Dental Implants: All-On-4s at Smiles of Mathews
Hello, my name is Dr. Aaron Marks. I'm the dentist at Smiles of Mathews in Hudgins, Virginia. Today I'm going to be answering some questions about what we call all-on-four or all X teeth, dentures, implants. It has a few names.
What are All-on-4 dental implants and how do they work?
All-on-4 or All-on-X. We say X because sometimes we use six implants. Four is the minimum. Six is usually the most I've ever done or needed. It just depends on the size of what we're working with. There are dentures that screw into the implants, and they don't come out. They're much more aesthetic and functional.
How is the all procedure different from traditional dentures?
They're not much different. It's the same type of implant. We're just using it in a different way. The implant itself is replacing the tooth root. If we're doing an individual tooth, that's just the little titanium screw that goes into the bone, which the crown then goes on top of.
Who isn't qualified to get All-on-4 dental implants?
The restrictions are those where we determine who can and who can't or who is and who isn't qualified for them. If you're diabetic and it's uncontrolled, we're hesitant to place implants. If you're a smoker, we're hesitant to place implants. If you've had head and neck cancer, we're hesitant or radiation. If you're on a bone therapy medication, commonly called bisphosphonates, we're also very hesitant. Not necessarily a no-go, but something to be very aware of and discuss with your dentist regarding the pros and cons and risks and benefits.
Who is a good candidate for All-on-4 dental implants?
A good candidate would be someone who doesn't have diabetes, isn't a smoker, and either has existing dentures or doesn't want to take care of what they have left due to various issues. You might just want to cut and run, which is totally valid. I've taken care of many people like that, and they're very happy with the outcome.
You don't have to worry about decay anymore because you don't have teeth. However, you need to keep them clean to prevent gum disease, which is a risk with implants.
Are All-on-4 dental implants suitable for patients with bone loss?
It depends on the amount of bone that's missing. Generally, that's why we do those because you don't have a whole lot of bone left or very minimal, and conventional dentures don't stay in or have a very hard time staying in.
Would All-on-4 dental implants be a good option for seniors?
Yes.
What is the onboard implant process involved?
The process depends on where we're starting. If you don't have any teeth or have current dentures, I generally use those existing dentures as a temporary while waiting for things to heal. The first step would be placing the implants where we determine they need to be.
You definitely want to be somewhere that the dentist takes a CT scan. Don't want to be doing this type of work without that.
What is the procedure for All-on-4 dental implants?
We put the implants in and attach the temporary dentures to those implants most of the time. Sometimes there are instances where we can't do that. But our goal is to place those dentures and screw them to the implants.
We then let things heal for 3 to 6 months. Once healed and all the implants are solid, we proceed to make the final hybrid dentures.
This is a multi-step process, and everyone handles it a little differently depending on their workflow. I usually go through the steps of making a prototype. You'll wear that to ensure the color, shape, and shade are correct before making the final. The final is more aesthetic and longer lasting. The prototype is a try-in phase to make any necessary adjustments.
How long would the actual procedures take?
Depending on what we're doing, if we're going from no teeth to a hybrid, it can take four to five hours, largely due to waiting for lab work for the denture to be attached to these implants. If we're extracting the majority of the teeth and need to do bone grafting and placing the implants, that's a whole day.
Are All-on-4 dental implants a permanent solution?
It is a permanent solution as long as the implants aren't rejected or get infected.
How do All-on-4 dental implants help?
The ability to chew is what we're after. Many studies show that conventional dentures give about 10 to 20% chewing efficiency. They also reduce your ability to taste because they cover the roof of your mouth. You have to hold your facial muscles in a certain way to keep them from moving around.
Quality of life is reduced because most people can't eat as much or the types of foods they like. Hybrid dentures, the all-on-four, all X, are super solid because they're attached to your skeleton. They're very strong, allowing you to eat pretty much whatever you want.
What is the recovery process like from All-on-4 dental implants?
The recovery process varies for everyone, but you will have pain the first day with the surgery. You'll be put on antibiotics and pain meds. I also provide some topical solutions to help with swelling and a special multivitamin formulated for bone building in this situation.
How long do All-on-4 dental implants last and what is the maintenance?
They should last the rest of your life, depending on the material they're made from. The ones I use most commonly are zirconia, a very strong material. There are others, but I like zirconia because it's aesthetic and strong.
Maintenance-wise, you'll need regular cleanings because tartar will collect on the appliance. Once a year, usually, we'll take the whole appliance out, unscrew it, clean it, ensure all the implants are still good, and clean around the implants where they come through the gums.
If you’re looking for dental care you can trust, call us at (804) 294-4362 or email [email protected]. We’re here to help you have the smile you've always wanted!