Same Day | All-On-4® Type of Implant Therapy

Where possible, we try to preserve bone and will give you this as a treatment option. We will also provide you with possible alternative treatment plans in addition to the Same-day Implant Prosthesis.

If most of your teeth are not salvageable, an immediate load implant-supported fixed prosthesis is an excellent treatment option. However, if many of your teeth can be saved with a good prognosis, that treatment should be presented to you as a treatment option to make an informed decision as to which treatment is preferable and why. 

We will explain to you, in our opinion: 

• why certain teeth are not salvageable
• why you are being considered for the Same-day Implant Prosthesis (Immediate Load Hybrid Prosthesis, All-on-4® type of prosthesis, etc.)
• what other treatment options are available to you (see Alternative Treatment Plans)

In short, if your teeth cannot be saved, why not?

Each implant maintains the integrity of the bone since it is a replacement titanium root. A greater number of inserted implants translates to enhanced support for the prosthesis along with additional preservation of the bone. 

With the Same-day Implant Prosthesis, a minimum of four implants is necessary to support the fixed prosthesis. However, additional implants can provide additional bone preservation and a greater number of future treatment options. We will discuss this with you at your consultation visit so that you can choose the treatment that works for you, considering your budget and desires.

The angulation of your new implants (such as in the All-on-4® technique) can affect your ability to have more implants placed near them in the future. In some instances, angling these implants is necessary because of a lack of bone in the posterior part of your jaw. But, in other cases, the implants do not need to be angled. Practitioners carry different opinions about when that technique should be used and what implant locations and angulations are ideal for certain cases. At your consultation, we will show you how we plan to place your implants as we demonstrate it on your CT scan (3D image).

Secondly, if too much bone is removed to insert implants without bone grafting, the ridge (where the bone has been reduced) may not be high enough or adequately wide enough to receive implants in the future. If significant bone reduction has been recommended, you need to ask how that will impact your option to have future implants inserted in other sites, if any existing implants were to fail or if a different type of restoration were to be desired.

Bone grafting preserves the jaw’s ridge when teeth are extracted. Once teeth are removed, the surrounding bone will shrink as it is no longer needed to support the teeth, except where the implants are placed. 

As an example or our different approach, according to the implant clinic ClearChoice® Centers:

“The Bar Attachment Denture Procedure can replace a full arch of teeth in one day, using only four implants and without bone grafts often saving time and money.” 

This statement implies that all teeth can routinely be extracted and replaced without any bone grafting. However, we disagree with this therapeutic approach. 

There are cases where a great deal of bone would have to be removed to insert the implants in one day. Without preserving the ridge by placing bone in the extraction sockets, patients will likely lose more bone over the years in areas where implants have not been placed. While, in most cases, the procedure can be performed at the insertion of the implants and the fixed prosthesis, preserving the bone may require an additional procedure. 

You need to be made aware of the advantages of preserving your ridges, along with the additional costs, to make an informed decision as to whether you want to have another procedure that would enhance your long-term prognosis.

With the appropriate design, you will be able to have good hygiene with your new Full Arch Hybrid or Screw-Retained Porcelain Prosthesis. If the appliance is fabricated too close to the gum tissue, it will be very difficult to clean under it. In order to maintain your new teeth, the restorative dentist needs to make sure that there is adequate room for hygiene brushes and other oral care products.

Until now, patients have to wear full dentures when they lose all of their teeth from bone loss and/or decay. Those appliances are inherently loose as they rely upon a suction fit to the residual gum tissue, which shrinks over time. The Same Day Dental Implant Restoration converts the denture to a fixed prosthesis by immediately connecting it to 4 or more implants placed that day.

In one visit, the patient immediately transitions from a sloppy fitting denture to a dramatic, solid, fixed prosthesis.

The customary and usual procedure for the All-on-4® procedure is to “table” or level the bone to speed up the process. Since no one can be sure if some bone will be needed in the future, at Elite Prosthetic Dentistry, we go to great lengths to preserve as much bone as possible.

They are connected to the denture using special abutments and connecting tubes.

Typically, the surgical site is opened and bone is leveled followed by the insertion of 4 or more implants. In our office, we offer our patients the option of first rebuilding the bone (instead of tabling it) and then placing the implants.

This procedure can certainly be done without bone grafting, but rebuilding the bone can increase the longevity for the implants in many situations.

The costs for this procedure can vary greatly depending upon the level of care and the type of prosthesis that is connected to the implants.

In certain situations, the bone is not as dense as we would like to see it. Therefore, to protect our patient, we offer the placement of two additional implants. This increases the long-term prognosis.

The duration of treatment takes several hours, and can vary, depending upon the procedures that are being performed. For example, Is the bone being tabled vs bone grafts being placed in the extraction sockets.

At Elite Prosthetic Dentistry, we have never had a failed All-on-4® type of case. Our success rate results from our detailed planning, making sure that the bone is dense and wide enough to ideally support the implants before they are placed, and finally due to our Precision Implant Placement and connection of them to the replacement teeth to create a hygienic appliance.

The ideal candidate has healthy bone that is wide and long enough is dense so that the implants have a very stable support. We assess these parameters with a very detailed analysis.

Yes. All of the various types of replacement teeth that we offer are very natural looking.

This procedure can be very exacting, requiring extensive attention to detail.

While a limited number of offices offer the final prosthesis within a couple of days, we are strongly against that approach. While speed can be very attractive, usually something is given up when many steps are by-passed. In addition, one cannot predict how the final tissue will heal and what its topography will be like so that the patient ends up with an inadequate prosthesis.

Since we make our appliances to the ideal aesthetics and/or bite, the lower arch can be fabricated at any time in the future.

The design of first the transitional and, ultimately, the final prosthesis needs to balance aesthetics with the allowance of enough space over the gum tissue for good home care. This is a very sophisticated process, but our patients receive a very aesthetic appliance that is also hygienic.

We provide hygiene care every 3-4 months using special instruments for cleaning implant abutments. Periodically, we take off the appliance for the hygiene visit.

The recovery period can be a few days. The predominance of our patients take only Advil, Motrin, or ibuprofen with Tylenol or acetaminophen, although we provide stronger pain medications.