The All on 4 dental implant procedure has become quite popular. You probably even hear about it on radio and TV advertising. Even many dentists don’t really understand it. It is sometimes advertised as the “smile and a day” procedure. All on four is simply a treatment option for replacing all of your teeth on the upper or the lower with just four dental implants. It is possible to replace all of your teeth in just 1 day. In fact I have been doing this for the last 15 years.
You just have to be very selective that you are the right patient for this type of procedure. I don’t suggest that the final teeth are made on the same day because you will not be able to test the teeth for how they look, feel or bite. There are many steps to achieve a really good result and a full mouth reconstruction.
The All on 4 Dental Implant Procedure Video Review
There is a lot of hype about all on four. What is perceived is not always the reality. In this video I will review several things you should know about total teeth replacement with “ALL ON FOUR”.
Some advantages are:
- No bone graft usually
- Spreading fewer dental implants more towards the back with purposeful angulation
- Dental implants can possibly be placed on the same day as an extraction
- Reduced cost
Some disadvantages are:
- Under engineered–only four implants are supporting what 14 upper natural teeth would do.
- Cost is reduced by making a “fixed hybrid.” These are essentially fixed dentures which have high maintenance and break very often.
- No implants are placed in the molar areas of your mouth where the bite force is the highest
Here is a patient a decade ago:
Generally speaking, 6 dental implants on the upper and 5 dental implants on the lower are minimum number for stable long-term bone.
This should be combined with an all zirconia or metal ceramic bridge rather than a hybrid, which are plastic denture teeth fused to a base metal. Depending on the size your jaw and bite force, you may need up to 8 dental implants on your upper jaw and 6-8 on your lower jaw.
Sometimes bone grafting cannot be avoided and is necessary to obtain good long-term results for you. You may require sinus bone graft if your sinuses are farther forward in your mouth.
I would strongly suggest all porcelain teeth, preferably CAD milled Prettau, if you have enough space from top to bottom. Porcelain teeth don’t stain, chip and break like plastic hybrid denture teeth do. I would also suggest that all on four or all on 6 or 8 are held in by screws rather than cement, if at all possible, based on dental implant angulation. This video should clarify a lot of questions you may have.
The all on four dental procedure is really heavily marketed and is rarely the best option but **can work for some**.
Remember your teeth are your body parts. I truly believe a customized solution for your particular situation is best. Some dentists just plan all on 4 dental implants for all patients regardless of their unique situations.
It is the equivalent of trying to make your mouth fit the prefabricated teeth, rather than making teeth to fit your mouth.
If my mom or dad were to ever need to replace all of their teeth, this is not the way I would do it.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry