All-on-4 Dental Implant Treatment

The All-on-4 dental implant treatment offers a permanent tooth replacement alternative for patients who have missing or non-restorable teeth. The advantage is that a stable, full-set of teeth can be fixed to as few as 4 implants in the upper or lower jaws compared to a denture that is unstable and removable.

Case Report

This patient presented with a history of bulimia, which caused erosion and decay of all of the remaining teeth (Figure 1). The teeth were determined to be non-restorable and the patient did not want dentures. After discussing her concerns and different treatment options, All-on-4 treatment was planned for the lower jaw and All-on-6 was planned for the upper jaw. In other words, a full set of teeth would be fixed onto 4 implants in the lower jaw and a full set of teeth would be fixed to 6 implants in the upper jaw. These treatments are highly customized. The position and number of implants, the shape, shade and number of teeth is specific to each patient. In our office, the patient is involved in deciding the characteristics of their new teeth.

Step by step process for All-on-4 or All-on-6 treatment:

1. Diagnostic Planning: Impressions are made of the teeth and a CT scan is taken of the patient’s upper and lower jaws. This information is used to plan for the position of the dental implants and to design the temporary set of teeth that will be inserted onto the implants immediately after surgery (Figure 2). This is called immediate loading of the implants and the patient will never be without teeth.



2. Surgery: The teeth are extracted and the dental implants are placed using surgical guides. Guides are used to precisely place the dental implants. After placement, the temporary set of teeth are inserted onto the dental implants (Figures 3).



3. Restoration: After 3 months of healing, models of the implants are made and a mock-up of the final set of teeth are made. At this stage the patient is able to provide feedback for the final shape, shade and characteristics of the teeth (Figure 4). The mock-up is digitally scanned and the final set is designed (Figure 5).





4. Final Delivery: The final set of teeth are milled in a durable ceramic material called zirconia (Figure 6). The zirconia set of teeth are then screwed into the dental implants as permanent restorations (Figure 7). These teeth can be removed by the dentist if necessary.

This treatment is the closest option to regaining the natural feeling of teeth:

• Like natural teeth, these restorations are brushed and cleaned. Instructions are reviewed for cleaning around the dental implants.
• Unlike dentures, All-on-4 treatments do not have to be taken out.
• Unlike dentures, All-on-4 treatments do not need adhesives for retention
• Your new set of teeth are stable and comfortable because the bridges do not press down on your gums.
• All-on-4 allows you to bite with increased force, there are no restrictions on the types of food that you can eat.
• Correct placement of the implants will limit complications.
• Replacing missing teeth with All-on-4 will help restore your facial features, enhance lip fullness and reduce wrinkles

ALL-on-4 Prosthodontist expert Dr. Adam Geach

To avoid complications with All-on-4 implant treatments in the greater Los Angeles area, contact Dr. Adam Geach and Geach Dental in Los Angeles, CA 90071. As an experienced Prosthodontist, with patients from California, Arizona, Nevada and New York, Dr. Geach has the expertise and experience to help you re-establish proper dental function.