New Alternatives for Denture Wearers
Video: All On 4 Surgery Example
All On Four Teeth In a Day
Nobel Biocare developed a hybrid tooth replacement protocol that incorporates the latest of what CAD/CAM technology (computer aided design and engineering) offers and coupled it with the precision diagnostics generated by 3 Dimensional Imaging.
The All On Four concept refers to a Nobel Biocare treatment protocol that incorporates the use of a proprietary implant placement guide that is used by trained Nobel Biocare implant specialists to configure implant locations, depths and angulations that provide rock solid stability and anchoring.
The adjacent photo represents the essential configuration of the patented Nobel Biocare implant placements and angulation for a typical upper jawbone. There is nothing is left to guesswork.
Lower and upper jaws can now be rehabilitated and restored with diagnostic and technical accuracy that was not possible just a few years ago. More material and discussion about omputer guided implants is availabe on our Guided Implants page.
|All On Four Implant Placement Protocol
Popular Treatment Choice for Avoiding Dentures
Many patients seeking a full reconstruction or rehabilitation of a lower or upper jaw are familiar with denture products and wish to avoid them altogether.
Some denture products (depending on characteristics of jawbone, amount of gum tissue and quality of denture) can force patients to make changes in eating habits, create new choices of what to eat, use special liners to prevent having loose or painful dentures, have difficulties with speech, etc.
|Upper Bone Resorption - Gum Loss
The All-On-4 concept refers to a hybrid placement pattern of patented implant devices and fittings that provide the attachment interface of a custom bridge prosthetic. Bridge material can be constructed of acrylic or porcelain.
The adjacent photos represent a complete reconstruction of an upper jaw for a 90 year old female. For her age she had good bone quality and very healthy gingival tissues.
|Lingual View Missing Upper Teeth
A common denture product was out of the question. Her goal was to have nice looking teeth that would function as normally as her original teeth, but with more biting and eating capacity that would come with increasing the number of teeth from 6 to 12.
Cosmetics were as important as normal function. She wanted to look nice and not "feel" or "look" like she was wearing a denture.
The patient selected a modified denture - bridge prosthetic made of acrylic material.
|Denture Bridge Modification
The proven design of Nobel Biocare's All On Four full arch tooth replacement configured to provide the strongest support possible for the prosthetic bridge which distributes the strong biting and chewing forces we all have across all four implants.
The pictures provided here show the all-on-4 dentist working with a denture acrylic that has already been modified with the implant attachments that will eventually mount to the corresponding implants that have been placed in the patient's upper jaw.
Specialized prosthetic compounds are applied to create a fixed bridge product that allows the removal of all excess acrylic material.
For replacing upper teeth, nothing surpasses the feel of an implant bridge.
|All-On-Four Fixed Bridge
Custom bridgework enables the complete removal of material that commonly causes the gag reflex response when using common dentures. For this patient, her prosthesis is also known as a palateless denture.
The Immediate Function implants allow treatment to be completed in one treatment session, if desired by the patient.
Extractions, supplemental grafts, implant placement and periodontal gum suturing were completed during the same appointment.
The dental bridge (acrylic, porcelain, PIB or modified denture) is attached at the end of the treatment session.
The denture product selected by the patient is regarded as Cosmetic Grade. The flesh colored areas representing gum tissue are created with realism.
|Premium Bridge Cosmetics
Artistic handiwork (Turbyfill style) with custom acrylic products and shading techniques creates variations in visual texture, complete with apparent vein structures throughout (no reason to have a denture look like a denture).
The custom bridge is attached to the implants on a semi-permanent basis. This type of bridge is designed to be removed by the dentist to on a routine basis that assures monitoring of optimal bone and tissue health that is critical for long term servicability of the implant.
Routine cleaning and maintenance eliminates the common problems associated with inadequate care for implant supported bridgework.
As can be seen in our final post operative photo, our patient has a great smile with great looking teeth that fits her facial structure, jaw positioning with promise of enabling her to eat nearly anything her heart desires.
|Great Looks - Great Function
Her new teeth, now numbering 12 instead of 6, look and feel natural, providing a renewed ability to smile as broadly as she wants... something she hasn't been able to do in years.... without making her appear older than she feels (patient reports she looks 15 - 20 years younger).
Amazing results for a 90 year old patient....
Dentures That Don't Look Like Dentures
Same day implants save a lot of chair time for patients and can eliminate the dread of having to live with a denture. Without exception, patients feel great about themselves after.
Material contributed by:
Ira D. Koeppel, D.D.S.
James Sanderson, D.M.D.
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tooth replacement procedures are technique sensitive and can incorporate different degrees of predictability for implant success dependent upon the skills and technologies used by the local surgeon periodontist specialist or local implant dentist diagnosis of occlusal function and restoration procedure
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