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Full Mouth Replacement

ALL TEETH MISSING

All on 4

The most popular way of replacing a whole arch of teeth is the All on 4 procedure.  There are many names that this goes by but the concept is the same.  One of the biggest hurdles in implant dentistry is having adequate bone to place the implants in.  A few years back someone realized that the most common place for patients to have enough bone is in the anterior/front of the jaw in upper and lower arch.  A technique was designed to utilize this bone which removed the need for costly bone grafts which are usually followed by months of healing before the implants can be placed or an appliance/restoration delivered.  Amazingly, the All on 4 procedure allows the patient to come in for one surgical visit and leave with a whole arch restored all in one day.  This was a total game changer for implant dentistry.  Dr. Frank Roach has been performing this procedure for years and has developed his own innovative methods of improving the outcome and reducing the healing time for his patients.  The only drawback to this procedure is the cost.  There is considerable amount of lab work due to the need for very precise placement of the teeth.  A few visits prior to surgery allow the team to design the final appliance to that almost nobody will realize that the patient has an appliance.  Usually, patients are told "wow, you have really nice teeth."  The last thing you want to hear is "who did your teeth."


Benefits of a fixed bridge on implants

When all teeth are missing or in such condition that they need to be replaced, a fixed bridge anchored to dental implants is the best permanent solution.

Before dental implants, there were no fixed solutions available for people who lost all their teeth. Today, it is possible to replace a full jaw with dental implants and a fixed bridge that results in a permanent, stable and highly esthetic solution.

  • Allows you to eat and function as if you have natural teeth
  • A solid, stable solution that will serve you for life
  • Preserves your facial appearance and prevents further bone loss 

Treatment:

The treatment procedure and number of visits is largely dependent on the specific conditions. But all in all, 8-10 visits should be enough to have a fixed bridge installed. Most patients report that they were much more comfortable following the procedure than they had anticipated.

COURSE OF TREATMENT

INSTALLING THE FIXED BRIDGE– STEP-BY-STEP

The course of treatment described here is one of several options available. Consult with your Periodontist to find out what the best solution is for you, given your specific condition.

1: Before the procedure
The Periodontist determines what needs to be done and prepares the patient for the coming treatment procedure.

 

2: Installing the implants
The first step in installing dental implants is to replace the lost tooth roots. In this case, five implants are used. Temporary teeth are attached that enable you to eat and function like normal while waiting for the permanent bridge to be installed.

3: Attaching the bridge
The final bridge is securely installed on top of the implants. With a full jaw replacement like this, it normally takes several visits to have the bridge completely attached.


4: End result
Your new teeth should be hard to tell from natural – both for you and others. People who have had traditional dentures before getting a fixed bridge often describe this as an overwhelming and very positive experience.


ALTERNATIVES TO A FIXED BRIDGE


An alternative to a fixed bridge is a removable overdenture, which is anchored on implants. The old fashioned denture still has advantages but will fit much better if there are four or more implants supporting this prosthesis.


 

Removable, implant anchored overdenture
A removable full denture that is connected to either a ball or bar attachment, which in turn is anchored on two or more implants in the front or back part of the jaw. 

The implants help keep the denture in place and provide better function and comfort. Cost is usually the reason why this solution is chosen over a fixed bridge – although the end result can’t be compared.

Removable full denture
A denture that is loosely placed on top of the gum to cover the missing teeth. This alternative has no real advantages – except for its low price and easy installation.  This isn't a widely popular solution due to the lower denture not having retention.  It is called a saddle fit meaning it just sits over the lower jaw with no mechanical retention.  The upper denture has suction to help keep it in place.  When you hear someone say they hate their dentures, they are almost definitely talking about their lower.  

The disadvantages are many: discomfort in eating, poor esthetics, affected speech, and sore gums from denture movement. Moreover, a full denture placed in the upper jaw severely reduces the sense of taste.

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