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All-on-4® Treatment Concept
Your teeth may only be a small feature of your mouth, but they perform some different essential responsibilities every day. Losing your teeth impacts your entire life. The more teeth you lose, the greater the impact. It used to be that if you lost an entire arch, or both arches, of teeth, your only option for replacement was dentures. Today, however, dental implants provide you with another option. While dental implants can be used to meet some different needs, they do rely significantly on having sufficient bone mass in your jaw. If you are missing an entire arch of teeth or have teeth that re in terminal condition, and do not have the necessary bone mass for a regular full arch replacement, Lehigh Oral and Maxillofacial Surgery can help with the All-on-4® Treatment Concept.
How Do You Lose Teeth?One of the most common causes of tooth loss is gum, or periodontal, disease. When you have gum disease, a buildup of plaque and bacteria leads to irritation of the gum tissue. This irritation causes the tissue to become inflamed. Inflamed tissue begins to pull away from your teeth, creating pockets. Bacteria fall into these pockets and begin to attack your periodontal ligaments and your jawbone. Over time, these supporting structures begin to weaken, causing the teeth to become loose and eventually fall out. Other causes of tooth loss include such things as
What Happens When You Lose Teeth?Tooth loss has several effects on your life. The more teeth you lose, the worse they become.
The Effects of Tooth Loss and Your JawboneIn addition to many of the obvious effects of tooth loss, something else happens below the gum line. Your teeth, specifically the roots, are responsible for the stimulation of your jawbone. This stimulation tells the body to send nutrients to keep it strong and healthy. Tooth loss means that you lose stimulation. The body then thinks that fewer nutrients are needed. Over time, the bone begins to weaken and resorb, eventually causing the bone to begin changing shape. This change in shape also has a major impact on your facial appearance. Your skin begins to sag. Jowls form. Wrinkles also begin to appear. Suddenly you look years older than you are.
What Are Dental Implants?Dental implants are a more recent treatment for replacing missing teeth. While newer, this particular treatment has quickly gained popularity. It is designed to be a long-term, even permanent, the solution to tooth loss, providing patients with an alternative to more traditional bridges and dentures. Implants involve the use of small titanium posts, which are surgically implanted into the jawbone. As you heal from surgery, your bone begins to fuse to the posts in a process called osseointegration. This process stabilizes the posts in your jaw so that they essentially become the roots that hold the ceramic crowns that replace your missing teeth securely in place.
Dental implants are a very versatile treatment. They can be used to replace a single tooth, or they can even be used to replace an entire arch of missing teeth. When replacing an entire arch of teeth, treatment typically involves the use of 6 to 8 implant posts. These posts are placed into your jaw and used to anchor an entire arch of replacement teeth in your mouth. This treatment is often referred to as a full arch replacement, or an implant supported denture. However, to be considered a candidate for this type of dental implant, you need to have enough bone mass remaining in your jaw.
The Importance of Your Jawbone and Dental Implant SuccessThe condition of your jawbone is critical for the successful placement of dental implants. The implant posts rely on your bone for stability. As you heal from surgery, the bone fuses to the posts, stabilizing them within your jaw. However, shortly after you lose your teeth, you begin to lose bone mass in your jaw. The more bone mass you lose, the less likely placing dental implants becomes. Without sufficient bone mass, the implant posts cannot successfully integrate into your jaw. They may not integrate completely, or they may not integrate at all. Both of these issues can lead to implant failure. Even if a single implant post in a full arch replacement fails, your entire restoration is compromised.
The Downsides to DenturesIt used to be that if you did not have enough bone mass in your jaw to support the implant posts necessary for a full arch replacement, your only other option was dentures. Dentures are still a common treatment used to replace missing teeth. They have been in use for hundreds of years. The dentures used today are significantly different from older styles. Modern improvements have made them more realistic in appearance and much less bulky. Despite having undergone numerous improvements, dentures still have a significant number of disadvantages.
One of the biggest disadvantages of dentures is that they rely on your gums for support. Your gum tissue was never meant to support the pressures that dentures apply to them. This can lead to discomfort. Dentures can also slip out of place, or even fall out completely, while you are speaking and eating. Not only is this embarrassing, but dentures that move around in your mouth can also cause denture sores, which can lead to significant pain.
Dentures require additional nightly care. Every single night, they need to be taken out and carefully cleaned before being left out to soak while you sleep. This care can become quite tedious but is essential for ensuring that your dentures function properly and that your mouth remains healthy.
Another one of the biggest disadvantages to dentures is that cannot stop the bone loss in your jaw. While dentures replace many of the functions of your missing teeth, they cannot stimulate your jawbone. Without this stimulation, your jawbone continues to change shape. Because your dentures are rigid, they do not change with your jaw. As a result, they need to be changed every few years. Wearing ill-fitting dentures is not only uncomfortable, but it can also speed up the bone loss that you experience.
What Is All-on-4?The All-on-4® Treatment Concept allows patients without enough bone mass in their jaws to support a regular implant supported denture the opportunity to get dental implants, completely avoiding the need for dentures. In addition to avoiding dentures, the treatment is also designed to help avoid the need for a bone graft surgery. However, how does it work?
The All-on-4® Treatment Concept uses dental implants to support an entire arch of replacement teeth. However, instead of using 6 to 8 implant posts, this treatment uses only 4. How can fewer implants provide you with greater success? The success of the All-on-4 treatment concept is not in the number of implants. Instead, success lies in the placement of the posts we do use. Two of the posts are placed vertically at the front of the jaw. There is naturally more bone mass in this area of the jaw. The other two posts are placed at the back of the jaw, one post on each side. These posts are placed at a 30-degree angle. With this angle, we can take advantage of the bone mass that you do have in your jaw by maximizing contact between the implant posts and your bone.
How Are All-on-4 Implants Placed?All-on-4 dental implants are placed in a similar procedure to regular dental implants. The procedure is performed under a local anesthetic, which ensures that you feel no pain. Sedation can also help to make sure that you can remain calm and relaxed throughout the procedure. Your sedation options will be discussed with you during your initial consultation.
Surgery begins with incisions in your gums. These incisions provide us with direct access to the jawbone. Next, we drill small holes into your jawbone and place the implants inside. Your gums are sutured closed around the implant posts. If you bone is adequate in volume and density such that the implants reach excellent primary stability at the time of surgery, then a temporary set of teeth will be screwed onto the implant posts either the day of the surgery or a day afterwards. In rare cases, if the implants do not reach adequate insertional torque at the time of surgery, then your Doctor will allow you to heal for a period of 3 months prior to having your final fixed teeth fabricated.
After surgery, there is a recovery period. You are provided with a set of aftercare instructions that will help you deal with common post-surgical issues as well as provide you with guidelines to ensure that you heal properly. During your recovery, your bone gradually fuses to the posts, stabilizing them within your jaw. Several follow-ups will allow us to make sure that you are healing and that the posts are integrating properly.
Once you have fully healed from surgery, we then begin the process of placing your final restorations. This process typically takes two appointments. During your first appointment, we remove your temporary teeth and place the abutments. Next, we take impressions of your mouth. These impressions are sent to our dental lab, where your final restorations are custom designed and created. Once they are ready, we check your new teeth for fit and bite and then secure them into place on the posts with small screws.
What Are the Benefits of All-on-4?The All-on-4® Treatment Concept provides several significant benefits.
While these benefits of the All-on-4® Treatment Concept are similar to regular dental implants, it also has some benefits that are unique.
If you have previously been told that you are not a candidate for dental implants due to a lack of sufficient bone mass, the All-on-4 treatment concept may be right for you. Call Lehigh Oral and Maxillofacial Surgery at (610) 435-6161 today to schedule your consultation and find out if All-on-4 is right for you.