Hello, I'm Dr. Alex Mat here at Matheson Dentistry & Implant Center. Today, we're going to be talking about and answering some questions about All-On-4 or All-On-X dental implants. We'll discuss what it is, who's a candidate, and hopefully answer some questions you have about the procedure.
Dr. Matheson, what is the difference between All-On-4, All-on-X, and some of the other similar terms?
It's good to know there's some terminology in this. All-on-4, All-On-X, teeth express, implant, dentures. There are many names out there that people will see online. It's good to know what all that means. All-on-4, which is a very common phrase that you'll see online, is actually a trademarked name. It's trademarked by an implant company called Nobel Bioare. They developed it many years ago and lots of other implant companies are in the game with various names, but it's basically the same thing. It's where someone who has had all their teeth removed has dental implants placed in the jawbone, usually between four to six of them.
You need a minimum of four, hence the name All-On-4. These implants will hold on to a prosthetic that looks like teeth, so when you smile and chew, it looks and functions like teeth. There are many names out there, but they're all talking about a similar thing.
How is all-on procedure different from traditional dental?
Dental implants have been around for a long time and have been used to replace teeth for many years. You can use implants to replace individual teeth. The All-On-4 treatment is where we're using only between four to six implants to replace all the teeth in that particular jaw, whether it's the top or bottom jaw, or both. You're going to use about four to six. Although you have more teeth than that, usually either 14 or 12 per jaw, you're only using a few implants to support the weight of all those teeth.
Are All-On-4 denture implants a good option for seniors?
All-On-4 denture implants or All-On-X are a great option for seniors. Unfortunately, as people age, they tend to lose teeth, making it harder to eat, talk, and socialize. People are sometimes embarrassed by how it looks. It's been very gratifying in my career to see seniors, in some of the best times of their lives, who struggled dentally because they were missing teeth or using dentures, receive teeth that don't come in and out, look great, and allow them to eat an apple. It's life-changing for so many people, and it's been rewarding to see people's lives change.
Are All-On-4 implants suitable for patients with bone loss?
The All-On-4 or All-On-X procedure was designed for people with significant bone loss. I've often had people come into my office who have been told, "You don't have enough bone to do this." I highly recommend you come in because we've done this procedure on many people who were told they didn't have enough bone.
One of the cool things at Matheson Dentistry is our ability to place implants robotically. We can thread the needle, so to speak, with our implants and get them into tight areas where it would be more difficult without robotic guidance. If you're worried about not having enough bone, I recommend you call the office and schedule a no-cost consultation so we can discuss if this procedure is right for you.
What does the All-On-4 dental implant process involve?
The all-in-four or All-On-X dental implant process is quick and easy. The hard part is done in one day. We'll put you to sleep, remove any remaining teeth, place the four to six dental implants per jaw, and make the temporary teeth. They're 3D printed in our office. We design and 3D print them, then screw them onto the implants, and you go home that day with teeth that don't come in and out.
We allow that to heal for about four months. After four months, we discuss any aesthetic changes you want to make. We want this to look great and tailor the smile to you. In the second phase, when you're healed, we'll talk about aesthetics again, make changes, take new scans of your jaws, and ensure the prosthetic fits against your gums intimately. We'll make a new temporary based on the changes, let you wear it, and once you're satisfied, we'll use that same computer file to mill the teeth out of zirconia and screw that in. That's pretty much it.
How long does the All-On-4 procedure take?
The All-On-4 procedure takes about four months. There are a couple of parts to the All-On-4 procedure. The first is the surgical phase, which takes one day. You'll come into our office, typically start early in the morning, around 7 o'clock, and be here most of the day. The surgery part is done, then we'll 3D print the teeth, which takes a couple of hours. We screw the teeth in, and you'll be here most of the day for that first visit, especially if doing both jaws. If it is only one jaw, it'll be quicker. We allow that to heal for four months, and after four months, we'll make the final teeth. That process is much easier, usually not requiring numbing, and it's not a surgical procedure. It ends up being about a five or six-month procedure once completed.
How many visits are required for the All-On-4 procedure?
There are a few required visits. The first visit is where you and I will discuss the procedure and specifics to you. We'll take initial records, digital impressions of your jaws, and pictures of your face and mouth to design what we want the teeth to look like. The second appointment is the surgical procedure, where our anesthesiologist will put you to sleep, remove any remaining teeth, place the dental implants, and 3D print the teeth. That's the big appointment.
We'll typically have you in for about two more appointments. We'll see you the next day to ensure you're doing okay and your bite is good, as you'll be groggy and numb after surgery. We'll see you again about two weeks after surgery to monitor healing and show you how to start taking care of it going forward.
The first two weeks, you won't brush or floss, only use a prescription mouth rinse. At the two-week mark, we'll show you how to start brushing and flossing. After four months, we'll make the finals, which could be three appointments or more, depending on aesthetics. But it's usually about three or four appointments for the finals.
Are All-On-4 implants a permanent solution for missing?
All-On-4 or All-On-X implants are a permanent solution to replacing teeth. The traditional way of replacing teeth when you have none is a denture. A traditional denture is not bolted into your mouth. It doesn't stay in, except for some who get a suction cup effect onto the roof of their mouth. Oftentimes, people use denture adhesives, which can be gooey and unpleasant. The All-On-X or All-On-4 or teeth express procedure is a more permanent solution to replacing teeth.
What is the difference between full arch implants and the All-on-4 procedure?
Full arch implants and the All-On-4 or All-On-X procedure can overlap in terms of what people mean. But there's another procedure in dentistry called the fixed prosthetic one or FP1. This usually involves six or more implants instead of four and focuses on replacing just the teeth, not the gums. In the All-On-4 or All-On-X procedure, also called an FP3 (fixed prosthetic three), we're replacing teeth as well as gums, so there's some white and pink on the prosthetic. In the FP1, where we're placing six or more implants, we're just replacing the white part, the teeth. There are pros and cons each way, and some people are candidates for both, some only for one. If you have questions, call us for a no-cost consultation to discuss which option is better for you.
What are the advantages of All-On-4 dental implants over other tooth replacement options?
The big advantage of All-On-4 or All-On-X dental implant teeth over other tooth replacement options is that it doesn't come in and out. While we can remove it when you come in, at home it stays put, like your regular teeth. Other tooth replacement options, like full dentures or partial dentures for those with remaining teeth, are removable. Removable options can be sore, may cause gagging, and can cover the roof of your mouth or go under your tongue. These are common complaints about removable dentistry versus fixed prosthetics using dental implants.
What do before and after results on all important dental implants look like?
Before and after results can be very striking. We'll go ahead and put a few before and afters up right here. It makes a huge difference for people. When people have been missing a lot of teeth, it can deform their face, making cheeks and lips look sunken. After the all-in-four procedure, it can give people that life back, making their face look more normal, which is very gratifying for both the patient and the practitioners.
How do all implants improve oral health and quality of life?
Many people suffer from missing teeth, called edentulism. Missing teeth make it harder to chew, speak, and socialize. When you're missing teeth, especially front teeth, it can be embarrassing and cause people to avoid socializing. It's really sad to see that, but the gratifying part of my job is providing people with a permanent solution for tooth loss, where it's not removable. It changes people. I've talked to many who were afraid to go out with friends and socialize, but with this solution, they're creating more friendships and relationships. It's one of the most gratifying aspects of my career, helping people get these on X permanent solutions for tooth loss.
What are the potential problems or complications on board?
Like any surgery, there are potential complications, and it's important to discuss these. Schedule an appointment at our office, and I'd be happy to talk about potential complications. One common complication of dental implant therapy is that implants can fail to integrate into the bone. Depending on the study, dental implants are about 98% successful, meaning out of 100 implants placed, two might fail to integrate. This can happen, but it's usually not a big deal because we try to place more than just four implants.
If one fails and we don't need it, we might just remove it and continue. If we need the failed implant, we'll replace it, and you'll be in the temporary phase a bit longer. Another rare complication is that implants might not torque at a certain value. If an implant is placed into the jawbone and it's like drywall, it might just spin. If we can't get four implants to torque at the right value, we delay placing teeth. You won't leave the office without teeth; we'd print a traditional denture for the four-month healing period. This is rare, happening only a handful of times in my career. Other potential complications include numbness after implant placement, which is usually temporary and goes away after a few days or weeks. In the rarest cases, it lasts longer. These are some potential issues, though not very common.
What is the cost of All-On-4 dental implants?
The cost of All-On-4 or All-On-X dental implants is important, and I recommend you come in for a free consultation to discuss it, as it might differ between individuals. The cost in the market varies greatly, from area to area, state to state. It can range from around $10,000 to as much as $50,000 or $60,000 per jaw. If you have questions about the cost, I highly recommend you make an appointment for a no-cost consultation where we can discuss the cost for your case.
What is the recovery process like after getting All-On-4 dental?
The recovery after an All-On-4 or an All-On-X procedure is usually pleasantly surprising, especially compared to getting a denture. When teeth are removed and a denture is placed, healing takes time and can be painful, as the denture sits on the surgical site. The nice thing about an all-in-four is that it's not resting on your gums. It's supported by the implants embedded in the jawbone, so people do better postoperatively than with dentures. There will be some pain after surgery, and we'll work with you on that, providing pain medication to make you comfortable as you heal. Pain and swelling usually peak around day three after the procedure, then subside. Recovery varies from person to person; some feel better after a week, others after a couple of weeks. But usually, the first few days are the most painful, and we have good pain medication to help you through that.
And how long do All-On-4 dental implants typically last?
Many people ask how long this procedure will last. My hope is that it will last a very long time. It depends on us doing our job well and you doing your job. We need to place the implants correctly, perform the surgery well, and make a good prosthetic. On your part, you need to keep it clean. We want you to come in every six months to see one of our hygienists to keep the prosthetic clean. We'll show you how to clean it daily by flossing and brushing. We encourage using a water pick after two months of healing to help keep things clean. If you do your part and we do ours, it will last for years to come.
What type of care and maintenance do All-On-4 implants require?
All-On-4 or x dental implants require maintenance. The main thing is daily cleaning, involving brushing and flossing. We encourage getting a water pick, which helps. You should come in every six months, as you did with your natural teeth, to see our hygienist and ensure no tartar buildup. Occasionally, we may remove the prosthetic to see all the parts underneath and ensure everything is well. But that won't be every time you come for a cleaning. Most visits will involve the hygienist keeping your teeth clean. These are the things you'll need to do going forward.
I hope I was able to answer some of your questions about All-On-4 or All-On-X dental implants. If you have further questions or think this procedure might be right for you, please call us at Matheson Dentistry for a no-cost consultation with me, Dr. Mat. I'd be happy to sit down with you, take an X-ray, ensure everything looks good regarding your bone, and discuss what this procedure will look like for you. I'm excited to help you get the smile you've been dreaming of.
If you live in or near Queen Creek, AZ, and are looking for dental care, contact us at (480) 888-8123 to set an appointment. Our staff would love to talk with you!