Fixed prosthesis on implant - Dental implants All on 4 / All on 6

By using the All on 4/All on 6 systems, all the teeth on an arch can be replaced in a single procedure. The systems use 4 or 6 dental implants to support the fixed prosthesis. Typically, fixed dentures use 6 implants on the upper arch and 4 implants on the lower arch. It is an effective solution for patients who want same-day dental rehabilitation with a reduced number of implants.

What is fixed prosthesis on implants?

The procedure involves the insertion of 4 or 6 dental implants, followed by the fixation of the denture. A temporary fixed acrylic prosthesis can be attached on the same day of surgery, which will be replaced after healing with a permanent one.

However, one cannot attach a fixed prosthesis to the implants from the start if the jaw/mandibular bone is not strong enough to support the implants. Instead, the patient will wear a removable prosthesis until the bone heals and the implants stabilize enough to support a permanent fixed prosthesis.

Who is the right patient for fixed teeth in 24 hours?

Suitable patients for a fixed prosthesis with 4 or 6 implants are:

• Patients who suffer from total edentation (have all teeth missing) and who are tired of mobile prostheses. The All on 4/ All on 6 systems replace the mobile prosthesis with a fixed work on implants, which resemble natural teeth;

• Patients suffering from partial edentation (have one or more missing teeth). In this case, the remaining teeth will be removed and the implants will be positioned in their sockets, provided that there are no infections or inflammations;

• Patients with loose or mobile teeth. Those suffering from periodontal diseases can opt for All on 4/ All on 6 to treat gum problems and obtain a fixed prosthesis on implants;

• Patients suffering from bone atrophy. If the bone is too thin or too fragile, the All on 4/ All on 6 systems are a better option because they less often require bone grafting procedures.

How much does a fixed prosthesis on implants cost?

The cost of a fixed prosthesis on implants varies depending on several factors: the type of implants used, the complexity of the patient's case, the number of implants required and other additional procedures.

Dental implants All on 4 / All on 6 – Price:

The price of fixed prostheses on implants at the DentArbre clinic are as follows:

For more information related to the cost of the procedures, please contact us.

Classic implants vs. All on 4 / All on 6 technology

The All on 4/ All on 6 technology differs from classic implants in that:

• Only 4-6 strategically placed implants are used to support a fixed prosthesis, unlike dental work that requires an individual implant for each missing tooth;

• It offers a more effective and less expensive solution compared to classic implants;

• It does not require equally dense bone over the entire surface because the implants are strategically placed.
• Thus, this system is a more efficient and convenient long-term option for patients.

What are the components of All on 4 / All on 6 implants?

The main components of these systems are the following:

• Dental implants – are small screws, made of titanium or zirconium, surgically inserted into the bone. They function as artificial roots to support the prosthesis;

• Prosthetic abutments – represent the connecting piece between the dental implants and the fixed prosthesis. They are attached after the implants have completely integrated into the bone through the osseointegration process;

• Fixed prosthetic work – represents the dental restoration mounted on prosthetic abutments. It can be made of materials such as acrylate, composite, ceramic or zirconium.

• The All-on-4 and All-on-6 systems are designed to provide patients with comfort, natural aesthetics and long-term durability.

Fixed prosthesis on 4 implants - All on 4

The All on 4 implantology technique uses only 4 dental implants to support a complete fixed prosthesis on a single dental arch (maxilla or mandible). Implants are strategically positioned to provide optimal stability and reduce the need for additional interventions such as bone grafting.

The implants in the front part of the arch are inserted vertically, in a straight line. This area of ​​the maxillary or mandibular bone is denser and provides stability to the implants. Posterior jaw implants are placed at a certain angle so as not to affect other anatomical structures, such as the maxillary sinuses.

Fixed prosthesis on 6 implants - All on 6

All-on-6 uses 6 dental implants per arch to support the fixed denture. The method is similar to the All-on-4 system, but involves two additional implants, and this can aid mastication and provide better stability to the prosthesis.

The technique is preferred in cases where the volume or density of the bone allows the insertion of several implants. Before the intervention, panoramic radiographs and CT scans will be performed to assess the volume and density of the maxillary or mandibular bone.

Fixed prosthesis on 2 implants

The prosthesis on 2 implants is not a fixed prosthesis in the traditional sense. It is possible to fix a removable prosthesis (which can be removed) with only 2 implants. The prostheses are fixed on the dental arch with the help of special metal staples and have an internal seal that ensures the stability of the prosthesis on the arch. The patient can easily remove the prosthesis for hygiene (unlike the All on 4/ All on 6 systems) and it is much more comfortable than the classic mobile prosthesis.

The stages of the All on 4/ All on 6 procedure

The All on 4/All on 6 procedures can be divided into two stages: the surgical and the prosthetic. Before these, the initial consultation takes place in which the doctor will assess the patient's general state of health and examine the oral cavity. Panoramic x-rays and CT scans will be taken to plan the correct placement of the implants.

Insertion of implants

During the surgical stage, the implants are inserted into the jaw or mandible, under local anesthesia or with sedation. The front implants are placed vertically, and the posterior ones at a specific angle (30-45 degrees) to maximize stability. After insertion, healing abutments are secured to support the temporary prosthesis and help form the gum around the implants.

Fitting the temporary prosthesis

Immediately after the implants are inserted, a temporary fixed prosthesis is fitted over the implants. This allows the patient to have functional teeth the day after the surgical procedure.

Healing period / osseointegration

There is a healing period that can last several months, during which the bone integrates with the implants. During this time, the patient must follow oral care instructions and attend periodic check-ups.

Installation of the definitive prosthesis

After the osseointegration of the implants has been achieved, the temporary prosthesis is replaced by the definitive fixed prosthesis. This will be customized to the patient's anatomical structure for a natural appearance and optimal functionality. It is the last stage of the process, which completes the dental treatment.

The advantages of fixed prosthesis on implants

The main advantages of the All on 4/ All on 6 systems are:

• Fixed teeth on the same day dental implants are inserted. After the surgical procedure, a temporary fixed prosthesis is fitted until the implants are completely integrated into the bone;

• Due to the specific number of dental implants and the way they are placed, these techniques offer better stability of the denture;

• The surgical intervention is less invasive, because it uses precise methods and is less traumatic for the patient;

• Bone addition is not required in most cases, unlike other methods;

• Implants in the All-on-4 and All-on-6 systems are very durable and resistant if properly maintained through proper oral hygiene;

• With these systems, the patient gets rid of mobile prostheses and their discomfort.

When you choose All on 4 vs. All on 6

The doctor will choose which technique is suitable according to the anatomical structures of the patient, the volume and density of the bone, but also the aesthetic and functional objectives of the treatment. Typically, the All-on-4 technique is more commonly used for the lower arch because the bone is stronger. All-on-6 is preferred for the upper arch due to the lower bone structure and density in that area.

Fixed prosthesis on implants - Contraindications

There are certain contraindications for this procedure. Not all patients are suitable for All on 4/ All on 6 techniques, especially those who:

• Suffers from complications of diabetes (uncontrolled diabetes);

• Suffers from complications of cardiovascular diseases;

• Suffer from bleeding disorders (those diagnosed with hemophilia or using anticoagulants);

• Are under immunosuppressive treatment.

These contraindications should be considered before treatment.

Frequently asked questions about fixed prosthesis on implants:

Frequently asked questions about fixed dentures on implants include issues related to the surgical procedure, the recovery and healing period, and possible complications.

Photo source: Unsplash, Freepik

Bibliography:

· lortontowndental.com, https://lortontowndental.com/all-you-need-to-know-about-all-in-4-and-all-in-6-implants/, accessed on 27.11.2024;

· creativesmiles.com.au, https://creativesmiles.com.au/all-on-4-dental-implants/, accessed on 27.11.2024;

· www.bupa.co.uk, https://www.bupa.co.uk/dental/dental-care/treatments/dental-implants/smile-in-a-day, accessed on 27.11.2024;

· draugustine.com, https://draugustine.com/complete-dental-implants-in-one-day/, accessed on 27.11.2024.