THE PROCESS
All On 4 Plus® involves the use of advanced techniques and technologies to produce Immediate Final Teeth, and control the outcome of implant therapy with hygienic interfaces, reduced bulk, and durable final restoration with a milled titanium frame inserted within 24 hours from implant surgery.
Preliminary Procedures
The process of creating Immediate Final Teeth™ starts in the planning stage in advance of the surgery. One of our trained clinicians will take pictures of your face and mouth as well as a 3-D scan of your teeth, which replaces the traditional impressions.
Your Input
Our restorative team goes over various options with you to decide on the shade and shape of your smile so as to ensure it is exactly what you want. We will show you before and afters of patients who have had the treatment and the different available arrangements and will guide you as to what might look good in your specific case going by the shape of your face, jaws and mouth. We love to create very natural looking smiles and teeth that don’t look fake, and we can achieve this in various ways even with the often desirable whiter shades, as long as the arrangement of the teeth within the arch is natural and the implants are correctly positioned. Ultimately, we will follow your specific desires.
Digital Smile Design
The first 3-D scan is used along with your pictures to design your new smile and to create a virtual set-up of your new teeth. This digital design is used by the surgeon to determine the appropriate positions of the implants.
Surgery
Typically the surgery is done while you are asleep at one of our dedicated facilities. After removal of teeth (if any) the surgeon reshapes the jawbone to allow space for the new teeth and positions dental implants according to the digital plan. The surgeon then undertakes additional procedures to improve the stability of the gum tissues, which substantially reduces or eliminates post operative shrinkage of the gums (such as what occurs when using the denture conversion method).
Digital Impressions
Immediately after your surgery the surgeon along with the restorative team undertakes digital scanning of the dental implants and gum tissues, which determines the precise positions of the dental implants and can be digitally correlated to the digital smile design that was done in advance (as above).
Try-in Templates
While you are still in recovery, our team of technicians starts working on your teeth immediately. A dedicated Computer-Aided Design (CAD) specialists will correlate the precise positions of the dental implants (obtained at surgery) to the digital smile design (done prior) and will convert the digital design into templates that fits the implants, which are printed at our production facility and can be tried in your mouth on the same day.
Aesthetic and Functional Fine Tuning
The printed templates mimic the digital design and incorporate the planned new arrangement of the teeth, but we fit them in your mouth to enable us to determine what additional changes are required to the arrangement and the bite in order to achieve the desired result. This is done within 2-4 hours after your surgery, which is the ideal timing to do this because of the following:
- you are still relaxed after your surgery;
- the anaesthetic in your mouth will have worn off, so you can move your lips and smile;
- pain or discomfort is often minimal and can be managed with medication that we prescribe in advance;
- the post operative swelling has not set in, which means that your face is not distorted and we can make proper assessment of the try-in
We take additional photos and precise bite position, which is used by our technicians to fine-tune the final design when creating the Immediate Final Teeth™.
Going Home with Teeth
Our restorative team goes over various options with you to decide on the shade and shape of your smile so as to ensure it is exactly what you want. We will show you before and afters of patients who have had the treatment and the different available arrangements and will guide you as to what might look good in your specific case going by the shape of your face, jaws and mouth. We love to create very natural looking smiles and teeth that don’t look fake, and we can achieve this in various ways even with the often desirable whiter shades, as long as the arrangement of the teeth within the arch is natural and the implants are correctly positioned. Ultimately, we will follow your specific desires.
Production of Immediate Final Teeth®
Using all the information obtained from using the templates, the CAD specialist designs a bar to precisely fit the implants and to support the final bridge. The bar is milled from titanium using sophisticated milling machines at our production facility, and this is done overnight. In the morning our technicians it the selected acrylic teeth on to the titanium bar whilst implementing all the changes from the try-in templates. Finally The gum colour is applied and the teeth are polished and made ready for insertion, typically within 24 hours from your surgery.
Having facilities that can produce Immediate Final Teeth™ with a milled titanium frame is a sophisticated and expensive set-up, but considering our large volume of cases and shared resourced of licenced All On 4 Plus® Implant Centres there is no additional premium for that.
The alternative older methods of a staged approach and temporary teeth typically involves simply gluing a pre-fabricated denture to the implant posts (as described at length later), which can cause long term issues with the implants because of overloading (described below) and inflammation from the bulky and rough surfaces
making it difficult to keep clean. More importantly, the patient experience is very different, they have to endure 3-4 months of wearing temporary teeth and then undergo another process to make the final teeth, as opposed to walking out with a great smile using All On 4 Plus® and our unique Immediate Final Teeth™ system.
