All-on-4 Dental Implants purely means that a full arch of artificial teeth is supported by 4 dental implants only. Typically the back implants in the upper and lower jaw are placed tilted in order to get bone anchorage and avoid anatomical structures. The term All-on-4 also comprises that the inserted implants are immediately (within 24 hours) loaded with a fixed arch of teeth.
Traditionally, more than four implants were placed to support a full arch of artificial teeth! The implants were of course placed straight and parallel in conformity with preexistent teeth and definitely not angulated on purpose. Also, a healing time of several months was adhered to before these implants were loaded with the arch of artificial teeth!
All-on-4 dental implant concept is a cost-efficient, graftless dental implant solution that provides patients with a fixed full-arch prosthesis on the day of surgery.
The All-on-4 treatment concept was developed to surpass the need of bone augmentation by tilting the back implants towards the region of available bone. Thus the maxillary sinus is surpassed in the upper jaw and the mental nerve is surpassed in the lower jaw.
Reducing the amount of needed dental implants of course also reflects in the financial load for the patient.
The All-on-4 concept is typically a treatment for patients with insufficient jaw bone quantities. It will be usually performed in patients who had lost their teeth many years ago and with it the surrounding bone structure. The All-on-4 treatment is the minimal requirement for a fixed implant bridge.
Nevertheless, in case the quantity of bone and the financial means are not restrictive, then placement of more implants (i.e. All-on-6) can achieve a safer situation for the patients in the long term.
It is purely the experience of surgery in the mouth after injection of local anaesthesia. The actual implant placements are usually less invasive then a tooth extraction and even postoperative complications such as swelling, bruising, discomfort are in general less prominent than after extraction of multiple teeth.
For the prosthetic restoration with a fixed arch of artificial teeth (implant bridge), an impression will be taken intraorally directly after implant placement. The placement of the temporary implant bridge usually takes place the following day within 24 hours and only seldom needs the application of local anaesthesia.
After a healing period of approximately 3 months, all implants will be checked for stability and the temporary fixed implant bridge will be replaced with a permanent fixed implant bridge that pays attention to the new conditions of healed gums.
Patients who have worn a removable denture and convert to a fixed bridge of teeth supported by implants do feel an immediate improvement of their quality of life. The feedback can be sometimes quite touching and patients often report it was one of the best investments in their life.
The results will look and feel very natural and the patient will regain full confidence in their masticatory function being able to eat anything without exception.