All-on-four dental implants, also known as four implants in one day, is an implantation procedure wherein up to 4 dental implants are placed into your mouth on just one day. The name "all-on" comes from the fact that they will replace all of your upper or lower teeth within just one session. Your oral surgeon will then use porcelain crowns to cover each tooth over the next year so you'll have a complete set of teeth by the second year after surgery.
Advantages of All on Four Dental Implants
- Improved treatment planning and preparation since the four implants are placed in one appointment.
- Less invasive surgery as there is less manipulation of the surrounding bone, eliminating the need for an osteotomy (bone cut).
- The patient experiences one surgical stage and can be fitted with complete dentures immediately at different stages after surgery. Many patients prefer immediate complete replacement teeth if they have a good number of natural teeth left. The time saved may well justify higher costs due to reduced inconvenience to patients and dentists alike. There is also an increased probability that the final prosthesis will be stable for many years.
- Immediate placement eliminates long periods where the patient has no teeth or no prosthesis, leading to bone loss and increased dental problems. In addition, the patient has more time to adapt to the prostheses than with traditional implant surgery.
- All surgically placed teeth are immediately accessible for cleaning. No tooth surface is obstructed by an adjacent tooth or restoration work.
- With four implants in the lower jaw, there may be decreased chance of implant failure due to lack of stability. However, it should be kept in mind that it is the number of implants and their placement that determines the support base for each implant.
- All-on-four produces better aesthetic results as no space needs to be created between the upper and lower denture teeth (whereas space would need to be made with less than four implants) since dental implants support all teeth.
- The patient may have the opportunity to enjoy a beautiful smile for many years instead of being toothless or wearing dentures that cannot provide aesthetics or stability.
- When the adjacent natural teeth are in good condition, it is possible to save them and place more implants instead of extractions (when adequate bone volume exists). This also reduces the number of surgeries and costs required. However, it should be kept in mind that there is no replacement-tooth like implant available on the market today, and even if one becomes available later on, this will not justify extra costs, as it will probably be cheaper to extract a tooth than to restore it.
Disadvantages of All on Four Dental Implants
- Not every patient is a candidate for four dental implants. So the dentist should know whether or not there is enough bone to place four implants that can provide stability for the prosthesis. Suppose it is necessary to fill the jaw with graft material (autograft, allograft or xenograft). In that case, this will be more expensive than if only two implants were placed during surgery and no other dental work was required. On the other hand, since the placement of four dental implants takes less time than if fewer were placed, the total treatment cost may be about equal to those procedures where fewer longer-lasting dental teeth are implanted.
- The risk of implant failure does double by placing 4 compared to 2 implants. However, recent studies have shown that this risk is even further reduced if greater attention is paid to selecting sites and surgical techniques, crown design and maintenance. Additional 3D planning software makes it possible to improve results still further.
- Dental implant surgery can be a minor procedure in some cases but may also require bone grafting or a tooth extraction for optimal results.