All-on-Four Implant-Supported Dentures

How are All-on-Four Dentures Different from Other Dentures?

In our previous blog, we discussed options to replace missing teeth for someone who has lost all of their teeth, including traditional dentures and implant-supported dentures.  Both of these treatment options are removable.  The dentures are removed from the mouth to clean and are typically left out overnight.

There is another treatment option for replacement of an entire arch of teeth, and the difference is that it does not require removal of the denture: a fixed-hybrid denture, commonly referred to as “all-on-four”.  This name is based on the traditional procedure of four implants placed into the jawbone to support a dental prosthetic which replaces all of the teeth in that arch.  The procedure is not limited to four implants, and sometimes more than four implants are used to adequately support the new teeth.

How are All-on-Four Dentures Different from Implant-Supported Dentures?

There are two main differences between all-on-four dentures and implant-supported dentures.

  • The implant-supported dentures we discussed in our previous blog have better retention by locking onto an invisible attachment hidden underneath the denture and do not rely only on the shape of the bony ridge and muscle control to stay in place, as a traditional denture does.  However, they are still removed for cleaning and left out overnight.  The patient is able to easily remove these dentures.  An all-on-four denture is not removable.  The prosthetic teeth are fixed to the implants by retaining screws by the dentist and are only removed by the dentist when needed.
  • The other difference between implant-supported dentures and all-on-four dentures is the angle of the implants. Implants placed in implant-supported dentures are placed to direct biting forces along the implant body.  Implants used in all-on-four are angled quite differently in order to create stability.  In a typical all-on-four case, the two front implants are straight, and the two back implants are placed at up to a 45° angle.  This angulation utilizes available bone instead of requiring a bone graft.

What are the Benefits of All-on-Four Dentures?

  • Immediate Teeth – A temporary prosthetic is placed over the implants the same day the implants are surgically placed.
  • Increased Comfort – Because of the support received by the implants, it is not necessary for the all-on-four denture to have bulky extensions into the lips, cheeks, under the tongue, and onto the roof of the mouth.
  • Improved Appearance – Because it is much smaller in size than a traditional denture or an implant-supported denture, an all-on-four denture can create a more natural appearance of the face.
  • No Need for Removal – Because the all-on-four dentures are retained by screws, which are tightened and covered by the dentist on the day of placement, the patient is not able to remove them. This creates a closer simulation of natural teeth, reducing the emotional complications that come with losing all of one’s teeth.

What is Required to Get Started with All-on-Four Dentures?

Pre-operative planning is a critical step in all-on-four denture treatment.  A three-dimensional scan of the jawbone allows Dr. Chowning to use precise measurements to prescribe the proper location for the four implants.  The prescribed location of the implants is translated from the three-dimensional planning software to the mouth via a surgical guide.  This guide ensures the correct placement of the implants and the perfect fit of the provisional denture.  Once the implants are in place, a provisional denture is attached to the implants.  This temporary prosthesis allows a patient to have “teeth” while the implants are healing into the jawbone.

What Post-Operative Care is Required for All-on-Four Dentures?

During the healing phase, which lasts approximately 4-6 months, it is extremely important to strictly follow the post-operative instructions.  These instructions are aimed at creating the healthiest and safest environment for the implants to heal into the jawbone.

The most important one regards eating only a soft diet during the healing phase.  This may seem like a long time to eat soft foods.  However, remember that many people in traditional dentures only eat soft foods because they’re unable to eat crunchy or chewy foods at all.  With all-on-four, this dietary restriction is only temporary.

Another important aspect of post-operative care is maintaining the cleanliness of the surgical sites.  An implant cannot get a cavity, but it can get periodontal disease.  It is essential to keep plaque and bacteria away from the implants and the denture.  In order to do this, a patient must follow the brushing and rinsing instructions prescribed by Dr. Chowning.

Could All-on-Four Dentures be Right for You?

Call our office today at 940-382-1750 to schedule a consultation with Dr. Chowning to discuss your best treatment options.

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