• Expensive initially
• Need to have minor surgery
• Time required for full osteointegration of implants (the mixing of the metal to the bone)

An option for those planning to replace a full set of missing teeth is available, which brings together the attributes of the two. It includes placement of four implants instead of the usual 6 - 10, to support a bridge or denture. This technique is called the All-on-4 implant system.

What does the All-on-4 procedure entail?

After your consultation with the dentist, an entire jaw radiograph (OPG x-ray) and perhaps a CT scan will be done to check out the amount as well as placement of bone in your jaw. This may let the dentist to identify if there is enough bone volume to securely place an implant. A comprehensive examination will also be performed to check out that there exists no problems within the mouth before starting.

Positioning of the four implants is similar to normal implant procedures. Treatment is done in a sterile environment much like a hospital, with the surfaces and surgeons scoured and covered. The operation is conducted under local anaesthesia and is pain-free. The implant blends with the natural bone over time. This process is called osseointegration or osteointegration and offers the replacement teeth maximum stability.

A couple of implants are put in front of the mouth, benefiting from the dense jaw bone existing there. The two implants at the posterior of the mouth are fitted at forty-five degree angles to allow maximum stability and get the most from the stronger bone in front of one's jaw and prevent the maxillary sinus’s in the upper jaw.

There is absolutely no requirement to wait for the mouth to heal before placing bridges or dentures on the implants with All-on-4 implants, so the patient leaves the surgery with a full set of functional and wonderful teeth.

The treatment remains popular and is generally successful when carried out by a skilled surgeon.

Am I suitable for All-on-4?

Prior to starting treatment the dentist will conduct a thorough assessment to guarantee suitability of treatment. Implants have the highest effectiveness when performed on suitable candidates. Factors that can be risks to success are if the patient is diabetic or smokes heavily. Smokers must note they are two and a half times much more likely to experience failure than non-smokers. However, this doesn't prevent smokers from having implants.

Those who are afflicted with gum disease will need to have the problem handled before proceeding with implants. Treatment can be a professional clean by the dentist (to reduce bacterial count) and a continuation of good oral hygiene regimes at home. For severe cases of gum disease a much more intense gum treatment carried out by a periodontist may be necessary. It is important the patient understands the importance of good oral hygiene and is able to undertake daily brushing and flossing using correct techniques prior to the positioning of implants. For videos and an explanation of correct oral hygiene techniques, click here.

You should discuss your suitability with the dentist before contemplating undergoing the All-on-4 treatment.

What are the benefits of All-on-4?

• Only requires 4 implants rather than the usual 6 - 10
• Is carried out far quicker than conventional methods with less surgery
• Less costs involved than standard positioning of 6-8 implants
• Bone graft unlikely to be required, which cuts down on the cost
• Permanent set of teeth can be built in the same appointment as the implants
• Durable and stable implants are a great way of preventing the hassle of denture looseness, slippage and wear, which helps when eating and talking, and enable the new teeth to be treated just like regular teeth. Those who have All-on-4 dental implants go through the same ability to eat as people with a full set of natural teeth and will experience no alteration in taste, i.e. the ability to eat hard and sticky foods which are normally challenging to denture wearers.
• The teeth All-on-4 do not rub opposed to the gums (thus no ulceration with denture wear) as they are securely anchored into the dental implants.
• All-on-4 replacement teeth are fixed permanently in the mouth and can be cleaned just like natural teeth. In time you will not think of the indisputable fact that you've got implants.
• High implant survival rate. Short term: 97.5%-100%, Medium term: 96.7-100%, Long term: 94.8% (Faculty Dental Journal Jan 2012, Vol 3 Issue 1 page 25).

What are the risks?

As with most dental treatments, there are risks involved when placing All-on-4 implants.

Although unlikely, you may experience some pain and swelling in the implant area after the All-on-4 implants are placed. Over the counter pain killers should help with the discomfort until it resolves. However, the procedure itself will be pain-free.

Your dentist will use x-rays or CT scans to determine the exact position of the many nerves which are in your lower jaw. These nerves supply your tongue, chin and lower lip and teeth; if they are disturbed or damaged during the implant procedure, you might experience tingling or numbness. Every effort will be taken by your dentist to avoid this happening.

As you can imagine, the amount of stress and force when biting and chewing can put great stress on the jaw bones. hence it is important the quality of the bone is good enough to cope with the pressure. Otherwise the implant may not fuse with the bone properly, and create failure.