Numerous advertisements are promoting affordable dental implant treatment to replace teeth in one day with only four implants. Basically, the “All-on-4” concept provides a full upper or lower arch of “fixed” (non-removable) replacement teeth supported by four implants. Since two of the implants are placed at an angle, it is possible to avoid critical anatomical structures and take advantage of the bone that is available, rather than grafting (adding) bone.
“All-on-4” can be a good option for patients who are missing all of their upper or lower teeth if they have adequate bone to support a full arch of teeth with only four implants. However, it is important to understand that not everyone is a candidate for this procedure in spite of what the advertising claims state.
There are some potential drawbacks. For instance, there is more support for replacement teeth when six implants are placed in the upper jaw, where the bone is less dense than the bone in the lower jaw. This creates more security for long-term success. Also, if for any reason one of the implants fails to integrate with the bone, it is not possible to secure a full arch of replacement teeth on just three implants.
“All-on-4” is not always the best option for people who have worn dentures for several years. Not only have they lost a significant amount of bone, but also lip and cheek support, which could make it difficult to achieve a truly esthetic result with the “All-on-4” procedure.
- The procedure requires removing bone
- This is not a good option for patients who grind their teeth
- The plastic prostheses need to replaced every few years
- If any teeth are extracted the day of implant placement, bone grafting is required
Therefore, patients who are interested in determining whether “All-on-4” implants is right for them should discuss the option with their general dentist or seek the advice of a Prosthodontist in private practice, rather than going to a “super” center advertising the procedure. As a specialist with expertise in complex tooth replacement, a Prosthodontist can evaluate all of the various treatment options and present recommendations for the ideal solution for patients based on their specific, unique needs.