What is the difference between a full arch immediately loaded implant supported teeth and the “All On Four” Teeth?
This question deals with Implants that are placed surgically and then the teeth are attached to them the day of the surgery or the day after.
This is in sharp contrast to the conventional way to restore implants, where the surgeon places the implants and then the patient has to wait three to six months to allow the implants to fuse to the bone (a process called osseointegration). After several months the implants can be restored.
Having to wait months before you can use them has been the most notable disadvantage of dental implants, so guidelines were designed by dentists to put implants into function immediately after they were placed. The “All On Four” technique was developed by Nobel Biocare and a Portuguese dentist, Dr. Paulo Malo in the 1990’s, and it uses four implants to support twelve teeth that are not removable by the patient. The literature shows evidence supporting a good success rate of this method after several years in use.
Full arch immediately loaded implants have no restriction on the number of implants except by the amount of bone available to place implants. It allows the dentist to over-engineer the case by placing a greater number of implants. This insures that the prosthesis will continue to be functional in the event that one or two of the implants fail. It also allows for smaller cantilevers and better distribution of forces in cases where forces are excessive such as bruxers and clenchers.
So the All On Four technique, in my opinion, is limited to cases with limited bone and limited financial funds. I encourage patients that are considering a full arch rehabilitation with implants to get six implants in the mandible and eight implants in the maxilla, where the bone is softer and the implants are more likely to fail from occlusal overload.
Implant Dentist in West Palm Beach
Carlos Boudet, DDS DICOI
1840 Forest Hill Blvd, Suite 204
West Palm Beach, Florida 33406
Phone: Call 561-968-6022
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