The Complete Guide to All On 4 Dental Implants
This is content you will not find anywhere else on the internet. This content is written and produced by Dr. Reza Khazaie, DDS, founder of Willow Pass Dental Care, the leading dentist in Concord, CA.
Dr. Reza Khazaie is a nationally known prosthodontist who is regarded amongst his peers and patients as the smile expert. Dr. Khazaie is an expert on the specialized treatment of dental and facial problems that involve restoring missing teeth and jaw structures. He is a highly trained specialist in dental cosmetics, dental implants such as the All On 4® treatment concept, bridges, dentures, implant-supported dentures, dental crowns, porcelain veneers, Ectodermal Dysplasia, TMJ/TMD, and many more dental procedures.
So if you’re looking to learn as much as you can about All On 4 dental implants, you’ll love this guide.
Are you ready? Let’s dive in.
Part 2: About
What Are All On 4 Dental Implants?
The All On 4 dental treatment concept originated in 1988 when Dr. Paulo Malo successfully treated the first patient with what has become known as the All On 4® dental implant treatment concept. Since then there have been over 3,500 dentists across the United States, including our own, Dr. Reza Khazaie, DDS of Willow Pass Dental Care who have followed in Dr. Malo’s footsteps. They are highly trained dental specialists who have devoted themselves to mastering dental restorations and facial problems that involve restoring missing teeth and jaw structures with treatments such as the All On 4® dental treatment concept, dental implants, crowns, bridges, dentures, TMJ/TMD, and many more.
They are known as Prosthodontists.
Prosthodontists – The Architects of the Smile
Prosthodontists are dentists who specialize in the field of Prosthodontics. They are often referred to as the “architects of the smile.” They are highly trained dental specialists who have devoted years to additional specialty training to become dental restoration specialists (Prosthodontists) and are often referred to as the “quarterback” of the dental team in executing the treatment plan, such as the All On 4 treatment concept.
The All On 4® treatment concept is the best solution in the marketplace for full-arch treatment using tilted implants. There are many imitation treatment concepts in the marketplace that try to compete or compare to the All On 4 treatment concept but none have the scientific documentation to back up the groundbreaking innovation of the All-On-4.
Characteristics of the All On 4 dental implant treatment concept?
The characteristics of the All-On-4® treatment concept are what makes it popular for those who seek to restore their smile.
It is cost-efficient compared to conventional dental implants
Conventional dental implants can be two to three times more costly. The All On 4 treatment concept has been refined using technological advances with its full-arch rehabilitation using only four implants. Unlike conventional implants, in which each dental prosthetic requires its own implant, the All On 4 dental treatment concept replaces an entire arch (16 teeth) with only four implants. Implants are strategically embedded, two straight anterior implants in the front and two implants in the rear that are tilted at 45-degree angles, in order to take advantage of areas that naturally contain more bone. These four implants support a prosthetic bridge, or arch, upon which artificial teeth are attached.
It is a graftless solution
When bone depth is inadequate for a conventional implantation procedure, a bone grafting procedure will be necessary. Bone grafts add cost and recovery time and can be quite invasive. The All On 4 treatment concept avoids a grafting procedure in most instances since the posterior implants are installed at a 45-degree angle. The healing process from a bone graft can take 3 months or longer. The All On 4 treatment concept eliminates this entire ordeal for most patients and allows you to leave surgery with a full set of new teeth!
Smile in a day --- due to shorter treatment time
With the All On 4 dental implant treatment approach, our patients often receive a brand new smile in just a single day. This is the beauty of a streamlined implantation procedure in which only four implants per arch are necessary. Due to the advances in technology teeth are often fabricated while Dr. Khazaie and his dental team of specialists are preparing your mouth and jaw. This leads to returning to full-functionality and a beautiful smile before you leave Willow Pass Dental Care.
All On 4 Dental Implants can last a lifetime
The All On 4 dental implant can often last a lifetime. They won’t accidentally fall out and they look completely natural. More importantly, the All-On-4 treatment concept contributes to improving your health by preventing underlying jaw bone loss or bone absorption.
“I guarantee you I will give you the best care available. I will restore your mouth and your teeth to their highest potential.”
Part 3: Getting Started
Getting Started with All On 4 Dental Implants
Deciding on All On 4 dental implants is exciting but potentially confusing. On the one hand, All On 4 dental implants are simple in principle: only four implants support an entire arch of brand new teeth. However, the process of obtaining dental implants can often be confusing. To remove the confusion to the process following are some steps patients should take before the actual All On 4 implant operation, placement, and fitting. This preoperative process is essential for determining the overall success of any All On 4 treatment procedure.
One of the biggest draws of All On 4 dental implants is the speedy execution and implementation. Many patients can receive load-bearing prosthetics in just a single sitting. The entire All On 4 surgical procedure, from start to finish, can often be accomplished in one day. Of course, before receiving All On 4 dental implants patients will often undergo a preliminary evaluation to determine their suitability for the procedure. This critical process includes evaluating a patient’s aesthetic and functional needs and desires, a physical examination, and, if necessary, preoperative and preparatory work.
While the ability to produce a beautiful set of brand new teeth for our patients in just a single day is technically impressive, there are essential preliminary steps we recommend to our patients for health-safety and quality control reasons. It is our goal at Willow Pass Dental Care to provide not only a seamless and comfortable patient experience, but also achieve perfect results.
That’s why preparation is essential.
The Initial Steps to All On 4 Dental Implants
1. Initial Consultation
A vital first step in every patient All On 4 journey is an initial consultation. Think of it as a mutual interview to determine the goals and objectives as well as to bond between the doctor and patient. Remember, we consider each and every one of our All On 4 patients to be like our extended dental family. That means that we’ll be there for you from the very beginning of the All-On-4 procedure through the life of the prosthesis. The initial consultation is a good opportunity for our customers to get to know our doctors and staff, to review options, to determine any potential obstacles, and to provide answers to all questions.
2. Professional Oral Examination
The initial consultation is typically followed up with a thorough professional medical examination. While the initial consultation is primarily intended for our patients to get to know us and to express their wants and desires, the oral examination allows us to get to know our patients existing oral and dental conditions. Understanding existing conditions is critical for developing a personalized treatment plan unique to each patient. The professional examination also gives our doctors the information they need to design an All On 4 plan that will produce the best results.
An important component of the oral examination consists of diagnostic imaging including x-rays and 3D computed tomography (CT) scans. The data produced will directly impact the patient’s individualized treatment plans and help guide the planning and execution of the implantation process.
3. Obtain digital mockups
With specialized imaging technology and in-house fabrication equipment, it is possible, based on the information obtained during the initial consultation and professional exam to produce digital or physical mock-ups of each patient’s individual All On 4 prosthetic. Mock-ups allow patients to visualize what their new teeth will look like and give both the patient and the doctor an opportunity to evaluate options and if necessary make adjustments. During the process, dental impressions and oral scans may be required.
Mockups provide our team with a quick, cost-effective way to visualize a patient’s All On 4 dental implants and improve the treatment plan before execution.
4. Pre-operative work
In some patients, preparatory dental work may be necessary before receiving All On 4 dental implants. Pre-operative work can include a bone graft, dental extractions of remaining teeth, cleaning of extraction sites, and preparation of the underlying bone to receive implants. Edentulous patients will likely not need to undergo extensive preoperative work.
Pre-operative Planning is the Key to Successful All-On-4® Dental Implants
Willow Pass Dental Care can provide All-On-4® dental implants in a single day, including planning, execution, and final fitting. However, it is important to emphasize the importance of pre-operative planning in the overall success of an All-On-4® procedure. We don’t take any shortcuts when it comes to the preparatory stage. An implant that is placed even the slightest bit out of place or off-axis can result in a failed implementation. In-depth preoperative planning allows Dr. Khazaie and the team of doctors to plan precisely how and where each implant will be located to maximize the strength and stability of the All-On-4® prosthesis.
These four steps will remove any confusion and ensure that our patients receive a seamless, comfortable All-On-4® experience with beautiful results.
Part 4: Advantages
All On 4 Is An Affordable Long-Term Investment
When it comes to costs, the All On 4 dental implant procedure can be very affordable. When budgeting for a dental procedure, patients should be careful to consider not only the cost of the procedure but also the associated expenses, such as follow-up appointments, maintenance, repairs and replacements, auxiliary procedures, as well as productive time lost during recovery.
This approach is known as the Life Cycle Cost (LCC). Many patients make the unfortunate mistake of comparing only the “sticker price” for tooth replacement strategies while forgetting or neglecting the associated long-term costs. When it comes to choosing the best teeth-replacement strategy, this can be a costly mistake.
For example, some patients hesitate in considering the All On 4 or traditional dental implants due to comparing price head-to-head with other procedures like acrylic dentures. They fail to recognize that acrylic dentures must be replaced fairly regularly, sometimes as often as every two or three years, while a properly executed implant procedure can provide a beautiful permanent solution that can last a lifetime. After a few rounds of replacing ill-fitting, uncomfortable acrylic dentures, many patients will agree that dental implants start to make a lot of financial sense.
Similarly, a patient could be tempted to opt for inexpensive implants from a cut-rate dental clinic or chain. Failing to consider that, should the implant fail due to improper placement or poor execution by the dentist due to a lack of experience, skill, or both, the costs of reparative dental work could end up costing the patient far more than they would have initially saved.
When considering the life cycle costs, the All-On-4 dental implants are a great long-term solution for a long-term problem: replacing natural teeth with permanent, functional replacement teeth that can last a lifetime. Look at your teeth like an investment that, while more expensive in the short-term, pays off richly over time with quality teeth, a beautiful smile, and a healthy, enhanced and vibrant lifestyle.
Advantages of All On Four Treatment
A cost-effective solution
Your new replacement teeth require only four dental implants for each jaw. With fewer dental implants required, the cost is lowered. Prices for cosmetic dentistry procedures are determined by several factors such as quality of final restorations, type of anesthesia patient prefers for surgery, whether bone grafting is necessary, and if there are teeth that need to be removed. At Willow Pass Dental Care we work with our patients to help design the best smile within a patient’s budget. The All-On-4® provides flexibility in price based primarily on the quality and grade of the final restorations. Also, due to the more efficient and less time-consuming nature of the All On 4 procedure, treatments for full mouth reconstruction often cost significantly less than similar processes executed with conventional individual implants.
The reasons for this are simple. First as previously mentioned, All-On-4 dental implants require fewer implants and, therefore, less surgical intervention, less of the doctor or surgeon’s time, and less recovery time.
Second, All-On-4 dental implants only require four (4) implants per arch or a total of eight (8) implants for complete teeth replacement. In comparison, conventional individual implants for a similar full mouth reconstruction would require a staggering 32 implants or four times as many implants. Furthermore, with a traditional approach, each tooth not only requires it’s very own implant, but it also needs its own crown. Once the costs of performing 32 individual implants have been tallied up, the number far exceeds what one could expect from All On 4 dental implants. On the flip side, All On 4 dental implants will also cost much more than the average denture. Dentures require no surgery and can often be mass-produced with minimal customizability. However, dentures do not come close to providing the same benefits that implant-based teeth replacement solutions offer.
Reduced surgical scope
Many patients, whether for health reasons or just out of a concern for safety, prefer to reduce and limit invasive surgery as much as possible. All-On-4® dental implants provide a full-mouth replacement solution with as little intervention as possible. Rather than penetrate the tissue and bone of the mouth for each tooth, the All-On-4® treatment dramatically reduces the number of implants necessary. That means less surgery and, as a result, less pain and discomfort. Also, All-On-4® dental implants allow most patients to skip bone grafts altogether.
Reduced need for bone grafting
Dental implants must be firmly anchored into the underlying jawbone and allowed to osseointegrate to be successful. As a result, patients that lack adequate jaw bone depth, density, or overall bone health must first undergo a bone grafting procedure before receiving individual implants. Bone grafts require that bony material to be removed from one part of the patient’s body, typically the hips, and placed underneath the soft tissues where jaw bone depth is considered inadequate. The grafted bone is then allowed to heal and osseointegrate to provide a firm foundation for future implants. As one would imagine, a graft procedure is a major surgical intervention in itself. Recovery from a grafting procedure can take two weeks to as long as three months depending on the severity of the bone loss in the jaw.
With All-On-4 dental implants, patients can often skip bone grafts altogether. With an All On 4 treatment, four implants per arch are strategically located in areas of the mouth where the bone is naturally deeper and denser. Two are located in the front of the jaw while two more are located in the rear of the jaw. One of the groundbreaking innovations of the All-On-4 treatment plan was to angle the rear implants to take advantage of naturally deeper and denser bone in the back of the mouth. When combined with an All-On-4 bridge, these four implants provide the support and stability necessary for a full set of brand new teeth.
Faster treatment and healing time
Your replacement arch can be attached to your dental implants immediately after insertion.
Scientifically proven and documented. The All On 4 treatment concept is supported by good clinical outcomes from studies over a decade with favorable results. One of the most appealing advantages of opting for All On 4 dental implants is speed. Many patients can receive surgery and a set of temporary All On 4 implants in a single day.
In other words, patients can completely reshape and remake their smile in just one appointment! Of course, a follow-up appointment is required for the final restorations and necessary adjustments to ensure a perfect fit. Nonetheless, compared to undergoing full mouth reconstruction utilizing conventional implants, All-On-4 dental implants are much more streamlined and, thus, reduce not only surgery time but also the likelihood of complications resulting from surgery.
Remember, with All-On-4 dental implants the prosthodontist needs to place a total of eight implants at most. These implants can be immediately ready for use. Replacing a full set of teeth with conventional implants requires 32 individual implantation procedures and a lot more time in the dental chair.
All On 4 dental implants provide some of the best dental aesthetics in the marketplace. Like high-end traditional dentures, the visible All-On-4 prosthetic can be customized to suit each patient’s needs and wants. Utilizing materials such as titanium and acrylic allow for excellent aesthetics at a very affordable price. Opting for more premium materials, such as all-zirconia can provide more durability as well as a very aesthetic appeal. Customized bridgework hand-crafted and designed for each individual patient blurs the line between functional industrial design and high-end custom art.
Part 5: Price
What Influences The Price for All On 4 Dental Implants?
What Influences The Price for All On 4 Dental Implants?
- Number of teeth requiring extraction
This has minimal impact on the overall price for your implants.
- Sufficient bone for implant
If there is not enough bone for implant it may be necessary for a bone graft to build up the bone. This can be a major impact on the costs of dental implants.
- Whether implants are needed for the upper jaw, lower jaw, or both.
- CT Scan
A CT scan is highly recommended. The cost is minimal.
- Preferred sedation (oral, intravenous, or general anesthesia)
Oral is the least expensive and is quoted in our price. If you choose intravenous (IV) sedation the costs are higher. General anesthesia is the most expensive.
- Level of implant surgery required
Level 1: If you have adequate bone in your jaw to place dental implants, Level 1 will apply to you. About 80 to 85% of patients will fit into this category.Level 2: If you have adequate bone or substantially-sized upper sinuses, Level 2, which is more costly will apply to you. About 5 to 10% of patients will fit into this category.Level 3: If you lack quality bone for dental implants, Level 3 which is most expensive, will apply to you. This category will apply to about 3 to 5% of patients.
- Same day teeth
- Final restorations
There are several options to consider for your final teeth from less expensive titanium and acrylic resin teeth to very expensive powerhouse options such as titanium and zirconia. So if cost if a driving force in the decision, then an acrylic resin is generally more cost-effective. If cost is not the driving force, then Zirconia is a very reliable option. If, you only want the very best you have several other options to consider.
Cost of All On 4 Dental Implants vs. Other Tooth Restoration Options
- Traditional dentures allow for easy replacement of all your missing, rotten, or damaged teeth.
- Traditional dentures are less expensive than many other available tooth replacement options.
- Traditional dentures give you excellent flexibility in eating a variety of foods that before were not possible due to missing or damaged teeth.
- Traditional dentures reduce the likelihood of developing jaw problems or adverse changes in your bite.
- Traditional dentures are often inconvenient and require intricate adhesives.
- A full upper denture appliance may block, limit, or partially cover the palate reducing your sense of taste and pleasure in food and eating.
- There is a risk of atrophy in the jaw bone since traditional dentures are not anchored in the jaw bone.
- Contaminated dentures pose a variety of health risks. If traditional dentures are not cleaned properly and on a regular basis, there is the chance of infection or gum disease. Soak, brush and rinse regularly.
- Traditional dentures can be troublesome to control in your mouth.
- Denture breath is always a risk without using a denture adhesive. Proper maintenance will kill 99.9% of odor-causing bacteria.
$800 – $15,000
- Snap-on dentures are more secure than traditional dentures mentioned above, and they are also removable.
- With snap-on dentures, there is no need to extract healthy natural teeth.
- Snap-on dentures fit over any remaining healthy teeth and attach directly to them with a snapping action, creating a secure and comfortable fit.
- If some natural teeth are missing, dental implants can be embedded into the gums and act as a support for the snap-on dentures.
- They are less likely to impede or rub against the gums and create irritation since the snap-on dentures attach to the teeth or dental implants and not the gums.
- Snap-on dentures are less costly than partial or complete denture implants.
- Some existing teeth may require filing into a shape to have a better anchor for the snap-on dentures.
- The fit may not remain as snug over time due to changes in the mouth or gum line. A big negative is this could require a whole new set of snap-on dentures.
- Snap-on dentures often take six months or longer to get a final set.
- Snap-on dentures are substantially large and bulky.
- Snap-on dentures need constant maintenance and replacement. They only last from 2 to 10 years.
$3,000 – $17,000
Traditional Dental Implants
- Traditional dental implants offer durability and permanence. Once the implant procedure is complete, your teeth are permanently affixed to the jaw and do not easily get loose.
- A prosthodontist can make dental implants look and feel like natural teeth.
- Dental implants are much more comfortable because they look and feel just like real teeth with no telltale “clicking” noises that often are a complaint with denture wearers.
- You care for your dental implants the same way you care for your real teeth — with regular dental visits and proper oral hygiene.
- Dental implants are much more expensive than other newer tooth restoration options. This reason alone is why it is often considered as a last resort.
- Dental implants aren’t a quick fix like the All-On-Four dental implants. Traditional dental implants often require a 1 to 2-year process from start to finish.
- Traditional dental implants are not suitable for everybody.
$50,000 – $95,000
All On 4 Dental Implants
- Restore an entire smile with only four implants.
- Treatment involves only one surgery.
- Get a full set of new teeth in as little as one day.
- Many people regain joy, comfort, and confidence by replacing missing teeth with All-On-Four dental implants.
- Secure placement deep in the jawbone, so implants will not shift or loosen over time like with snap-on dentures.
- There is usually no bone graft that is necessary.
- 90%+ chewing ability is restored
- Lower cost than any other treatment alternative, making it easier to replace teeth with the affordable All-On-Four dental implants.
- A high level of bone is necessary to hold dental implants securely in place.
The All-On-4® dental implant is the most state-of-the-art solution for patients who are missing teeth, whether due to neglect, illness, accident, or disease. This revolutionary dental approach replaces your missing, damaged, or rotten teeth with a full dental bridge. It is a permanent solution supported by as few as four dental implants per arch. The implants are placed at a precise angle to provide the most stability in the bone.
It is a permanent result that is supported by as few as four dental implants per arch. The dental implants are placed at a precise angle to ensure ideal stability in the jaw bone.
This method provides a permanent lasting solution from the first day. You will leave Willow Pass Dental Care with new teeth that will look and function just like natural teeth. You will be able to enjoy smiling, chewing your food, and resume your life with confidence and joy. After 3 to 6 months of healing time, your new permanent teeth are placed.
Choosing The Right Doctor
“My final upper All-On-4 arch (even after the surgeon gave me an All-On-6) is awful! Definitely not worth the $30,500 in cash I paid up front. I have 12 ‘teeth’ which takes up only the front half of my mouth. I don’t have any molars, just an inch of pink gum material in the back. My bite is off and chewing food is awful! They’ve changed the shape of my jaw and now my mouth looks sunken because of the lack of molars which I had at my first visit.”
“I also had a single implant on my bottom jaw that I never received a temporary for. I expected the look and function of actual teeth. Dr.”
“Kim told me the final would look like my real teeth with veneers. OMG so far from the truth!”
Not All Dental Implant Specialists Are Created Equal
Unfortunately, this is not a rare circumstance. We see patients on a consistent basis at Willow Pass Dental Care who have had similar experiences as Kim, many who come to us after an All On Four dental implant failure from well-known dental chains or “professionals.”
When it comes to your mouth and your health you should not take chances. The following are steps to ensure you are dealing with a professional who has the experience and knows what he or she is doing.
Following are 9 steps I recommend for choosing the right All-On-4 dental implant specialist:
Does the Prosthodontist have the knowledge, skills, and experience with dental implants?
One of the easiest ways to determine if a prosthodontist is right for you is to do a simple check of their professional credentials.
Do the prosthodontists have the proper credentials, designations, certifications, awards, accreditations, and up-to-date training to show that they are the best at giving you the care you deserve?
Does the Prosthodontist and office have a good reputation?
When you see 213 total reviews for Clear Choice, with $770,000 in claimed losses and an average of 2.3 out of 5-star reviews, that is not the kind of office to you whom you want to entrust your teeth and smile. Sure, you can always find a critical or bad review from time to time. It’s when you find a lot of them that you need to take notice.
Does the prosthodontist provide you with useful resources and case studies of their own?
One of the greatest things about the Internet is that all brands stand naked in front of their customers. Not literally, thankfully, but there is transparency in the marketplace. We all have access to all the information we want. Check out the Prosthodontist. Is there published material and resources that provide you the confidence that he or she is talented and skilled at what they do?
Does the Prosthodontist have a support staff of dental specialists?
The prosthodontist is like the quarterback of the team. They lead in the execution of the dental treatment strategy. A proper team of specialists will include a prosthodontist, oral surgeon, dental hygienist, and dental assistant. If you look carefully you will see reviews where patients speak in awe of the team. A great team works together and it shows.
Meet the prosthodontist and team of specialists.
It is hard to fathom but some patients never meet the team until the day of surgery. I recommend you take the time to meet the team prior to committing to a dental office or prosthodontist. Make sure you are comfortable and that you’ve done your research about the office as well as the doctor.
Discuss with the prosthodontist specific case studies you read online.
Ask which case study best resembles your situation and what are the challenges he or she expects. If there are challenges that are expected have the prosthodontist explain the treatment strategy and what the risks are.
Ask for a tour of the office.
Know where the surgical setting will take place and what it looks like. Observe the equipment in the room. Is it clean and comfortable? Are the facilities updated or outdated? Ask if the equipment used is the latest dental in dental technology. If so, they should have equipment such as a 3D scanner and at least one CAD/CAM machine and milling unit for designing your restorations. This is important to know and can save you money and lots of time.
Pricing should be transparent.
You should not have to experience any hard sell. The pricing for All-On-4 should be easy to compute based on these factors. If you find it hard to determine what quality you are paying for and what your price includes, you should leave.
Local vs. Dental Chains
I believe being locally-owned and operated like Willow Pass Dental Care brings us much closer to our patients. We are involved and part of the community. This also results in a higher retention of patients versus dental chains who tend to focus on volume rather than providing ongoing dental care. Many dental chains offering All-On-4 dental implants are less skilled and experienced and assemble a dental team based on the cheapest price rather than providing the best in talent, experience, and skill. When it comes to your smile, including your mouth and teeth, it is best to invest in a doctor with the experience, knowledge, and skills to produce truly successful results.
Part 7: Popularity
Why 98% of Patients Would Recommend All On 4 Dental Implants
Success Rate: Results Speak For Themselves
Patients who have received the All-On-4 treatment concept to replace missing, damaged or otherwise unsatisfactory teeth overwhelmingly recommend the treatment. That’s no surprise as the All-On-4® concept provides the functional and aesthetic benefits of dental implants but at a significantly reduced price and with less surgical intervention. These are two of the many advantages of opting for an All-On-4® teeth-replacement procedure over other alternative teeth-replacement solutions.
The most popular argument for choosing All-On-4 dental implants are the results. It’s hard to argue with teeth that are perfect, beautiful, and flawless. All-On-4Dental Implants provide an ideal smile that patients of Willow Pass Dental Care seek. They want teeth in a day that are affordable and with results that speak for themselves.
If you are struggling with bad teeth, whether as a result of bad genes, an accident, or simply a case of bad luck, All-On-4 dental implants more than likely will be an excellent solution for you! Not only is the All On 4 a revolutionary step in the field of cosmetic dentistry, but it is also the procedure of choice for patients looking for long-lasting, beautiful results with a single surgical operation.
Top 5 Reasons Patients Overwhelmingly Recommend All On 4 Dental Implants
1. The All On Four can provide you with new teeth in a day.
Very few surgical procedures can provide as noticeable a visual enhancement as an All-On-4 dental implant procedure. Your smile is more often than not the one feature that people notice first, remember, and will find themselves irresistibly attracted to without fail. That’s why investing in cosmetic dentistry is often the cosmetic procedure of choice for many celebrities, socialites, and people just like yourself. With the All-On-4 treatment plan, even those on a tight budget can now get brand new teeth without waiting months or years by undergoing multiple dental procedures.
2. The All On 4 does not require bone grafts.
One of the most significant advantages of the All-On-4 treatment concept is that it solves a problem that has plagued the field of cosmetic dentistry for decades. That problem was how to provide beautiful, functional replacement teeth for older patients who may lack adequate bone depth or density. Conventional dental implants require a certain jaw bone depth and mass to be embedded successfully. In the old days, patients who wanted perfect new teeth or who were looking to replace missing teeth either qualified for conventional implants or had to make do with traditional dentures. Those days are now over!
The All On 4 provides lasting results
Implant-based solutions have inherent structural advantages over other tooth replacement treatments. Traditional dentures, for example, rely on suction to remain in place. This solution of the past, while it works most of the time, doesn’t work all the time, which can result in embarrassing moments. Implanted prosthetics stay in place, remain stable over decades, and last longer with minimal additional maintenance. For lasting results, choose an implant-based solution such as All-On-4 dental implants.
The All On 4 provides flawless aesthetics
The All-On-four provides some of the best cosmetic aesthetics in the dental field. The visible replacement teeth are custom-crafted, color-matched, and fitted to each patient’s mouths providing a unique, personalized solution for every customer. Materials such as dental grade porcelain or zirconium give replacement teeth natural depth, shine, and character that would be difficult to achieve with pure acrylics. Of course, with precise craftsmanship and attention to detail, even acrylic can be made to look flawlessly natural and remains an economical option for more budget-conscious consumers.
The All On 4 has supreme functionality
All-On-4 Dental Implants are designed to not only look like natural teeth but to work like them too. Implants transfer the forces of biting and chewing into the underlying jaws which lend them to a more natural feel and look in the mouth.
Furthermore, because the implants are osseointegrated into the jaw bone itself, the entire prosthetics become a standard, functioning extension of your natural teeth and a perfect replacement.
Part 8: Challenges
The Challenges of All On 4 Dental Implants
All-On-4 Dental Implants: Not Perfect, But Close
Many of the biggest challenges with All-On-4 dental implants are also highly situational. The vast majority of patients will have a superb aesthetic and functional experience with All-On-4 dental implants. From the first consultation to the day of surgery to the final fitting, All-On-4 patients report overwhelming satisfaction.
Studies show the procedure to be a highly reliable and effective way to treat edentulism or toothlessness with an over 98 percent implant survival rate but there are some obstacles that may require additional attention.
5 Challenges of All-On-4 Dental Implants
1. Minor surgery is required
All-On-4 dental implant therapy does require one surgical appointment for the placement of supportive implants. During this appointment, the prosthodontist and the surgical team executing the procedure will have to cut into the soft tissues of the gums in order to access the underlying bone. With the digital and dental technologies available today, it may be possible to accurately penetrate the gums and bone with minimal impact. In fact, in comparison to conventional individual implants, All On 4 dental implants are recommended precisely because of the substantially reduced surgical impact.
As is the case with any surgical procedure, All On 4 implants have potential procedural risks. All On Four dental implants, for example, require the use of anesthetics and analgesics and comes with a predetermined recovery period. As with any medical procedure, consult your prosthodontist about the risks of receiving treatment and explore alternatives to find the best treatment option for you.
2. Improper placement could result in a damaged bridge
One of the innovations that make the All-On-4 treatment concept viable is the use of an intermediary bridge upon which the dentition is placed. This allows the prosthodontist to drastically reduce the number of implants required. One potential hazard is any damage to any part of the bridge prosthesis may require a completely new bridge replacement. This is why it is important to make sure your treatment procedure is completed by a highly skilled oral surgeon and prosthodontist for proper fitting and use.
3. All-On-4 dental implants require a highly-skilled prosthodontist
One of the most complex parts of the All-On-4 procedure is determining the prosthodontist with the proper skills and experience to provide the best All On 4 treatment. Correctly executing an All On 4 procedure requires a high degree of skill, talent, and experience. This often can be an obstacle for patients since there are only 3,500 prosthodontists throughout the United States.
4. All-On-4® dental implants are permanent and require precise placement
All On 4 dental implants are a permanent solution to edentulism. This is a substantial advantage over more transient alternatives, such as traditional dentures. However, if an All-On-4 procedure is executed poorly or if post-operative issues arise, it can result in implant failure. Once embedded in the jaw, misplaced implants, even those that are placed a fraction of degree off, can result in pain and multiple issues. That’s why choosing the right prosthodontist is most critical.
5. Peri-implantitis in rare cases can occur
In very rare cases, at no fault of the prosthodontist or patient, implants can fail. Typically, this is because the implant has failed to integrate into the underlying bone or because the soft tissues around the implant have developed a condition known as peri-implantitis. While rare, studies show that 5 percent of all implants, both for All-On-4 and conventional implants, may fail as a result of peri-implantitis. If peri-implantitis becomes a problem, there are options patients can pursue ranging from antibiotics to surgical resection to bone regeneration techniques. In extreme cases, the implant may have to be extracted for further treatment options.
The Biggest Factor In All-On-4 Success: Choosing the Right Prosthodontist
By far, the biggest indicator of success is having the right prosthodontist with the at the helm of your All-On-4 implant procedure. The right prosthodontist makes all the difference.
Remember, not all dentists are the same and not all dentists are prosthodontists who are qualified and trained to provide All On 4 dental implant treatments. Patients should seek out board-certified implant specialists with the American College of Prosthodontists (ACP) recognition.
All On Four dental implants are a permanent personal investment that can give patients a brilliant, brand new smile, new beauty, and priceless new confidence in themselves. However, like all cosmetic surgery, skill and knowledge are key. Choosing the right prosthodontist to perform the procedure ensures that your All On 4 investment is sound and will provide a vast improvement in day-to-day functions and continue to give you joy for decades to come.
Part 9: Procedure
The All On 4 Dental Implant Procedure
What You Need to Know About The All-On-4 Procedure
The ultimate goal of the All-On-4 procedure is to replace missing, damaged, or otherwise unsatisfactory teeth with implant-supported dental prosthetics. Typically, this can involve either a top or bottom arch or, more commonly, both arches at once. The All On 4 procedure is a comprehensive rehabilitation and remaking of a patient’s smile to provide dramatically better aesthetics and functionality. It is also referred to as the smile makeover.
A complete smile makeover utilizing All On 4 implants begins with an initial consultation with Dr. Khazaie to determine the patient’s needs and desires. This first meeting also gives the patient the opportunity to ask questions, discuss concerns, and outline the strategy for how the procedure will benefit the patient.
Following the initial consultation, if the patient is determined to be a good fit for an All On Four treatment plan, preparations can begin immediately. Impressions of the mouth may be taken followed by diagnostic imaging tests such as a 3D CT scan and x-rays.
Data about the existing conditions of the patient’s mouth will be gathered, analyzed, and used for the creation of immediate, load-bearing prosthetics.
Mock-ups and other pre-surgical models may be produced at this time to provide the patient with a visual of the anticipated outcome of the final product.
With all the data gathered and reviewed, the next step is the surgical procedure itself.
The 5 Phases of an All On 4 Dental Implant Procedure
The All-On-4 procedure consists of four distinct phases as described below.
1. Site Work & Extraction
The first step in the surgical portion of an All On 4 procedure is to prepare the mouth to receive dental implants. This means that the patient is sedated and any remaining existing teeth are extracted, if necessary. The gums and soft tissues are then cleaned. Remnants of debris or diseases are removed. A dental alveoplasty may also be essential for some patients to provide a smoother jawbone surface for the treatment procedure.
2. Implant insertion
Four dental implants are embedded into the jaw at strategic locations in each arch for a total of eight implants for patients receiving complete mouth reconstruction.
For the upper arch, two implants are located in the front of the mouth in the cortical bone beneath the nose where dental bone is naturally strongest. Another two implants are inserted at an angle, tilted distally, in the back of the mouth. These tilted implants engage the mesial wall of the sinuses for superior spread stability.
For the lower arch, the same implant strategies apply with two implants located towards the front and two in the rear tilted at an angle. Implant insertion location and angles are unique to each patient and are heavily influenced by the data gathered during pre-surgical consultations.
Once the implants are anchored in place, multi-unit abutments are affixed to the implants to provide a mounting point for the visible dental prosthetics. These abutments provide a uniform platform to perform the reconstructive prosthetic procedure.
Dental bridge attachment
Finally, with both the implants and abutments in place, a temporary load-bearing bridge prosthetic is put in place. This bridge is retained with tiny screws. The temporary bridge provides a functional and aesthetic prosthetic placeholder until a final, beautiful set of teeth can be fabricated. Some offices, like Willow Pass Dental Care, possess the equipment to manufacture dental prosthetics in-house, significantly reducing the time between the initial consultation and a final set of perfect teeth.
Finally, with the implants and associated dental prosthetics in place, Dr. Khazaie will perform “touch-up” work to ensure flawless aesthetics and a functional fit. This period of adjustments may include gum recontouring to provide better visual aesthetics or modifications to the fit and bite of the dental prosthetics themselves.
Part 10: Surgery Checklist
Day of Surgery Checklist
Day of Surgery Checklist
On the day of the All On 4 implant surgery, it is essential to be prepared. The following is a list of what you will need to bring with you to ensure a successful and comfortable treatment procedure:
Checklist for Day of Surgery
- Medical & dental insurance information
- Payment method (credit card, debit card, or check)
- Comfortable, loose-fitting clothing
- A driver to ensure that you get home safely
- Painkillers or personal medication as recommended by Dr. Khazaie
It is also important to be aware of what NOT to do before an operation. In general, these are things you should NOT do:
- Do NOT smoke
- Do NOT consume alcohol
- Do NOT eat a large meal
- Do NOT take certain medications, such as blood thinners
- Do NOT undergo surgery if you are ill
- Do NOT wear jewelry or makeup as it will only get in the way
Part 11: Considerations
All On 4 Dental Implant Considerations
While All-On-4 Dental Implants are an excellent and the preferred teeth replacement treatment for most patients, the technique is not without a few minor considerations. Patients should be aware that the best teeth replacement strategy for their individual needs will depend on a variety of factors including the current condition of their teeth, budget, and overall health. The All On 4 treatment is suitable for most patients, but not for everyone.
4 Things You Should Consider
1. All-On-4 Dental Implants Are More Expensive than Traditional Dentures
All-On-4 dental implants are a cost-effective alternative to conventional individual implants when it comes to replacing missing teeth. However, All On 4 dental implants are still more expensive than traditional dentures. Most dental professionals will agree that the benefits provided by All-On-4 dental implants are by far worth the additional costs.
However, each patient is unique. Elderly patients may not wish to undergo implant surgery. Others will find that traditional dentures more than meet their needs.
All On 4 dental implants can range in price from $10,000 per arch to $50,000 or more depending on the level of finish required and materials selected.
Meanwhile, an economical traditional denture can be had for as little as a few hundred dollars. A custom set of dentures crafted from the best materials may run as high as $7,000. The average price of a typical set of dentures, however, only costs between $800 to $2,000 per plate.
2. Less Room for Error
Because the entire dental prosthesis, or dental bridge, found in an All-On-4 system relies on just four implants, there is little room for error. Each of the four implants must be correctly placed and seamlessly integrated into the underlying jawbone. If even a single implant fails, the prosthesis may likely require refitting. In comparison, traditional dentures which are effectively plug and play, and conventional implants can be individually replaced as needed.
3. Requires expert execution
As a result of the high degree of expertise and skills required to execute a successful All On 4 procedure, finding a qualified dental specialist (Prosthodontist) can be difficult and expensive. Remember, All On 4 dental implants are a challenging surgical intervention that should not be attempted by a general dentist. While some unscrupulous practitioners may claim to provide All On 4 treatments, always opt for a true expert to get the best results.
4. Entire bridge prosthetic must be replaced if damaged
One of the most significant drawbacks of All On 4 dental implants is its monolithic nature. The entire system is effectively composed of four dental implants and a single dental prosthetic piece known as a bridge upon which all the teeth sit. What this means is that should a single tooth be chipped, damaged, or otherwise in need of repairs, the entire prosthetic must be removed and refitted. This can be troublesome should there be damage to the dental bridge.
How To Prevent All-On-4 Dental Implant Failures
The primary and best way to prevent an All-On-4 Dental Implant failure is to select a prosthodontist with experience in providing All On 4 dental implants and a track record of successful operations.
Skill, experience, and credentials are crucial to minimizing any potential complications during and after surgery. While the most skilled and experienced providers may be in high demand, it is worth the wait or the extra costs, if necessary. Remember, the cost to remediate or repair failed implants can be as expensive or even more expensive than the cost of an All On 4 procedure itself.
Other underlying causes of All On 4 failures include lifestyle choices, such as smoking and alcohol use, and neglecting to follow proper maintenance and care routines. After All On 4 dental implants have been fitted, doctors will typically provide the patient with postoperative care instructions. These instructions usually include directions for routine hygiene, dealing with postoperative issues including bleeding, swelling, and pain, as well as diet, medications, and necessary follow up visits. It is essential to follow all of the prosthodontists’ instructions to minimize the risk of implant failures and to maximize the longevity and beauty of your brand new smile!
Part 12: Innovation
Innovative & Easy
Getting a brand new smile is as easy 1-2-3!
The All-On-4 dental implant solution receives exceptional reviews when it comes to consumer satisfaction, and it is our honor to offer this cutting-edge service to our patients at Willow Pass Dental Care.
The All On 4 dental implant is an innovative restoration procedure that has revolutionized the way surgeons, and prosthodontists go about replacing a full set of damaged or missing teeth.
Standard dentures are unsecured prostheses that bring along inherent limitations. Most often, dentures are painful, inconvenient, and unstable which often make chewing foods difficult thereby limiting the foods that you once enjoyed.
Today there are better options available.
The All On Four dental implant treatment replaces your missing teeth with a full dental bridge supported by only four dental implants. With fewer implants needed, overall treatment time and cost are reduced. The unique All On 4 dental implant concept ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume.
Typically, a temporary set of teeth can be placed on the same day of surgery. The temporary teeth allow you to lead a normal life immediately after surgery.
After a short healing period, your prosthodontist will place the final bridge.
The result — your quality of life is improved and you can begin enjoying your favorite foods once again with renewed confidence.
A Full-Mouth Solution
Partial and complete edentulism, or the lack of teeth, as a result of tooth loss, is a major problem for many Americans.
The American College of Prosthodontists (ACP) estimates that 178 million Americans are missing at least one tooth. An astonishing 40 million Americans suffer from complete edentulism and are missing all of their teeth! One-third of all adults over the age of 65 have no natural teeth. As an interesting economic aside, research shows that tooth loss results in $63 billion dollars of lost productivity globally as a result of dental downtime.
On a more personal level, tooth loss can have profoundly adverse effects on the emotional well-being of many individuals. As perhaps one of the most visible signs of aging or a lasting reminder of a traumatic incident or period of illness, missing teeth can engender feelings of sadness, fear, and even depression.
Tooth loss bites.
However, there are solutions to the problem of missing teeth. Surveys show that although untreated edentulism had a negative emotional impact on most subjects, 90 percent of those treated for their edentulism with prosthetics reported acceptance of their tooth loss and higher levels of satisfaction. Did you know that it is entirely possible to replace all of the teeth on either your lower or upper jaw with only four total implants? Indeed, All-On-Four dental implants offer a third solution, a middle path if you will, between the two common conventional treatments for tooth loss and missing teeth: individual dental implants and traditional dentures.
Let's Compare: All-On-4 vs. Dentures vs. Traditional Dental Implants
Individual dental implants were once the gold standard for an effective treatment for tooth loss. Individual implants mimic the natural look and function of natural teeth, last a long time, and offer better comfort. The process, however, is incredibly time-consuming, labor-intensive, and as a result, prohibitively expensive. Individual dental implants are also not right for everybody. For the titanium screws that are embedded into the jaw to fuse properly with the jaw, there must be sufficient bone already in place.
Traditional dentures are one of the most common and most economical solutions to tooth loss. 5.25 million sets of complete dentures are made every year for those suffering from edentulism. While popular, traditional dentures can be a hygienic nightmare. They are also prone to shifting, breakage, and can cause ulcers on gum tissue, all of which result in daily discomfort. From a medical standpoint, dentures also do not adequately stimulate facial bones.
Unlike individual implants and All-On-Four dental implants that are embedded into the jaw bone itself and transfer the weight of each bite into the bone as natural teeth do, traditional dentures merely rest on the gums. This lack of stimulation to the jaw bone actually causes it to waste away over time changing a person’s facial structure.
A third and better solution: The All-on-4® Dental Implants
The All-On-4 procedure offers a much simpler, much more affordable alternative to individual dental implants while retaining many of the same strengths, including near-natural aesthetics, longevity, functionality, and comfort. Instead of individually implanting each replacement tooth, the All On 4 procedure only calls for four strategically placed implants (typically two near the front of the jaw and a second pair placed at an angle near the back).
These four implants then support a bridge upon which all of the replacement teeth are permanently attached. Once these titanium implants fuse with a patient’s bone, it essentially becomes a part of his or her mouth and a natural extension of the jaw. Thus, unlike conventional dentures that rest on the gums, All On 4 dental implants behave like a natural set of complete teeth.
Once healing is complete, you can eat, drink, and chew whatever you want, whenever you want, wherever you want.
Dental implant costs for the All-On-4 Dental Implants
All On 4 dental implants will be more expensive than conventional dentures, but significantly less costly than opting for individual implants.
Ultimately, total costs will depend on the experience of the dentist you select for this procedure, your overall dental health, the type of implant selected, and the quality of material used for the prosthesis.
Also, diagnostic tests may be required (X-rays, CT scan, etc.) and whether or not additional procedures such as a bone graft or sinus lift are necessary.
One of the great benefits of opting for an All-On-4 procedure compared to conventional individual implants is that bone grafts most often are not required. This significantly reduces the complexity of the process and recovery time. Depending on the dental clinic you select, the All On Four procedure can often be completed in a single day!
Part 13: Care
How To Care For Your All On 4 Dental Implants
Just Like Natural Teeth
All-On-4 dental implants are functionally very similar to natural teeth. Many if not most of the same daily care and maintenance routines that work well for natural teeth also work great for dental implants.
Just like natural teeth, routine brushing and flossing are also recommended for All On 4 dental implants. Just like natural teeth, regular visits to a dental clinic such as Willow Pass Dental Care for professional cleaning, at least once every six months to one year, will also help to prolong the life of your dental implants.
The reason implants and natural teeth are so similar goes beyond just form. Not only do implants mimic the visible portion of a natural tooth in the form of a dental crown, but they also mimic the roots. This critical component of the implant assembly, the part that is hidden beneath the gums and embedded into the underlying bone, is what gives All On Four dental implants their stability. More importantly, thanks to the use of biocompatible metals and alloys, such as titanium, implants can be osseointegrated into the bone itself.
This is why caring for All On 4 dental implants is relatively straightforward. Generally, the same good dental hygiene habits and routines that work for natural teeth will also work for dental implants. However, while dental implant may look, act, and feel like natural teeth, some important distinctions that need to be considered.
One Big Difference
While functionally very similar to natural teeth, dental implants and natural teeth do have some differences that impact dental care.
The soft tissues surrounding natural teeth commonly referred to as the gums form a tight seal around the hard surface of the tooth. This seal prevents bacteria and food debris from penetrating the gums and forming challenging to reach infectious pockets below the gums.
When this seal has failed, or bacteria is allowed to penetrate the gums, periodontal diseases can occur. While dental implants mimic the physical structure of a natural tooth, it does not precisely reproduce the tight natural seal between healthy gums and natural teeth. Specific procedures such as gum recontouring can help, however, because the soft tissue seal around a dental implant is generally looser, there is a higher probability of developing a unique form of periodontitis known as peri-implantitis. Like dental periodontitis, peri-implantitis is an infection of the soft tissues around a tooth. In patients with dental implants, untreated peri-implantitis can lead to bone loss around the implant, and eventually, implant failure.
As a result of this critical difference between implanted teeth and natural teeth, it is essential to keep the area around an implant clean and free of both food debris and bacteria. Some doctors recommend removal of as much as 85 percent of all bacteria from the area around the implants daily.
6 All-On-4 Care & Cleaning Techniques
Exceptional cleanliness around the area of dental implants is critical for the long-term success of the implants and good oral health.
1. Check-in with your dentist regularly
Routine dental checkups at Willow Pass Dental Care is essential no matter who you are. However, for patients with All On Four dental implants, regular checkups with Dr. Reza Khazaie is highly recommended.
During a routine checkup, will allow Dr. Khazaie the opportunity to remove your All-On-4 implants for proper and thorough cleaning. This also gives Dr. Khazaie the chance to examine the condition of the underlying soft tissues and identify any potential problems before they become a serious concern.
Properly designed and fitted prosthetics should leave a minimal gap between the gums and the dental bridges. Even well-designed and executed prosthetics may still collect tiny bits of debris and bacteria over time. Visiting Willow Pass Dental Care for teeth cleaning will provide the preventative care necessary to prevent potential issues such as peri-implantitis.
2. Brush and floss daily
3. Floss gently
Flossing is still important. However, patients with All-On-4 dental implants should floss very differently than they would with natural teeth. Floss very gently around implants with a coated floss product if possible.
Regular uncoated string floss can rub off microscopic pieces that become attached to the implants. Over time, these bits of floss can cause irritation, inflammation, or worse, result in an infection.
4. Use a rubber tip
Very few patients have heard of gum simulators, also called rubber tips. Even fewer know how to use this essential dental tool effectively. All-On-4 patients will want to add this versatile and vital tool to their daily dental hygiene routine.
To use a rubber tip effectively, patients should gently rub the gum stimulator in a circular motion along the gumline. The pointed tip can be used to remove food debris and plaque from between the teeth.
5. Use a water pick
A water pick also known as a water or oral irrigator is an excellent tool for reducing biofilm and plaque around implant sites.
Research shows that a water pick alone isn’t very useful unless it is used in conjunction with daily brushing, flossing, and other recommended cleaning devices.
6. Use an Interdental Brush
An interdental brush, sometimes called a proximal brush, is a small, Christmas tree-shaped brush that scrubs off plaque and biofilm in between teeth.
Be sure to get nylon-coated interdentals as uncoated metal brushes can scratch or damage the implant, the All-On-4 prosthesis, and even surrounding soft tissues.