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All-on-4 is a branded prosthodontics dental procedure. The name refers to supporting “all” teeth using only 4 dental implants. Learn more about this popular procedure below:
All-on-4 is a treatment process offered by Nobel Biocare. It’s not a device the company specially invented. Rather, All-on-4 refers to prosthodontics treatments that have evolved over time into one, simplified procedure.
All-on-4 uses dental implants to support a full set of teeth on a jaw. A dental implant is a screw-like device, typically made from titanium, that can be surgically inserted into the jaw. Once drilled into the jaw, the implant subsequently fuses with the surrounding bone tissue. Then, it can act as the root of a tooth.
If you are just getting a dental implant, one implant would be fitted to a single crown to make up an artificial tooth. But the All-on-4 procedure makes it possible to support 10 to 12 teeth in a single jawline just on four implants.
The implants are inserted in the front and the back at an angle. Then the dentist fixes dental bridges or dentures to the implants, so the patient can replace all missing teeth on a jawline. The implants here act as anchors for the teeth.
The process needs 4 dental implants per jaw. So it would be 8 total implants to restore a full smile on upper and lower jaws.
This procedure can be performed even if the back jaw lacks bone density. It takes advantage of the bone density in the front jaw to support dentures or bridges. The implants are placed at an angle to avoid sinus glands in the back.
All-on-4 procedure requires same day care to have the implants inserted without delays in between. Once the implants are put in, the patients would need to recover minimum 3 months before the dental bridges or dentures are fixed.
There is only one All-on-4 procedure as offered by Nobel Biocare. But you can receive two types of dentures from the brand:
This option allows you to get titanium implants paired with an acrylic denture with titanium support. It may appear as obviously metallic to outsiders, but this option is generally considered cheaper than the porcelain option.
You will get titanium implants paired with porcelain dentures. Porcelain emulates enamel much better than acrylic. It can reflect light, just like real teeth. Porcelain is aesthetic, but the looks would cost you more to purchase new and also to repair afterwards if necessary.
The difference between the above two is mainly looks and cost. Functionality for both options is basically the same.
The All-on-4 procedure is a serious surgical procedure that require several weeks of recovery. There are several steps associated with the complete procedure. Here’s an overview:
Before you get the procedure, a dentist would examine your teeth and discuss the treatment with you. At this point you can choose what type of All-on-4 dentures you want. The dentist will x-ray your mouth if necessary. If you have teeth stubs or lone teeth that might interfere, your dentist may recommend tooth extraction.
After you qualify, you should schedule your surgery with a qualified oral surgeon. Patients are typically given a local anesthetic to numb the gums for the procedure. In some cases, a general anesthetic, which sedates you completely, might be used. This is the case if you have a dental phobia.
The surgeon will first prepare your gums for receiving the implants. This may involve tooth extraction and removing diseased gum tissue (from gingivitis).
The implants are placed two in the front, and two at the back. The back implants are placed at an angle to act as “anchors” for the dentures you would wear. The oral surgeon would make small cuts in the gums for the implants. Then, the surgeon would drill into the jawbone and insert the implants. The gums would be stitched to allow healing.
After the surgeon cleans the surgical sites, then procedure would be over. You will be transferred to a recovery room to allow the anesthesia to wear off. You may experience some pain as the feeling comes back to your mouth. At this point, a dentist may prescribe you antibiotics to minimize the risk of an infection.
The recovery period can be roughly broken down into two stages. The first stage is allowing your gums to repair itself from the wounds of the surgery. This would be a quick healing process that might last a week or two.
It’s highly recommended to rest for the first week after the implant surgery. Expect the initial days to be difficult and painful. You will have to limit yourself to soft foods. You would also have to manage the pain from the surgery.
You may experience some side effects from the surgery, such as these:
Pain—Recovering from an implant surgery would be painful. Different patients experience pain differently. Some patients experience severe pain that might require a prescription painkiller. Your dentist would recommend treatments to manage the pain the best. Resting well after the surgery should reduce discomfort levels.
Bleeding after Surgery—Soon after the surgery, you may experience gum bleeding. A small amount is fine but persistent bleeding is a cause for concern. You would have to remain in the in-clinic recovery room longer if you experience this issue.
Swelling—It’s quite normal for a surgical site to show signs of swelling. Some people may experience this problem worse than other. The surgical site may swell up to two or three days. The dentist would prescribe medication to manage the swelling. You can also try home remedies, such as using ice packs.
Nausea—The surgery itself doesn’t cause nausea, but the medication you are taking to aid in recovery might. Also, if you accidentally swallow blood from the gums, it may cause nausea. The nausea should go away in a day or two. But if it persists, you must immediately seek medical attention.
Bruising and Discoloration—In some cases, the surgical site looks bruised or discolored several days after surgery. The site may turn black, yellow, or blue, which is not unusual. But the discoloration should go away on its own. You can try applying heat to the area to reduce the discoloration. If it doesn’t go away, you must contact your dentist.
Dry Lips—The gauze and stiches in your mouth may cause dry lips. Difficult swallowing may cause the problem as well. Keep your lips hydrated by drinking water or using chapstick to reduce discomfort.
Sore Throat—A sore throat following surgery is not a sign of an infection. If you keep your mouth open mostly after the surgery, your throat may become sore. The sore throat must pass away on its own. Persisting sore throat indicates a serious medical issue.
Weird Sensations in the Mouth—After the surgery, you may experience prickly or sharp feelings in your found. It might feel as if something is jabbing in there. This occurs if jawbone pieces, broken off from the drilling, poke from the gums. The walls of the jawbones from tooth extraction can cause this sensation as well. If the feeling is particularly uncomfortable, you must speak with your dentist immediately.
The side effects should disappear as your mouth heals. If you experience continuing or particularly severe side effects contact the dentist or your general practitioner.
Afterwards, you would need a much longer period for the jawbone to heal. The jawbone must repair itself around the implants. The new growth of bone tissue would fuse the implants to the jawbone, at which point the implants can act as artificial roots for teeth. This process can take 3 to 8 months, depending on your individual health profile.
There would be several dentist visits following the surgery to make sure your gums and jaws are healing properly. When the dentist determines the implants are fused to the jawbone, you can get the dentures.
The dentist would fix the dentures to the implants as a permanent fixture. This process is relatively simple. However, your dentist may make minor cuts in your gum to expose the implants. But recovering from this procedure won’t take long as the surgery.
Once the implants are in, the All-on-4 procedure would be complete.
As a surgical medical intervention, the All-on-4 procedure is not without complications. While complications are not common, you should be aware of the following risks:
Surgical risks are the main issues for receiving All-on-4 dental implants. Unlike side effects from the surgery, surgical complications are much more serious.
Possible complications from the implant surgery includes infections, severe bleeding that persists, and poor healing. Such complications can be managed, of course. You will have to talk to your dentist about such risks.
Your current health profile may put you at more risk for certain complications. For example, if you have a condition like diabetes, which may hinder proper healing, your dentist may not recommend the All-on-4 procedure.
In some cases, the dental implants may not fuse with the bone as intended. In this case the surgery would have failed. There could be may reasons for the implants not to fuse.
One primary reason is the lack of bone density. If old age or physical damage has seriously reduced the size of your jawbone, the tissue may not grow back to support the implants. In other cases, immunity issues or diseases like gingivitis could prevent implant integration.
In implants don’t fuse, the dental surgeon would remove them. Then you might get new implants for a second try.
The All-on-4 procedure is very expensive pretty much anywhere in the world. Costs are mostly associated with the product itself. The porcelain All-on-4 dentures and implants could cost you somewhere between $25,000 and $35,000. The acrylic composite option is only slightly cheaper, costing between $20,000 and $30,000. Repairing dentures can cost between $10,000 to $15,000.
It’s not just the cost of the implants that you have to worry about. You must calculate dental surgery and clinic fees in addition to the branded product. While the All-on-4 implants are costly just about anywhere in the world, dentist fees will vary.
You can save up on the overall cost of the procedure by receiving All-on-4 implants in a country where dental care costs are low. For example, Turkey is a great option where you can receive the same Nobel Biocare implants, but at lower surgical and clinical costs compared to other countries like the U.S. or Germany.
Some insurance plants may cover All-on-4 implant procedures. However, some plans consider the procedure to be cosmetic and will not underwrite it. You should consider options in your area.
If you end up having to pay for All-on-4 out of pocket, find a country or an area where dental care costs are low, like Turkey as mentioned above. Then you won’t have sky-high clinic charges on top of the implant cost.
If you can’t afford All-on-4, there’s a cheaper alternative called the Golpa-4 (G4) procedure. The idea is the same as All-on-4. The G4 procedure also uses titanium implants, the industry standard, with dentures or bridges made from zirconia or ceramic type material.
However, the G4 procedure becomes permanent just hours after the surgery. That might not be ideal if there’s a mistake. In any case, you must consult with a dentist regarding whether G4 is a good procedure for you. All-on-4 has been around longer and is more established, so don’t be surprised if your dentist recommends it anyway.
You won’t have to settle for the cheaper option if you can secure funding for All-on-4 with a good insurance plan. If not, try Turkey for reduced cost of care. Don’t sacrifice the quality of implants for cost because you might put yourself at risk for serious complications after the procedure.