower costs, with high success rates.
What does treatment involve
- Initial assessment
- At an initial appointment an assessment is made as to your suitability for the treatment. This will include a full examination of your mouth and jaws, x-rays, photographs and impressions to make models of your teeth. We will provide you with an initial assessment of what your options area. A CT scan is usually needed at this stage and a full estimate is provided for the cost of the treatment.
- Diagnostic Planning stage
- Models of your jaws and measurements of your bite are taken to allow your new teeth to be made.
- Implant stage
- On the day of your treatment any remaining teeth are removed and the implants are fitted. Two implants are placed at the front of your mouth and two at the back tilted at 45 degrees. Providing your implants are stable then a temporary bridge is fitted later in the day.
- Post operative and healing phase
You will be provided with full instructions for after care after the fitting of the implants and bridge. This involves a careful oral hygiene routine, a diet of soft foods (to allow your implants the best possible chance of healing) and advice regarding what to avoid such as smoking, excessive drinking, contact sports and heavy exercise. These can severely compromise the ability of the dental implants to bond with the bone in the jaw.We will provide you with any post operative medications such as antibiotics and pain relief medication. Most patients report limited discomfort after the treatment.In the weeks and months after implant placement bone tissue grows onto the implants producing a bond known as “osseointegration”. This is why it is important to follow advice regarding such things as smoking and maintain a soft diet to avoid interfering with this process.
During this phase you will need to attend the practice to review healing and provide any necessary adjustments.
Permanent restorative phase
After you have worn the temporary bridge for three to six months work will be undertaken to make a final bridge. There are different materials available for the final bridge
Maintenance and care.
After the final bridge is fitted you enter the maintenance phase. Regular visits to the dentist and hygienist are needed to review and maintain your implants and bridge. Thorough home care in terms of cleaning is essential. Periodically repairs or replacement of the bridge will be required just as with any restoration on natural teeth.
What are the alternatives
For patients with no teeth in a jaw the alternatives to the All on 4 technique are:-
- Standard fixed implant treatment. In this option, provided you have enough bone, six implants are placed and a fixed bridge fitted. Bone grafting is often needed with this approach and an extended treatment time (usually several months) is usually needed. This is often a more costly approach than an All on 4 option.
- Implant retained denture: In this option a number of implants are placed and a denture made which clips onto attachments on the implants. The denture is removed for cleaning and left out at night.
- Standard denture. A standard removable denture without implants is the other option. This needs to be removed at night and is often loose and bulky.