All on 4 Dental Implants: A Guide To Full Set Teeth Replacement

All on 4

An advanced, cost-effective procedure that can transform your smile and allow you to eat foods you never thought you’d eat again. The Sydney Implant Institute can deliver you a new set of teeth in as little as a day.

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What is an All on 4 (AO4)?

All on 4 dental implants are an innovative and increasingly popular procedure whereby an entire set of broken down, loose, painful or missing teeth are replaced with a new set of fixed teeth. The new teeth are supported by just four dental implants, which are inserted into the jaw bone.

A cost-efficient and permanent solution that provides a fixed, full-arch prosthesis. Implants are fixed and do not need to be removed

Surgery is usually completed in one day and the teeth are issued that evening or the following day

Fewer surgical appointments means faster recovery time and less trips to the dentist!

Recommended by 98% of patients who see a rapid improvement in function, aesthetics, speech and self-esteem*

How does All on 4 work?

An All on 4 replaces an entire arch of teeth (upper or lower) with four dental implants and a fixed bridge. If you need the upper and lower teeth replaced, there will be eight dental implants and two bridges. Before All on 4, we used six to ten implants per arch of teeth and usually with a large amount of bone and gum grafting.

All on 4 utilizes the bedrock bone in front of the sinuses in the upper jaw and in front of the dental nerves in the lower jaw. Bone grows into the implants allowing them to be fixed and able to support teeth. The back implants are angled which means we use the good bone in the front part of the jaws. This angulation also allows the top of the implant to be in line with the position of a first molar, meaning we can replace 12 teeth (first molar to first molar) with just 4 implants and no bone grafting.

The All on 4 technique importantly allows the implants to be further apart from each other as well. This means the implants are surrounded by more healthy bone and gum and they do not disturb the blood supply in the bone around adjacent implants.

The use of only 4 dental implants means the force is spread evenly along the bridge making it stable much like the 4 legs of a table. The bridge also splints the implants together which prevents them from moving independently, this is why we can put teeth on the implants immediately in all on 4 where it usually takes 3 months in conventional implant treatment.

All this means, fewer implants, less cost, healthier implants, less surgery and fewer visits.

Is All on 4 right for me?

The experienced surgeons at the Sydney Implant Institute can conduct a thorough examination to determine the best course of treatment for you. All on 4 may be the best option for you if you are suffering from one or more of the following:

You have teeth that are breaking down, loose or painful
You have a denture that you can’t wear
You have no teeth at all
Your teeth are failing and you want your smile transformed in as little as a day.

The All on 4 technique is a full mouth dental implant technique for the upper teeth, lower teeth or both. If there are teeth that can be saved we often recommend a more conservative approach, we can show you all the ways we can transform your smile when you come in for your complimentary consultation.

Most people are healthy enough to undergo an All on 4 procedure at The Sydney Implant Institute. There are very few medical conditions that preclude you from being treated with an All on 4, however we still do a thorough medical history and check and will often involve your GP if necessary.

Age should not be a concern, we have performed All On 4 on patients as young as 24 years of age and as old as 91! If you are healthy and your teeth are in the condition to warrant it, you can be treated with an All On 4.

The best way to really find out is to book in for your complimentary consultation which includes;

Thorough medical and dental screening for suitability
Digital radiography and digital surgical planning
Full photographic work up
Moulds taken for study and assessment models
Tailor made treatment planning including all treatment alternatives and costs.

Dental AO4 Bridges (Initial and Upgrades)

Your All on 4 bridge can be made from a number of different materials. Everyone undergoing an All on 4 at The Sydney Implant Institute will initially be issued a metal reinforced acrylic bridge. We utilise Sydney’s most specialised and premium dental laboratory to fabricate our bridges. Located just up the road in Macquarie street Assia and his team (see video) use Phonares premium teeth and high impact Ivocap acrylic to create a beautiful and durable bridge. This bridge is included in the initial All on 4 cost.

After a period of 3 months to 2 years you will usually need to change your bridge to one with a stronger material.
As a rule the more premium the bridge, the stronger the material is and therefore the thinner the bridge can be.

Acrylic and Titanium

Also known as a “hybrid” bridge, this bridge utilises a custom milled titanium substructure to support the same material and teeth the initial bridge was fabricated from. The main difference between this bridge and the original bridge is that the strength is obtained from the titanium substructure, not the bulkiness of the acrylic.

The titanium substructure is manufactured in Sweden by Nobel Biocare and carries a ten year warranty from the manufacturer. Our technicians then overlay the titanium with high-impact acrylic and the very aesthetic Phonares teeth.

This bridge is light, thin and aesthetic, the disadvantages are that it still can wear as all resin/acrylic based materials do and that in extreme impact situations, will not perform as well as the porcelain based materials.

Porcelain

Zirconia All on 4 Bridges are recognised as the best quality bridge in the industry. Zirconia bridges are solid, long-lasting, visually appealing and function more like your natural teeth as compared to other types of bridges.

Zirconia bridges are milled from Zirconium, a super hard and durable material. Our technicians then make the bridge bespoke by cutting back the zirconium and adding layers of highly aesthetic porcelain to give the bridge the translucency and natural look of pure enamel and untouched teeth.

Zirconia Porcelain Bridges are a great solution for younger patients, heavy bruxers (tooth grinders) and those after the highest aesthetics modern dentistry can offer. Because this material is so strong the bridge is thin and the most natural looking and feeling.

As with all our bridges, the shape, position and colour is determined by our patient’s wishes and decided upon after a consultative process involving our patient, the technicians and our team.

All on 4 treatment process

Complementary Consultation:

Digital and surgical planning
Cone beam 3D scan taken
Take impressions of your teeth
Medical history checks
Evaluate your teeth for implant placement

Second consultation:

Discuss your questions about the procedure with our team

Review of digital smile design and picture of final outcome

Full discussion surrounding treatment options and costing

Presentation of similar cases and patient journeys

Tooth colour and shape selection

Any additional radiography, photography or measurements

All on 4 dental implant procedure:

Review and discussion with the medical doctor performing your sedation
Checking into the recovery suite where you will be based after surgery and where you will be able to secure your belongings
Final review of the procedure and the day ahead with your surgical team. Pre-op medications will be given.

You will be given the anaesthetic which will mean you will not remember anything and it will make the surgery seem as though it has taken 5 minutes.
After you are sedated you will be made numb and any remaining teeth and infection will be removed before commencing the All on 4 procedure.
During the procedure the jaw bone will then be flattened to enable the fitting surface of the bridge to be smooth. This also ensures that when you smile the junction between the All on 4 bridge and your gums cannot be seen. It also removes the dirty and infected bone that often surrounds the necks of the teeth. This process is called an alveolectomy.
Four dental implants are then placed on the upper or lower arch (or both) according to the pre-designed surgical guide. Abutments (connectors) are then fitted to the implants before the gums are sutured back over. These abutments go through the gums and connect the implants to the bridge.
Once you have woken up, the surgical guide is then attached to the abutments by titanium cylinders. This allows our team to assess the look and position of the teeth before the bridge is made.
Copings are then placed onto the abutments in order to take impressions of the implants and surrounding tissues. This is then picked up by our master technicians who spend the rest of the day, or overnight (if upper and lower), creating your custom fitting bridge.
That evening (4-6pm) the bridge is then screwed into the abutments and the bite is evaluated and adjusted. We are now working on the implants so there is no need for anaesthetic and the procedure is painless.
Post operative instructions are then explained to your carer and you and printed for later revision. Prescriptions, ice packs and a mouthwash are included in your take home pack.
Our team will contact you in the next two days to see how you are doing.

Post Operative Review:

At the 2 week mark we take the bridge off, remove the sutures and evaluate the healing process. The bridge is replaced and the bite and aesthetics are again checked. The access holes for the screws are then sealed with a resin material.
Your dedicated oral health therapist then goes through the cleaning process at length with you. You will be shown how to best maintain your All on 4 and look after your bridges.

Finally at a 6 month review we evaluate your All on 4, the way it is wearing and how it is being cleaned. A final healing check is done and a review of maintenance and a clean is done with your oral health therapist. You can also discuss upgrading your bridge and the alternatives at this appointment.

All on 4 pre operative care

You must fast (no food or drink except a few sips of water) from midnight the night before surgery
Do not drive yourself to or from the surgery and please be accompanied by someone. They will likely want to go for a walk or leave the surgery while you are in surgery and recovering. They can go home and come back before the bridge is issued if that is more convenient.
If you have any questions, write them down so you can ask the team before surgery.
Discuss your medications with your dentist, GP or sedationist prior to taking them before the procedure .
Wear comfortable, loose fitting and warm clothing.
Bring an Ipad or something to read if you’d like and a secure bag for your belongings

All on 4 before and after

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Before After

Before After

Before After

Before After

Before After

Before After

About Full Mouth Dental Implants