All on 4 Dental Implant

All on 4 Dental Implant | MDS Implantologist In Vadodara | Aries Oro-Facial

All-on-4 Dental Implant Procedure: From Start to Finish

The All-on-4 dental implant procedure is a revolutionary solution for patients suffering from complete or multiple tooth loss. This technique reconstructs the entire mouth, restoring both function and aesthetics with a permanent set of fixed teeth—all using just four implants per arch.

Whether due to trauma, advanced gum disease, or tooth decay, tooth loss can impact your ability to speak, eat, and smile confidently. All-on-4 offers a modern, cost-effective alternative to traditional dentures or complex individual implants.

Understanding the All-on-4 Concept

A major challenge in implant dentistry is alveolar bone atrophy, especially in fully edentulous patients (those with no teeth). In cases where the bone is thin or weak—especially in the posterior (back) jaw—placing standard implants becomes difficult.

The All-on-4 approach solves this problem by using tilted implants, which are angled to make use of the denser, more stable bone in the front (anterior) jaw. This strategic placement avoids the need for bone grafts in many cases and allows full-arch rehabilitation with just four implants.

General Considerations for All-on-4 Implants

To ensure success, specific anatomical and clinical guidelines must be followed:

• Primary stability of implants should reach between 35 to 45 Ncm.
• Minimum bone width required: 5 mm
• Minimum bone height:
  • 10 mm for the upper jaw (maxilla)
  • 8 mm for the lower jaw (mandible)
• Tilted implants can be angled up to 30 degrees, helping avoid sinus cavities and nerves.
• Ideal candidates:
  • Older patients
  • Patients with oral submucous fibrosis (OSMF)
  • Those with advanced periodontal disease

Pre-Procedure: Patient Evaluation & Planning

Before the procedure begins:

• A comprehensive examination, including 3D imaging, is performed.
• The dentist confirms the patient’s suitability based on bone condition, health status, and expectations.
• Precise measurements are taken to determine the placement of implants and the design of the final prosthesis.
• The goal is a stable, long-lasting fixed prosthesis that mimics the function of natural teeth.

Step-by-Step: All-on-4 Procedure

1. Sedation and Preparation

Once the patient is sedated, the procedure begins:

• Any remaining teeth are extracted.
• Diseased or damaged gum tissue is removed.
• Incisions are made to access the jawbone and reduce any ridge irregularities.

2. Implant Placement

• Four implants are strategically placed per arch, two of which are tilted to maximize support.
• Temporary teeth may be attached same-day, allowing patients to leave the clinic with a new smile.

• Four implants are strategically placed per arch, two of which are tilted to maximize support.
• Temporary teeth may be attached same-day, allowing patients to leave the clinic with a new smile.

• Four implants are strategically placed per arch, two of which are tilted to maximize support.
• Temporary teeth may be attached same-day, allowing patients to leave the clinic with a new smile.

Same-Day Smile: How It Works

Thanks to advancements in 3D imaging and CAD/CAM technology, All-on-4 allows patients to walk in and walk out with functional, fixed teeth on the same day. However, final permanent restorations are only placed after complete healing and integration of the implants.

Tilted vs. Straight Implants: Which is Better?

Studies, including those by Krekmanov, show that tilted implants can:

• Improve force distribution across the prosthesis
• Reduce stress on the implant by optimizing angulation
• Avoid anatomical barriers (like sinuses or nerves)

Biomechanical benefits include:

• Better support for longer prosthetics
• Reduced cantilever length
• Enhanced prosthesis stability

Occlusion in All-on-4: Immediate Loading Protocol

• Minimize the cantilever length
• Favor group function during lateral movements
• Ensure bilateral contacts on anterior teeth
• Avoid excessive force on the distal prosthetic teeth
• Maintain a flat occlusal pathway with minimal vertical interference

Advantages of All-on-4 Implants

• No need for bone grafts in most cases
• Shorter treatment time
• Less invasive than traditional full-mouth reconstructions
• Lower cost due to fewer implants
• Immediate functionality and aesthetics
• Easy maintenance
• Excellent long-term success rates

Fixed Implant Dentures: Pros & Cons

• Restore natural aesthetics and full chewing ability
• Improved speech and confidence
• No messy adhesives
• Support jawbone health by preventing further bone loss
• Easy to clean and maintain
• Shorter recovery time

Cons

• Requires surgery (though minimally invasive)
• Initial cost is higher than removable dentures
• May cause temporary discomfort or soreness post-surgery

Caring for All-on-4 Dental Implants

Maintaining your new teeth is essential for long-term success:

• Brush twice daily with a soft-bristle brush
• Use floss or water flossers to clean around implants
• Attend regular dental checkups and cleanings
• Report any gum irritation or prosthesis movement to your dentist immediately

Post-Surgery: Common Issues & Management

It’s normal to experience some discomfort after surgery. Common side effects include:

• Bleeding
• Swelling
• Mild pain
• Dry lips or sore throat
• Jaw stiffness
• Discoloration or bruising
• Heightened sensitivity

Most of these symptoms subside within a few days and can be managed with medication and rest.

Frequently Asked Questions (FAQs)

Conclusion

The All-on-4 dental implant procedure is a life-changing treatment that offers patients a fast, effective, and long-lasting solution to complete tooth loss. With careful planning, advanced technology, and proper aftercare, patients can enjoy a beautiful and functional smile for many years to come.

If you’re considering All-on-4, consult with a qualified dental implant specialist to find out if you’re a good candidate.