Full Mouth Implants

All-on-4 Dental Implants: A Permanent Solution for Your Smile

The All-on-X dental implant protocol is a revolutionary procedure designed to restore a full set of teeth in patients who have lost all or most of their teeth. It offers a permanent, stable solution with fewer implants, and is strategically designed to avoid the need for bone grafting and sinus lifting in most cases. This makes the procedure faster and minimizes the overall healing time, allowing you to enjoy the use of your new prosthesis much sooner.

What is the All-on-4 Protocol?

The All-on-4 protocol involves placing 4 dental implants strategically into your jaw to securely anchor a full set of replacement teeth. What makes this protocol unique is that the implants are often placed at specific angles rather than straight up and down. This angled approach is used to maximize the available bone, providing superior stability and strength, particularly for patients with lower bone volume.

The angled placement allows for optimal implant positioning, avoiding the need for costly and time-consuming bone grafting and sinus lifting procedures that are often required in traditional implant methods. By bypassing these steps, the All-on-4 protocol can be completed more quickly, and you’ll experience faster healing times, helping you achieve better results in less time.

Materials Used in the All-on-4 Prosthesis

The All-on-4 prosthesis is custom-made to fit your mouth perfectly, using durable, aesthetic materials such as acrylic, zirconia, or hybrid zirconia-acrylic combinations:

This prosthesis is securely attached to the 4 strategically placed implants, which might be placed at either straight or angled positions. The angle and positioning are determined to achieve the best aesthetic and functional outcome, giving you the most secure and comfortable fit possible.

Evaluation and All-on-4 Planning

The first step is an in-depth evaluation to understand your unique situation, which includes:

• Medical History Review: To ensure you're a good candidate for the surgery.
• Smile Line Assessment: The position of your upper lip is carefully evaluated to see how much of your gums show when you smile, which impactsthe final appearance of your new teeth.
• Assessment of Current Dental Condition:

FP1

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Design

Uses only tooth-colored parts (white), and the prosthesis will have "ovate" pontics that gently come out from the gums for a more natural look.

Uses tooth-colored (white) and gum-colored (pink) parts to mimic the natural look of your teeth and gums. The gum portion is flat and parallel to your bone and gum.

Material

Zirconia
(no pink porcelain used)

Acrylic
(can be upgraded to Zirconia)

Bone reduction

Less to none

Requires flattening
(changes narrow ridge to wide ridge, easier hygiene, hide transition zone)

Cost

+45,000 THB

As part of package

We also evaluate if you're currently using dentures. Here’s how this assessment works:

• Good Denture Fit (Vertical Dimension): If your current denture fits well, restores your facial profile, and your speech sounds (like “S,” “F,” and “V”) are clear, we can use it as a reference to match the new All-on-4 denture.
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• Poor Denture Fit: If the denture feels uncomfortable or doesn’t restore your facial profile well, we might recommend creating a new temporary denture. This removable, acrylic temporary denture allows us to test your bite, phonetics, and comfort before proceeding with the implant surgery.

Making New Temporary Dentures

An acrylic denture is made without placing any implants yet. The denture is made to verify that we have achieved proper function (bite position), esthetics (tooth color, shape, size, length), and phonetics. The steps are as follows:

Try-in occlusal rim
Visit 1 = 30-60 mins

Try-in teeth (on wax)
Visit 1 = 30-60 mins

Place denture
Visit 1 = 30-60 mins

We will continually check the denture’s fit, height, and comfort for 2-8 weeks. Once you're happy with this setup, we move on to planning the implant placement.

Creating the All-on-4 Prosthesis

The temporary removable denture will be used to make your final acrylic prosthesis. This denture will be a horse shoe shape which will be connected to the implant on surgery day.

The implant placement planning done digitally, using advanced technology to plan out the exact angle, size, and length of implants required. This allows us to ensure that the implants are placed with maximum stability for your final prosthesis.

To ensure optimal accuracy, we also design a surgical guide. This custom guide will help place your implants exactly where they need to be, minimizing risk and providing better results, especially for more complex cases.

Day of Surgery: Placing the Implants

On the day of surgery, we begin by removing any remaining teeth if necessary. We then place 4-6 implants in your jaw. After the implants are secured and show good stability, the final acrylic denture is fixed onto the implants. This denture provides both an immediate functional and aesthetic result.

Post-Surgery Care

After surgery, it is recommended to follow a soft diet for about 1-2 weeks. This allows the implants to properly integrate with your bone before you start chewing hard foods.

The All-on-4 prosthesis is secured to the implants but is also detachable by your dentist if maintenance or adjustments are needed.

Options and Add-Ons

There are options to enhance your All-on-4 treatment:

Bar: If your final denture is made of acrylic, we may recommend adding a bar. This bar reinforces the acrylic, increasing durability and stability.

This can be prepared before placing the implants.

Add-on cost:

 

Zirconia Denture: For a stronger and more natural appearance, we can create a zirconia denture. Note that this requires having an acrylic set of teeth placed for 1-3 months as a trial before moving to zirconia.

Alternatives to All on X

While All-on-4 is a popular choice, there are alternatives like full-mouth bridges and overdentures. Your dentist will help you choose the best option based on your needs.

Full Mouth Bridge: Requires placing 6-8 implants, and 3-4 sets of dental bridges. This option provides the closest look and feel to having natural teeth, but is known to be more invasive, costly and requires more healing time.

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Over Denture: This is an option where the dentures fit over implants but can be easily removed. It’s ideal for patients who prefer something removable. This option requires a minimum of only 2 implants. Patients can always choose to upgrade and up to 4-6 implants for better stability of the denture. Ultimately, patients can also later upgrade to a more fixed solution like the All-on-4 denture.

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Removable Full Dentures: This is the conventional method of restoring full mouth missing teeth. Although these dentures are initially more affordable than All-on-4 implants and are easier to modify and replace, they can shift, or feel loose or cause discomfort while eating. Overtime, with no tooth root present in the jaw bone, the bone will slowly recede, making it more difficult to place implants later. Patients are also recommended to avoid certain foods, use denture glue and ‘reline’ the dentures regularly to compensate the bone loss and regain the denture’s tightness.

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Which is Better: All-on-4 or Overdenture?

There are many factors to consider:

• Personal Preference: Would you prefer your teeth to be fixed in place (All-on-4) or removable (overdenture)? Your peronsal preference will be considered as part of treatment planning.
• Cleaning Needs: With All-on-4, you’ll need to use a Waterpik (water flosser) or similar tool to keep your prosthesis clean. If you require help maintaining hygiene, cleaning the denture or struggle with dexterity, an overdenture would be more suitable as it can be removed and cleaned outside your mouth.