All-on-4
All-on-4 is a dental concept for edentulous patients to anchor a fixed dental prosthesis on four dental implants. Only titanium is suitable for the material of the implants; a fixed All-on-4 is not possible with ceramic implants.
Procedure for All-on-4
Edentulous patients receive four dental implants in each jaw. A horseshoe-shaped dental prosthesis is firmly connected to the inserted implants with screws. The screwed prosthesis remains immobile anchored in the jaw and can only be removed by a dentist.
Advantages
- Lower costs, as fewer implants are used.
- Shorter surgery duration compared to eight implants.
- Bone augmentation can often be avoided due to the angled position of the implants and the prosthesis.
Disadvantages
- Only titanium implants can be used.
- Unfavorable loading of the bone.
- Bone resorption continues between the implants.
- Food residues can remain under the prosthesis, affecting hygiene. Bad breath, gum inflammation, and peri-implantitis can be the result.
- A gap between the fixed dental prosthesis and the gums can cause difficulties in speaking, and unwanted hissing may occur.
- The horseshoe-shaped prosthesis blocks the entire jaw. Physiological movements in the area of the sutures are no longer possible.
- Aesthetics are limited, and the restoration often looks unnatural.
- The screwed prosthesis frequently leads to a foreign body sensation in the mouth.
Do we recommend the traditional All-on-4 concept?
No. In our opinion, the All-on-4 method has too many disadvantages for patients.
We do not offer this concept in our dental practice. To avoid the drawbacks and to provide a edentulous patient with a fixed restoration without compromises, a minimum of eight dental implants per jaw is required. Read more about All-on-8.
Even the All-on-6 concept is insufficient to achieve a permanently stable fixed solution with ceramic implants.
Alternatives to All-on-4
The choice of alternatives depends on whether the patient prefers a fixed or removable dental prosthesis. Generally, we recommend a permanently stable, fixed restoration in most cases.
- A satisfactory fixed restoration for an edentulous jaw can only be achieved with a minimum of 8 implants per jaw. Read more about All-on-8.
- A removable restoration with a dental prosthesis can be achieved with 4 to 6 ceramic implants.
Dr. Tobias Steinherr M. Sc.
With the All-on-4 concept, four implants are used for your dental restoration. We are happy to show you the advantages and disadvantages.
Further information
Here you will find further information on the subject for a deeper insight.