All-on-4

Recommended For All-on-4

All-on-4 dental implants are recommended for patients with a large number of missing teeth due to trauma, tooth decay or other reasons. Patients suffering from bone loss, which are unable to opt for traditional, vertical dental implants can also benefit for this procedure.

Not Recommended For All-on-4

All on 4 dental implants are not recommended for heavy smokers or patients suffering from bruxism. Pregnant patients should postpone their surgery until after giving birth. This procedure is also not recommended for patients with a weak or suppressed immune system as well as patients who suffered a heart attack recently.

Duration Of Operation

2 - 3 hours

Overview

All on 4 dentistry procedures or all-on-4® dental implants are a type of prosthodontic treatment which can be used to replace broken, decayed or otherwise compromised teeth from the lower and upper jaw. Paulo Malo invented the all-on-4 dental implants procedure around 30 years ago, and it quickly gained popularity among dentists as well as patients from all around the world. All-on-4 procedures have several advantages over other types of dental restoration procedures, including: 

• All on four implants are known to be extremely reliable, with most restorations lasting over 20 years
• No post-operatory dietary restrictions for the patient after undergoing this operation
• The average recovery period is reduced, in comparison to other types of dental surgery
• The patient's teeth will have a natural-looking color and translucency
• Bone graft surgery is generally not needed before undergoing this treatment
• It’s much more affordable than getting 12 or 14 dental implants
• Most patients will not have to return for a second appointment at the dentist when this technique is used
• The all-on-4 fixed prosthesis can be applied on the same day

Preparation

Patients will first need to have a set of dental X-rays done in order to check for any potential problems related to bone loss in the area. A CBCT scan may also be used for this purpose. If there are any remaining teeth on the maxilla or mandible, they will have to be removed.

How It Is Performed

The procedure begins with the dentist administering local anesthesia to the patient. Once the implant area is numb, the dentist will begin creating 4 different incisions in the patient's gum tissue. With the gum tissue out of the way, the patient's bone is exposed – implants then can be screwed into place. The implants are angled at 30 to 45 degrees – this is done to avoid sensitive areas such as the mental nerve in the mandible or the sinus in the upper jaw. After placing the implants, the dentist will close all incisions with sutures. Depending on the patient's state of health, a permanent or provisional prosthesis is placed over the implants, and the patient may begin recovering. The procedure generally lasts between 2 and 3 hours.

Recovery

Most patients can return to work in a few days after undergoing the all on 4 procedure. The next three months are essential for the success of the surgery – patients will receive a complete guide on what to do and what to avoid during the time necessary for the bone to heal. Solid food is prohibited for up to four weeks after the procedure – patients can consume liquid food instead. During the first seven days after the operation, most patients will experience discomfort and a lot of swelling.

Risks

The following risks and complications are associated with all on 4 dental implants: 

● Infection 
● Nerve damage 
● Osseointegration failure 
● Damage to the sinus 
● Loss of jaw bone 

Side Effects

Patients can expect the following side effects after an all on 4 dental implants procedure: 

● Pain 
● Discomfort 
● Considerable swelling 
● Minimal bleeding 

Success Rates

All on 4 reviews set the success rate at 94.8%, 10 years after the procedure has been performed. 

Before And After

After the all on 4 procedure, patients will be able to enjoy natural-looking teeth with no dietary restrictions. Patients will need to maintain good oral hygiene practices in order to maintain the longevity of the implants and prosthesis.

Faq

– What are the alternatives available? 
All-on-6 and all-on-8 dental implants are available as alternatives for an all-on-4 procedure. Some patients might want to opt for traditional dentures, for example, but the all-on-4 system provides a permanent solution based on a fixed prosthesis.

– How long does the procedure take? 
An all on four procedure usually takes around 2-3 hours, but it depends from case to case. 

– Are angled dental implants safe? 
Definitely. A study based on 245 patients with a total of 980 implants revealed a 94.8% success rate, ten years after the procedure was performed. When the all on four systems is used, any pressure on the prosthesis is distributed among all the implants, so the angle of the implants has no ill-effect.

Back To Work

3 - 5 days

Extra Content

This content is written and reviewed by our medical content team in September, 2019.