When it comes to replacing missing teeth, there are a variety of options to choose from, including dental implants, bridges and dentures. The pros and cons of each treatment should be weighed along with your dentist’s recommendation when deciding which option to pursue
Dental implants are widely viewed as the optimal restorative option for missing teeth given their aesthetic qualities and durability, but given the fact that a single implant can cost upwards of $3,000 or more, the cost can be prohibitive for many patients when a full arch of teeth or all teeth (full mouth reconstruction) is required. Dentures are far more affordable, but many people hold a negative view of dentures, viewing them as passé and not wanting to deal with the potential gum and mouth irritation, or the associated maintenance hassles of removing and cleaning.
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Well, what if you could get a fully reconstructed arch using only six or even four implants instead of the eight you usually need? This is the basis for a popular trend in dentistry called implant supported dentures and branded in various ways such as \"All-on-4 Implants\", \"Pro Arch Implants\", \"Teeth Tomorrow\" etc.
How Do Implant-supported Restorations Work?
The core functionality of implant-supported dentures/bridges is not really any different from traditional implants. A titanium or zirconia implant is surgically placed in the jaw where it can fuse with the surrounding bone (a process called osseointegration) and serve as an artificial tooth root. What makes the implant-supported full arch variant special is the fact that a minimal number of implants support the replacement of all 16 teeth in an arch. This allows for the same sort of aesthetics and support that you get from traditional implants for a fraction of the cost when it comes to arch reconstruction.
Another difference relates to the manner in which the implants are placed. In the case of All-on-4 implants, in order to provide maximum support, two anterior implants are placed near the front the mouth, and two posterior implants are placed farther behind. The anteriors are placed in a traditional, straight manner, whereas the posteriors are tilted at a 45 degree angle. The reason behind the tilting of the posteriors is to avoid the need of a bone graft. Such grafts are relatively common if the patient does not have enough bone density to support an implant. The angled posterior placement of All-on-4 and other implant-supported full arch restorations therefore helps simplify the procedure and reduce costs by taking bone grafts out of the equation.
Understanding the Procedure
The procedure itself can vary depending on the specific brand of full arch implant-supported restoration you opt for. But to give an idea of what’s involved, let’s take a look at the All-on-4 process step by step:
Step 1: An initial consultation to evaluate your oral health and determine your treatment options. If you are a candidate for an implant-supported denture, your dentist will evaluate some of the functional and aesthetic aspects of treatment, including the length of the crowns required, bite placement, etc. 3D imaging (cone beam computerized tomography – CBCT) can help analyze anatomical structures involved with treatment, namely the jawbone, to determine if any reshaping is required.
Step 2: Using the 3D imaging of your mouth, your dentist will prepare a computer simulation of treatment, which will identify exactly where the implants will be placed for optimal support. (Fabrication of a surgical template may also be done at this stage to help serve as a guide.)
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