Less is more in terms of cleanability and design, and four is ideal and symmetrical. However, in some cases, such as in poor quality bone, additional implants may be required to improve system’s ability to withstand the functional pressures. It may also be an option when wanting to increase the number of teeth beyond the typical arch of 12 teeth.
Irrespective of whether additional implants are required, we make every effort to position them correctly for enhanced comfort and spread them for simpler cleaning.
If your surgeon determines that more that four dental implants are necessary All On 4 Plus® system helps ensures high quality design.
When using additional implants it is even more critical to ensure that they are positioned correctly and spread evenly to maximise comfort.
This approach is used for severely resorbed upper jaws or when the structure and/or quality of the jawbone is extremely limited. It facilitates immediate rehabilitation with fixed replacement teeth. The zygoma implants are inserted from within the mouth, along with one or more additional regular implants in the front part of your jaw on each side.
In the most severe of cases two zygomatic implants may be used on each side, which is referred to as Quad Zygoma, which may sometimes also be combined with an additional midline implant when required.
Repositioning of nerve bundles may be required in situations of extreme bone atrophy in the lower jaw, and allows improved placement and spread of lower implants for immediate fixed replacement teeth (below).
All-On-4 Plus® Immediate Final TeethTM system is permanent by way of its titanium substructure (page 9). The teeth themselves are made from High Impact Acrylic and these are the working elements that are subject to wear and tear over time. Repairs or replacement of the teeth themselves using the original titanium substructure is reasonably straightforward with minimal downtime.
The average lifespan of the teeth is 8 years, and whilst it is not uncommon for us to see patients 10-15 years later still with their original teeth, we also see certain patients who need replacement after less than 5 years. This may be the case in the heaviest of bites where the improvements in functional forces are beyond the physical tolerance of the acrylic material. It is in those situations that there may be an indication for needing to upgrade to stronger teeth like Zirconia (also known as Ceramic or Porcelain teeth).
Zirconia would looks very similar to the acrylic teeth but it is far more durable. It is also heavier and has greater hardness. It is only used when appropriate and not as an immediate bridge because it transmits the impacts of the bite more readily through to the supporting implants and potentially disturbing their healing, unlike acrylic teeth which are more forgiving and better able to absorb functional impacts during the early stages.
Using All-On-4 Clinic’s sophisticated CAD-CAM production systems, we are able to convert the Immediate Final TeethTM to Zirconia at any stage at substantially reduced upgrade-only rates.