All On 4 Dental Implants:

A SUCCESSFUL DENTURE RESTORATION

Slider

There are several adverse effects that edentulism poses on those patients suffering from tooth loss. These issues are physical, affecting speech, chewing, and overall oral health. They can also be psychological, affecting self-esteem, social confidence, and overall quality of life.

With over 35 million people affected by edentulism in at least one arch, seeking solutions that improve the oral health of these individuals has been at the forefront of dental technology advancements over the last decade.

With a consistent foot in the door, we at Burbank Dental Lab have held on and approached every digital and technical progress in the most professional way possible. For over a decade, All On 4 Hybrid Implants have shaped how the dental industry treats many patients suffering from tooth loss.

All On 4 Hybrid Implants

Edentulous patients will usually present with bone loss in either the upper or lower jaw or both. These patients can be treated with conventional dentures, fixed implant-supported bridges, or an implant-supported removable. Placing implants in these cases may be difficult because of inadequate bone structure and possible nerves and other anatomical challenges. These difficulties are what led to the development of the All On 4 concept.

All On 4 allows for the placement of four to six implants per arch. Two implants are placed vertically in the anterior region, and two are placed at an angle in the posterior. Through this technique, the ability to maximize the existing bone and bypass the need for procedures such as nerve repositioning, bone grafts, or bone regeneration is much improved.

In addition, the benefits of the All On 4 process are as follows:

  • Easy to clean
  • Immediate function
  • Improved biomechanics
  • No need for a bone graft
  • Less complex surgery
  • Excellent treatment option when the cost is an issue
  • A well-documented success rate

Patient Protocol

The All On 4 treatment modality has enough clinical data to support this type of restoration in the treatment of edentulous patients. It is vital to select those patients who will benefit the most and assess if they would make suitable candidates for this procedure. Typically patients who smoke, take certain medications, or have other medical issues have a higher chance of experiencing implant failures. Therefore, the selection of patients is critical in ensuring case success. A full exam, including x-rays and cone-beam computed tomography (CBCT), is essential in adequately evaluating whether or not this type of restorative option is right for a particular patient.

Once a diagnosis is made to treat a patient using the All On 4 technique, there are several restorative options available to provide the ideal treatment to meet a particular patient's needs. These options are all used here at Burbank Dental Lab to ensure that each patient receives the correct hybrid restoration.

Restorative Options

1. Acrylic with Titanium Substructure
Acrylic with Titanium Substructure

This option is designed with a titanium frame that is precision milled to accommodate the implant placement. Acrylic and denture teeth are then used to provide esthetics and function. The benefits of a titanium acrylic hybrid are as follows:

  • Impact forces are reduced and not transferred to implants
  • Easy to repair
  • Easy to clean and polish
  • A cost-effective option for those patients needing a less expensive option
  • Acrylic teeth are kind to opposing dentition
Digital Workflow Success Guides
SmartComposite Hybrid

This option is designed with a milled cobalt-chromium (CO/CR) frame and milled composite restorations.

The benefits of this type of Hybrid are as follows:

  • Compressive strength of 480mpa
  • Easy to polish
  • Light material
  • Easy to repair intraorally
  • Wears the same as natural dentition
  • Composite density prohibits the absorption of fluids and odors
3. Zir-MAX.M Hybrid
Zir-MAX.M: Strength in Zirconia Implant Fixed Prosthesis

One of the most durable options is the Zir.MAX hybrid. These restorations have a flexural strength of 1200 MPa. They are ideal for cases where the occlusal load is a significant consideration in material selection.

The benefits of this option include the following:

  • The strongest all-ceramic material
  • Excellent esthetic option
  • Feels like natural teeth
  • Resists fracturing
4. Zirconia over Titanium Bar

This restorative option is fabricated with a CAD/CAM designed titanium bar and milled zirconia restorations. The key benefit of this option is the strength of the titanium bar. While extremely durable, titanium is more flexible than other frame types allowing for flexure of the mandible.

Other benefits of this option include the following:

  • Resistant to wear
  • Less inter-occlusal space is required
  • The frame can be seated, and then zirconia placed over screw channel eliminating the need for angle corrections
  • Biocompatible
5. Porcelain Fused to Metal Hybrid
Porcelain Fused To Metal Hybrid

This option is the most esthetic option. It consists of a metal frame with a porcelain layered build-up. It requires the least amount of vertical opening than any of the other options.

Other benefits of Porcelain Fused to Metal are as follows:

  • Well documented longevity
  • Extremely versatile
  • Highly customizable
6. Malo/Thimble Bar

In these cases, the bar is either made of titanium or resin-filled fiber. The bars are designed to accommodate individual crowns that can either be fabricated in zirconia or e-max.

Following are the benefits to prescribing this option:

  • Computer-aided design and manufacturing to aid in accurate adaptation
  • Versatile fabrication materials creating a highly esthetic result
  • Teeth are individually restored

The restorative choices available offer unique options to fit any given situation. There are clear reasons to prescribe one option over the other, and it depends on the conditions presented with each case.

The implant team at Burbank Dental Lab has been a part of the fabrication of thousands of these types of cases and is available to evaluate which options would work best to fit the needs of the patient.

All On 4 Workflow

The workflow for this type of case can follow the traditional methods for implant-supported restorations, but they can also be completed through digital techniques. The digital workflow method would be completed as follows:

  1. Create a duplicate denture or create a new denture set-up (depending on the situation).
  2. Use the new denture as a template for a CT scanning appliance.
  3. Plan the implant placement.
  4. Create a guided surgery appliance.
  5. Use the guide to place implants.
  6. Take a digital impression.
  7. Fabricate a PMMA Provisional.
  8. Deliver the final restoration.

There are several possible workflow methods in the treatment of All On 4 cases. It is best to plan this type of treatment from the beginning and include the laboratory early in the planning phases to see which method will work best for any given situation.

Restoring edentulous cases using the All On 4 technique is an excellent option for many people suffering from tooth loss. Burbank Dental Lab prides itself in being one of the most knowledgeable dental laboratories in restoring edentulous cases. Our implant team is available for pretreatment consults to help with planning and restorative considerations.

Click the chat icon below, we are here to help you with your next implant-supported fixed prosthesis.

Did you like this article?

Let us know by giving us a clap!

Top 10 Most Clapped Articles

Resource Center

Products

Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

Slider