All-On-4® Treatment Concept
Flower Mound, TX
At DFW Oral Surgeons, we understand how hard it can be to lose teeth. Tooth loss is never an easy thing to deal with, your diet starts to narrow, the discomfort your experience starts to expand, and you find yourself withholding your smile from the world. Fortunately, we have you covered with a variety of dental implant supported options that can increase the beauty of your smile and the quality of your life. Our most popular options for those who are fully edentulous (lost all or most of their teeth) is the All-On-4® Treatment Concept. All-On-4® gives you a full set of teeth, both the top and bottom arches, that is permanently supported by implants! Let’s take a look at how the All-On-4® Treatment Concept can change your life.
What Is All-On-4®As the name implies, All-On-4® is a full arch of prosthetic teeth that are permanently mounted to four dental implants on that arch. If you are having all of your teeth, top and bottom, replaced by All-On-4®, you will end up with 8 dental implants – four on the top and four on the bottom.
The reason we can support a full arch of prosthetic teeth with only four dental implants is because of the positioning and angles we use to place the implants. Two implants are placed in the anterior part of the jaw in a vertical fashion. The other two are placed at an angle on either side of the jaw. The angled implant are supported by and add support to your jaw bone, allowing the easy success of the prosthetics.
How All-On-4® Revolutionized Teeth ReplacementUntil very recently in dentistry’s long history of tooth replacement, the best we had to offer a fully edentulous patient was dentures. Dentures restore the appearance of teeth and most of the function that teeth allow, but are far from perfect. Having to be held in the mouth with denture fixative that can wear off means that many of the foods you would normally enjoy have to be missed. Dentures require you to remove them at night and have to be taken care of with special toothbrushes. The All-On-4® Treatment Concept gives you the same freedoms that your natural teeth did - a permanent tooth replacement option that you don’t have to worry about and can rely on for years to come.
Planning Your Implants Made EasyWe use the NobelGuide Treatment Concept to plan and perform the placement of your dental implants so that they are accurately placed and will last you a lifetime. This software suite allows us to take a digital scan of your mouth that we can then use to run some placement simulations on to more accurately determine how and where to place your implants. Everyone’s mouth is different, and we always aim to perfect our treatment plans to our patient’s mouth. NobelGuide even helps us to execute the perfect and accurate placement of the implants into the correct positions so that they have the best chance for long-term success.
Prosthetic FlexibilityWith an All-On-4® treatment, our patients benefit from immediate implant-supported restoration, as a temporary tooth restoration is screwed onto the implants right after surgery. Final solutions for the All-On-4® treatment concept include both fixed prostheses, such as NobelProcera Implant Bridge Titanium with acrylic veneering, or individual NobelProcera crowns cemented to the bridge framework, and removable solutions, such as acrylic overdentures on a NobelProcera Implant Bar Overdenture.
Dental Implant PostThe post is always the first step in receiving a dental implant assuming your mouth is healthy and ready to receive implants. An example of a situation where the post is not the first step is when the patient lacks the bone volume required to support implants, usually due to bone loss in the jaw. In a case like this, the first step in the implant process would be a bone graft. The post is made out of titanium because of the way titanium interacts with human biology. Titanium is a biocompatible metal, meaning the bones and tissues in our bodies do not try to reject the implant, rather choosing to grow around the post, forming strong mechanical bonds.
The post can require several months of healing time following its placement to allow the bone to form a strong bond with the implant. Sometimes we can place the other dental implant components the same day that we place the post – it all depends on the health of the mouth of the patient.
Dental Implant AbutmentThe abutment is screwed into the top of the dental implant and is meant to provide the surface area for the restoration to be attached to permanently. Once we are certain that the implant post has healed properly and can support a restoration that will be used to help the patient speak and chew properly, we will place the abutment into the implant post. The abutment is secured permanently into the post with a permanent dental fixative.
Dental Implant RestorationDental implants can be used to support single tooth restorations, bridges (made of several prosthetic teeth that span a gap), and full arches of teeth like the All-On-4® Treatment concept. The All-On-4® restorations are different depending on whether they are being placed on the top arch or the bottom arch of the mouth. Obviously, the teeth that they are made to look like are different, and they must mirror that difference. Also, the places where the abutments attach to the restorations are in different places, and the width and length of the arches are significantly different.
The All-On-4® restorations are made to resemble not only your natural teeth but the gums that advance into the spaces between the teeth. They do a remarkable job of passing as real teeth, and we are certain you will be quite pleased with the result!
The Process To Receive All-On-4®It is important to understand that the process to receive the All-On-4® is more detailed than it is to receive a more simple restoration like a dental crown, but don’t worry, at DFW Oral Surgeons we do all the heavy lifting! This process usually require 2-3 trips to our office to complete fully but can require as few as one trip!
Consultation and Information GatheringIf you are interested in having dental implants placed to replace one or all of your teeth the first part of the process is picking up the phone and calling us at (972) 539-1491 to schedule your no obligation consultation.
When we meet, we will discuss what you want for your smile, and any frustrations or worries you may have. We will let you know what we believe we can accomplish with your smile and approximately how long we expect it will take.
Treatment PlanningOnce we reach the treatment planning phase, it’s time for us to take some measurements and impressions. It used to be that measuring a patient’s mouth was a long, drawn out process that was uncomfortable and unsavory. We have adopted some impressive dental technology that allows us to take digital impressions of your mouth without all the messy impression paste we had to use in the past. Now, taking an impression of your mouth is as simple as opening your mouth for a few moments, and standing still while our machine does the work.
Using these measurements and impressions, we can build a treatment plan for you in our NobelGuide software suite. This plan will help us to determine the exact placement of your implants as well as the what products to use.
Dental Implant Post Placement and Healing TimeOnce we have built a working treatment plan for you, it will be time to place the implants into your jaw. The first step in this procedure is ensuring your comfort by thoroughly numbing the surgery sites and giving you an anesthetic to help with anxiety. We offer a variety of anesthetics ranging from nitrous oxide to general anesthesia. Once you feel comfortable and relaxed, we can begin the implant placement procedure.
We will gain access to your jawbone by making small incisions in your gums at the points where the implant posts will be placed. Once we have access to the bone, we will prepare it by drilling a small hole with a surgical drill at the precise angle that the implants need to be placed. We insert the titanium dental implant posts into the jaw bone and suture the sites closed around the base of the posts. This is the point at which the healing process begins.
Healing can take anywhere from 2-9 months depending on your oral health. It is important that you refrain from smoking once you have had dental implants placed as the likelihood of implant failure skyrockets with tobacco use.
Building Your All-On-4® RestorationDuring the time that you are waiting for the titanium dental implant posts to heal in your jaw, a few things will be happening. We will be hard at work crafting your All-on-4® full arches. We use some pretty impressive milling machines to help us achieve a perfect reproduction of your natural teeth.
Also happening during this time the bone in your jaw will be growing closer to the implant posts in a process known as osseointegration. This process can take a decent amount of time, but it’s very important to the long-term success of your implants. When you have the final All-on-4® arches placed in your mouth, and you are using them to chew and speak, they will need plenty of support from the implants placed in your jaw.
Final Placement of the All-On-4®The last step in the procedure is placing the restoration in your mouth. Depending on the kind of implant posts we placed in your mouth, we may need to apply a numbing agent before placing the abutments in the posts. The abutments will be permanently affixed to the posts using dental adhesive, and the restorations will be carefully placed on top of the abutments. Once on the abutments, the full arches will be permanently set in your mouth, also using dental adhesive. Before placing the adhesive on the restorations, we will check to make sure that your bite fits together and feels natural in your mouth.
Dental Implant Post Operative InstructionsThe surgical portion of the procedure is the dental implant post-placement process. Following this procedure, you will have some gauze pads placed over the implant sites, and there will likely be some bleeding. It will be important that you have an adult to accompany you out of the office and help get you home. It is important that you check the gauze pads about a half hour to an hour after surgery and change them if there is still some bleeding.
The most critical thing following any surgery is that you get some good rest. Take it easy and don’t overexert yourself following a surgical procedure, as increased blood pressure can put unwanted stress on the surgical sites.
To manage minor pain, feel free to take some OTC painkillers like acetaminophen or ibuprofen according to their dosage instructions. Ibuprofen is good at relieving swelling. For more intense pain, take the prescription medications that we prescribe to you following your surgery. Always take prescriptions according to the dosing instructions and follow all warning advisories.
Swelling and bruising around the mouth and on the cheeks is common and typically peaks around the second or third day following surgery. Handle swelling by applying a cold compress or an ice pack wrapped in a towel or cloth.
We will schedule follow-up appointments with you to check on the healing progress of your new dental implants.
If you notice the implant sites bleeding significantly after the first day, please call us at (972) 539-1491 and let us know.