All-on-4 Dental Implant Dentures

For patients missing all their teeth, there are 4 options:

And the fourth option is what I’ll cover here:

All-on-4 Implant Dentures, aka Fixed Hybrid Dentures

Strictly speaking, these aren’t necessarily limited to just 4 implants, but we have to have at least 4 implants for the bottom jaw, and 4 implants for the upper jaw.  Certainly, while adding more implants increases the cost, it also keeps adding stability.  The other big advantage of more implants?  If one implant fails, for whatever reason, you still have 4 implants to hold your implant denture.  If there are only 4 implants and 1 fails, depending on which it is, you might need a whole new implant denture.  That doesn’t happen very often, but it is a possibility.

Don’t worry about the terminology so much, but the main differences here are: 1) at least 4 implants are needed on the upper or lower no matter what.  2 implants are put in straight, while 2 are at a steep angle, which creates a kind of tension so we can actually use screws to attach the denture.  This means that only a dentist can remove it, and you leave it in full-time.  These are so strong, you can bite into practically anything you want with your front teeth and chew anything you want with confidence.

Am I a candidate for an implant denture?

As with dental implants that are used to replace single or multiple natural teeth, one of the key determining factors of whether or not someone is a dental implant candidate is the amount of bone they have remaining. Because patients who have worn lower denture wearers a long time tend to have significant bone loss (which is why dentures fit worse over time), it’s critical to have an evaluation sooner rather than later to see if enough bone is present. We evaluate the amount of bone present with our Planmeca CBCT 3D X-ray, which lets us look at bone height, width, and even density in incredible detail.  Bone shrinks over the years, and the longer that you wait to have implants placed, the greater the chance that there might not be enough bone to support the implant. The good news though, is that, even in cases where there isn’t adequate bone, we can rebuild it in a procedure called a bone graft.  Sometimes we can place the implants at the same time as the graft, but sometimes we have to do the bone first and let it heal, then place the implants and let them heal.

How Long Does It Take to Finish an All-on-4 Implant Denture?

This procedure is often marketed as “Teeth-in-a-Day” by large dental chains, because it is true that you often get your new All-on-4 Implant Denture placed on the same day that teeth are extracted and the implants put in.  Of course,  we have to do a little planning first.  😀  So here are the basic steps for doing this, assuming that we have to extract teeth, too.  If not, the process beforehand will be a bit different.

  • Take records like photos, the 3D x-ray, molds of your mouth, choose the color and shape of your teeth with you, etc
  • I plan where the implants will go, if we’ll need to reshape bone, remove bone, or add bone, etc
  • Send everything to the lab to make the All-on-4 implant dentures
  • We should get everything back from the lab within 2-3 weeks
  • We schedule your appointment and go over what will happen, what you need to do before and after the procedure, etc.
  • On your appointment date, teeth will be removed, the bone smoothed, implants placed, attachments placed, and acrylic added to hold the attachments into the All-on-4 implant denture.
  • If there are any complications during the surgical part of treatment, we may send the denture to the lab for them to do the attachments, in which case, we’ll attach the denture to the implants 2 days later.  Some patients even prefer this, because it means they can go home and rest sooner after the surgery.

Taking Care of All-on-4 Implant Dentures

Once you have your new All-on-4 Implant Dentures in place, it’s still very important to take care of them properly.  And yes, you still need to come see us for checkups on a regular basis; we usually recommend twice a year.