“Teeth in A Day” or All-on-4 is an immediate solution for complete lower or upper tooth replacement that is as close to natural teeth as is available today.
With as little as four dental implants per arch, we can place a full set of teeth that will immediately function like natural teeth.
With All-on-4, your chewing ability goes from about 10% with dentures and about 35% with snap-in dentures, to up to 95% of your normal chewing capability. Which for most patients means being able to eat whatever they want.
How All-on-4 Works
You can use your new teeth right away, taking a little time for the implants to heal before you chew into hard foods. All-on-4 uses dental implant technology to place titanium implants into the jawbone. Temporary teeth that will look very similar to your final replacement teeth are immediately attached to the implants making it virtually impossible for your new teeth to slip, shift, come loose or fall out.
Consultation and 3D scan
Dr. Gurney or Dr. Jones will meet with you to discuss your goals for your mouth, review your dental and medical history and do an oral exam. We’ll also do a 3D scan of your jaw, teeth and gums using our 3D cone beam CBCT scanner to get a full view of your mouth. This scan is very valuable as it shows us the quality and size of your bone as well as sees potential issues that will need to be dealt with before your treatment.
After your consultation and exam, you will return to our office to go over solutions for various treatment plans so that you are completely educated on your situation, know all of your options and how to move forward with treatment and costs.
Preparation of your temporary teeth
As your dental implants will need time to heal before placing your permanent new teeth, you will be given temporary dentures the day of the implant surgery. These are beautiful, fully functional and are immediately usable.
Preparing for the surgery
We use the 3D scans and impression models to prepare for your surgery. We plan ahead of time the exact location and angle of the implant needed to take advantage of the bone available. This means we may be able to avoid bone grafting. You will be referred to an oral surgeon that we trust for a consultation of your surgical needs in order to get ready for your treatment.
We make a surgical guide to help the surgeon guide the implants into position with minimal impact on the gum and bone, making the procedure minimally invasive, and your post-treatment discomfort minimal. And most important, greatly improves the outcome of your procedure and greatly reduces complications.
Minimally invasive surgery
Due to the thorough pre-planning and the use of the surgical guide, your implant surgery is a relatively fast procedure requiring no extra cutting or suturing. We can usually put four implants on the bottom arch, and four to six on the top arch. How many we put in depends upon the density of the bone and how much bone is available.
If we need to extract any teeth, this is done in the same visit. As the procedure is lengthy, patients can opt to have oral or IV sedation for full relaxation.
We place your temporary dentures on the implants, so you have fully functional teeth when you leave.
Permanent replacement teeth
You will continue to wear your temporary teeth for approximately 6 months while you heal, and adjustments and esthetics are made to make sure you are comfortable and happy with the esthetics of the teeth. When you are healed, we can place your permanent, high-grade zirconia teeth, aesthetically designed, and fitted just for you. We adjust them as needed so that you have a fully aligned bite.
We do several bite adjustments over the upcoming weeks until your bite alignment is just right. This is an essential part of the procedure, as a misaligned bite can cause damage to your new teeth and make for uncomfortable chewing and TMJ pain. The bite must be evenly distributed for your new teeth to work optimally without causing undue stress on the implants.
See some of our Teeth in A Day/All on Four patients here
Description of Treatment
Most simply stated, this treatment describes the process of receiving a temporary acrylic (esthetic resin) set of teeth that screw onto four to six implants on the same day that the implants are inserted. The concept allows people to avoid experiencing a removable denture and the inherent difficulties of dentures.
What is the process?
It is a miss conception that it only takes one day to get your new implant teeth. The most important and critical part of this treatment is the planning and preparation process. It cannot be stressed enough that this treatment needs to be planned and performed by well informed and highly trained dentists. The process includes these main steps:
- Initial consultation and examination
- Diagnostic records: impressions, photos, bite registration, and Conebeam CT Scan
- Discussion and presentation of plan:
– Review risks of proposed plan
– Review sequence and guidelines
– Arrange surgery and teeth delivery
– Remove teeth
– Insert implants same day
– Insertion of immediate/temporary acrylic teeth
- 24 hour evaluation
- 1 week evaluation
- 8 to 12 weeks healing (more time may be needed)
- Fabrication of final prostheses (4 to 6 visits)
Implant companies are encouraging Dentists everywhere to offer this treatment to their patients because they know the value dental implants can be for so many people. The dilemma lies in the fact that many Dentists want to provide this treatment for their patients, but may not have received the proper training to adequately do so. In attempts to get some form of training, they attend weekend courses that provide various degrees of information regarding the process. The only formal education and training available regarding the history, techniques, literature, research, and clinical experience are found in advanced dental specialty residency programs. The most highly trained dentists with respect to this type of treatment are generally Prosthodontists.
The major advantages are related to avoidance of a denture. As a result, most people experiences consists of less discomfort immediately following the implant surgery. There is less pain and an easier transition to the loss of their teeth and the addition of new artificial teeth.
- Improved comfort
- Better function
- Provides a future back up interim prosthesis when repairs may be needed
- Preservation of bone around the implants during healing
- Provides a trial run with new teeth (aesthetics and function) prior to fabricating the final teeth
Who qualifies for this Treatment?
This treatment is a great option for anyone who desires a highly functional and aesthetic option to replace all their teeth. Candidates may include those who have already lost all their teeth or those who are going to lose all their teeth in the future. With proper planning, most people have adequate bone for the use of strong quality implants of regular size. Again, the importance of proper planning and understanding of success and failure of implants is critical. In some situations, one’s bone may not be adequate for implants. In many instances, success can be obtained by augmenting the bone (grafting of the jaw or in the sinuses) or through the use of more advanced implant techniques and procedures (zygoma or trans-sinus implants).
What are the disadvantages?
- Added cost
- Possibility that the implants may not be stable enough to immediately load
- Greater chance that people will overuse/abuse their implants during healing
What are the possible complications?
Sometimes the implants are not be sufficiently tight in the bone as needed in order to screw a temporary bridge onto them the same day. If this happens, you’ll be required to use a temporary denture while the implants heal (about 3 months).
- The all acrylic bridges may break during the healing time
- The screws that hold the temporary bridge may loosen or break
- The abutments that screw into the implants may loosen
- Implants may fail
The above listed complications may be minimized, and in most cases avoided, if proper planning and guidelines are followed. If the listed complications occur, most are correctable with minimal affects to the outcome of the treatment. Screws can be tightened and replaced and breaks in the acrylic can be repaired. If an implant fails early on, a new one can be placed and the prosthesis adjusted.
One thing that is important to state is trying to avoid repairs during the critical healing that occurs 2-4 weeks after the initial implant surgery. At weeks 2-4, the bone is actually weaker adjacent to the implants as a result of the natural healing process and as such any unnecessary movement or torquing of the healing implants should be avoided.
What are the final teeth like?
There are various options available to restore ones teeth with a final definitive prosthesis. The final prosthetic teeth should be discussed prior to starting as the different options have different requirements for proper aesthetics, strength, implants, and function. The basic options include but are not limited to:
Metal framework screwed to the implants with denture teeth
Zirconia Pratau Bridge
Dense strong full zirconia one piece bridge
Zurick, Promax, or Component Bridge
One-piece framework screwed to the implants with individual aesthetic crowns cemented to the framework
Bridges or Implant FPD’s
Three separate implant bridges of metal and porcelain, zirconia, or zirconia and porcelain