All-on-4 treatment concept - Leading Implant Centers

What is the All-on-4 method?

Anyone who suffers from tooth loss and would like to forego a removable denture must resort to dental implants. Modern dental implants can restore the patient a bit of quality of life if they have lost their own natural teeth.

The All-on-4 treatment concept was developed for the fast and cost-efficient supply of dental implants and was first introduced in 1998 by Dr. Paulo Malo. In the meantime, more than 100,000 patients have been treated with implants using the All-on-4 method. Prior to the development of the method was that for fixed dentures with complete edentulousness in the maxilla at least eight and in the lower jaw at least six dental implants must be set. The All-on-4 method requires only four implants per jaw. Thus, the concept offers a good solution to provide patients with complete tooth loss more cost-effective.

Overview of this article

For whom is this treatment concept suitable?

The All-on-4 method is particularly suitable for people who have an unsustainable dentition. Although dentistry offers numerous methods of dental treatment, not every diseased tooth can be saved. For example, pronounced carious damage, root inflammation of a dead tooth or dental fractures can affect the health of the teeth so much that the dentist must pull the affected teeth.

One way to compensate for tooth loss is the wrong dentition. However, the removable denture may limit taste or chewability. Some patients with full dentures also complain of pain from pressure sores.

An implant treatment is a good alternative here. However, many patients are afraid of this method because of the high costs involved. A fixed bridge manufactured using the All-on-4 method, is therefore particularly suitable for people who:

Want to save on costs for dentures
Want an uncomplicated treatment
Have little jaw bone to attach the implant

Since the implants need to be well maintained, there must be a willingness to perform careful oral hygiene. Patients prone to inflammation on implants should also seek advice from their dentist on alternative dentures and refrain from using the All-on-4 method.

How does the All-on-4 treatment work?

Whether the All-on-4 treatment is the right method for you, you should check with a dental surgeon or dentist in advance. This also makes an accurate finding and makes a two- or three-dimensional radiograph. He also analyzes the condition of your teeth as well as the bones and looks at the relationship between the two mandibular arches.

On the actual day of treatment, you will then be given a light sedation or general anesthetic and the dentist will insert two implants in the anterior and two implants in the posterior region of the edentulous arch. In order for the implants to be able to catch the entire masticatory pressure that lies on the bridge or the prosthesis, they are inserted slightly obliquely into the jawbone. If the patient's jaw offers only a small amount of bone material, the dentist can call on so-called Zygoma implants. These are longer than the normal implants and thus provide better stability.

The doctor then takes a jaw impression and also makes a temporary restoration, which he incorporates on the day of treatment. After about half a year, the dental implants are fused with the jawbone. From a new impression, the dental technician creates a dental prosthesis, which the dentist firmly anchors on the dental implants.

For cleaning and control, regular follow-up examinations and prophylaxis sessions are recommended every three to six months.

Illustration of the attachment of an All-on-4 solution © Nobel Biocare / Wikimedia

What advantages and disadvantages does the All-on-4 treatment concept have?

In contrast to other dentures, the All-on-4 treatment concept provides a fixed restoration of the teeth completely without waiting time. You get a fixed denture, which brings you back after a short settling time a whole piece of life quality. Since the dentist has fewer implants than the usual methods, the cost of the dentures are also lower than other fixed crown or bridge restorations.

Immediate loading is possible after the bridge has been integrated, so you do not have to do without certain foods. In addition, the All-on-4 method leads to an aesthetically pleasing final result.

But the concept also has disadvantages. Since this is a relatively new technique, there is no long-term experience. In addition, the implants require a lot of care and a thorough oral hygiene.

Otherwise, it can lead to inflammation, a so called peri-implantitis. This is similar to the periodontitis and is associated with the decline of mucous membrane and bone in the implant area. Sooner or later, peri-implantitis always leads to the loss of the implant. A replacement of the dentures is associated with high costs, since usually all implants and the entire bridge structure must be replaced.

How much does an all-on-4 treatment cost?

The cost of the All-on-4 treatment varies depending on the condition of the dentition, jaw, and implants that are to be placed. On average, you should expect to pay between 7,000 and 8,000 euros for the All-on-4 standard implantation and immediate restoration of the maxilla and mandible. If you are insured by law, you will receive from your health insurance a fixed subsidy for the attached dentures. The statutory health insurance does not participate in the implants. Supplementary insurances take over parts of the treatment or even the complete costs depending on the tarif.

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