All-on-4® Treatment Procedure:
Step by Step

Our dental implant treatments like this require two separate trips, each around 6 months apart. This is necessary as the dental implants need time to fuse with the jawbone–a process known as osseointegration–before the heavier, final fixed prosthesis can be loaded. An immediate-load denture can be worn during this time, although this is only temporary.

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First Trip:

1. Pre-surgical appointment: The patient first attends a pre-surgical appointment, during which the dentist will determine their suitability for the All-on-4® treatment concept.

Several tests, such as x-rays, 3D cone beam images and photo evaluations, will be taken so that the dentist can formulate a detailed treatment plan.

 

2. Custom-made immediate-load hybrid denture is processed: using information from the pre-surgical appointment and impressions of the patient's mouth, a specialist dental laboratory processes an immediate denture which will be attached during the surgical phase.

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3. Surgery: Before the placement of the implants, any remaining teeth are extracted. The implants can then be inserted at predetermined positions in the jaw. For this and other similar techniques, the use of four dental implants is considered to be the optimal number, although it is possible to support a bridge on four or more implants.

Using abutments and coping cylinders screwed onto the implants, an immediate denture is attached. This is then trimmed down to become a fixed implant bridge to complete the surgical phase. 

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What to know about implant surgery:

• The procedure may be carried out under local anesthesia with IV sedation, or under general anesthesia in the case of longer, more complex surgeries.

• Other sedation options may also be available, depending on the clinic and its facilities.

• Both jaws can be operated on during the same session (dual arch surgery).

• Surgery can take between two and six hours, depending on the complexity of the procedure.

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Healing phase:

After surgery, the patient returns home with their new, natural-looking teeth. However, it should be noted this is the provisional (temporary) restoration. 

Over the next three to four months, the implants fuse with the bone (a process called osseointegration), during which time the patient is generally advised to follow a diet of semi-solid/soft foods, as well as adhere to a hygiene and maintenance routine as prescribed by the dentist.

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Second Trip:

Final restoration: After four to six months, the patient returns to the same dental clinic to have their temporary bridge removed and replaced with the permanent one (final prosthesis). 

This stage may involve further tests and adjustments; however, the process is non-invasive, as the temporary bridge is simply unscrewed before being replaced. 

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Does the Fixed Bridge Require Special Care? What Else Should I Consider?

Following the completion of your treatment, patients should take note of the following:

• When your implants have first been placed and you have a temporary fixed bridge, you will be advised to eat soft food for a while–certainly not anything chewy or hard that could interfere with the osseointegration process. 

• For the first two weeks, patients are instructed to use a special mouthwash. After around 14 days, cleaning with a soft bristle toothbrush can resume. 

• Teeth function increases to approximately 90% after the attachment of the final prosthesis, allowing patients to eat practically anything they want. 

• Apart from maintaining a healthy oral hygiene regime–with careful brushing, flossing and regular check-ups, you should not have to do anything different following the completion of the treatment.