All on 4 : Dental implant solution

All on 4 is a dental implant solution designed primarily for patients who are completely edentulous. In certain rare cases (a majority of teeth decayed by cavities, advanced periodontitis, i.e. severe tooth loosening, an accident, serious trauma, etc.), patients may not be able to keep any of their teeth.

The All on 4 allows these patients to regain a “fixed” dentition in a single session and at a more affordable cost than a conventional implant solution with 8 implants. The “4” in “All on 4” refers to the number of implants used to anchor the prosthesis: two anterior implants and two posterior implants.

The All on 4 concept is based on a protocol known as “immediate loading”. In practical terms, this means that functional implants can be obtained the same day (or within 48 hours of the operation at the latest). After fixing the 4 implants in your jawbone, the dentist fixes the immediate prosthesis (a temporary prosthesis) on top so that you can benefit from an aesthetic and functional result immediately: at no point are you left “without teeth”, and the advantage comes from the fact that you don’t wear a removable prosthesis either, since your prosthesis is immediately fixed on the 4 implants on the day of the operation…

– The procedure is fast and avoids the removable denture phase: the prosthesis is immediately fixed onto functional (and therefore usable) implants in a single operation. The procedure is generally carried out using a simple local anaesthetic;
– They provide a rapid aesthetic and functional result, so patients are not left toothless for the duration of the implant treatment;
Compared with removable prostheses, the All on four is a “fixed” solution that offers patients a high level of comfort;
– The All on 4 is generally more affordable than other dental implant techniques, such as a total dental bridge;
– They can be fitted even if the patient has low bone mass (and wishes to avoid bone grafting);
The success rate of All on 4 procedures is extremely high, including over the long term;

The price of an All on 4 procedure varies according to a number of criteria: the dentist and/or dental practice you choose, the quality of the materials used for the implants and prosthesis, the complexity of the operation, and so on. In Switzerland, you should expect to pay an average of between CHF 15,000 and 20,000 per dental arch.

Don’t hesitate to make an appointment with your dentist for a personalised estimate.

The main disadvantage of All on 4 is that there are only 4 implants to support a complete prosthesis. This means that each implant has to support a very high chewing load. This can lead to a number of problems, such as a lack of stability, or even the loss of an implant in the medium to long term if the patient’s chewing strength is too strong, as in the case of people who grind their teeth to an extreme degree.

One of the risks of All on four is also that if there is a problem with an implant, it is generally necessary to remove the entire prosthesis in order to correct it.

Finally, All on 4 also has its limitations in terms of oral hygiene. You need to be aware that an All on 4 prosthesis is made up of several teeth (between 12 and 14) and an “artificial gum” part. In terms of hygiene, this presents a major disadvantage, since certain areas are difficult to access and therefore complex to clean: the prosthesis must therefore be unscrewed every year by the dentist, and all the secondary parts must be cleaned. This follow-up is an integral part of the treatment, with the aim of ensuring long-term maintenance and conservation of the implants.

There are several alternatives to All on 4 implants: solutions based on the same principle but with a larger number of implants, such as the All on 6 or the All on 8.

Complete removable prostheses can also allow you to replace all your lost teeth, while limiting the cost, but they do not offer the same level of comfort or the same resistance.

Finally, other alternatives to dental implants can be considered on a case-by-case basis, such as dental bridges.

Talk to your dentist to find out which solutions are available to you and which option is best suited to your needs.

To find out whether the All on 4 solution is right for you, ask your dentist for advice. He or she will be able to carry out a full examination of your oral health (and your general health). By taking into account your situation, your preferences and your budget, he or she will be able to offer you a personalised solution that’s right for you.

The duration of an All on 4 procedure depends essentially on the complexity of the operation. A number of criteria come into play, such as the condition and thickness of the jawbone to which the implants are attached, the size of the patient’s mouth, the number of teeth to be removed, etc.

On average, an All on 4 procedure takes between 2 and 3 hours in the morning to remove the teeth, place the implants and then take an impression of the implants, while the afternoon session involves fitting and adapting the prosthesis to the implants, which takes around 2 hours.

The procedure for fitting All on 4 is relatively standard in implantology. The first stage consists of assessing the patient’s situation, during which the surgeon must carry out various examinations of the patient’s mouth: clinical examination, photographs, dental impressions, x-rays, etc.

A second consultation is generally used to record all the data needed to make the prosthesis. It is usually during the 3rd appointment that the implants and immediate prosthesis are fixed.

In practical terms, the dentist begins by removing all the teeth, adjusting the bone crest, fixing the four implants in the patient’s jawbone and then taking an impression of the 4 implants, which is sent to the laboratory. The laboratory makes the immediate provisional prosthesis during the day, which means that the afternoon is devoted to fitting and adapting it directly in the mouth onto the implants. The final prosthesis will be fitted between 4 and 6 months after surgery.

The lifespan of All on 4 implants varies according to a number of criteria: regular check-ups with the dentist or hygienist, the patient’s state of health and oral hygiene habits, eating habits, whether or not the patient smokes, and so on. The All on 4 solution should be absolutely permanent, and generally lasts 15 to 20 years.

To promote good healing, it is important to adjust your diet in the first few weeks after the operation. Choose a soft diet after treatment and you will be able to return to a “normal” diet within a few weeks. Once the final prosthesis has been fitted, there are no real limitations, as long as chewing is “classic”, i.e. only edible foods within physiological limits.

To prolong the life of your All on 4 implants, it’s essential to adopt impeccable oral hygiene by following the advice of your dental hygienist, complying with regular cleaning check-ups with your dentist, adopting good eating habits and avoiding harmful substances such as tobacco and alcohol.

Your dental hygienist will be able to guide you through the maintenance of your dental implants.

If you currently have a complete removable prosthesis (a “denture”), you can opt for another solution instead: All on 4, All on 6, All on 8, or another dental implant technique.

However, the structure of the denture itself is not suitable for an All on 4 modification, as the material used is unfortunately too fragile and the distribution of forces has to be carried out on the spot by the laboratory, after the implants have been fitted.

Ask your dentist for advice to find the solution best suited to your needs.