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Bad Teeth: Candidates for All On Four

Treatment Needs and Popular Recommendations

Teeth replacement via the all-on-four concept involves removing all defective teeth in the bony ridge of an affected jaw. Four to six implants are usually placed in strategic positions to provide good long term function. Some dentists offer denture prosthetics while others provide fixed bridge solutions.

Full roundhouse bridgework is often used as well as custom cantilevered bridge configurations that enable to have teeth where no implants exist. Bone grafting is used as necessary to create new, immediate bone for extraction sites as well as ridge splitting and pulverized graft material to plump up bony ridge width and gum tissue.

The conditions leading to this type of treatment recommendation are typically include gum disesase damage, bone loss issues due to overuse of dentures or partials, drug abuse issues, untreated orthodontic issues that have caused odd occlusal abnormalities, excessive, untreated extractions, untreatable crown replacement needs (multiple) and rampant decay.

This gallery contains examples of different types of full arch teeth replacement needs as recommended by the dentist for providing the most sensible protocol for tissue replacement, tissue maintenance that assures ideal endurance for a lifetime of dental function and acceptable cosmetics.

Mobile teeth, shifting teeth, occlusal damage and ongoing periodontitis issues that have caused bone loss and soft issue loss are extensive. The All On 4 protocol substantially eliminates the absurd costs that would be associated with treating each tooth individually.

The actual number of implants (typically 4 to 6) will be determined during treatment. The use of Implant Guides and CTscans can be used to create a treatment session where teeth are removed and replaced during one appointment.

All On Four Treatment Candidate
Impending All on 4 Teeth Replacement Patient
Dr Chris McFarland

Just about every imaginable oral health and tissue condition has affected this patient. Rampant cavites, gum disease, tooth breakage, loss of vertical dimension, malocclusion and radical loss of bite has ensued after years and years of negligence.

Bone loss issues that create too many variances in height and width will require the used of Implant Surgery guides, which are based on CTscans. This additional protocol assures accuracy of implant sizing and placement which will limit the need for substantial grafting in some locations. It is anticipated that 6 to 8 implants will be placed in both jaws along with fixed titanium bridgework.

Guided Implant Surgery Candidate
All on 6 (or 8) Teeth Replacement
Dr Ara Nazarian

A rather extreme example of how partials, if used too long, can destroy precious bone density and depth within the bony ridge. The anterior, front most, area of the lower jaw can be augmented with custom bone grafting that provides the precise amount and span of bone for a series of implants.

Five implants are configured in a particular way that will support an All on 5 Cantilevered Bridge of 10 teeth that have no apparent support at the tail (posterior) ends of the bridge. The use of an upper denture product limits however the amount of biting pressure that would normally damage such a bridge. A common tooth replacement strategy that unfortunately has been mastered by relatively few implant dentists.

Mandibular Cantilevred All on 4 or 5
All on 5 Cantilever Bridge Physics
Dr Ara Nazarian

One of the most unusual adaptations of the All on Four concept used today. A male patient had extreme loss of bony ridge height that eliminated the ability to use a normal denture product. A heavy duty metal frame is designed to make up for the lost bone height while providing the ability to use a special configuration of specially selected implants to keep things in place.

A custom upper denture was crafted with this metal framework "inside" the denture. Upon placement, the patient had a new full set of upper, metal reinforced denture teeth at a fraction of the cost that would typically be associated with complex bone block grafting and conventional bridgework.

Metal Denture
All on 4 Metal Core Denture Prosthetics
Dr Chris McFarland

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