All On 4 dental implants are a revolutionary approach for solving the problem of missing multiple teeth and reconstructing and restoring full mouth function.
While conventional dentures sit on top of the gums, All On 4 dental implants are permanently fixed to the jaw, providing a stable connection for full-set dental prosthetics. As opposed to standard single implants, which require each tooth to be implanted individually, All On 4 dental implants only require four implants that support the full-arch prosthesis.
Once installed, these implants function and look like natural teeth. All On 4 dental implants are less invasive and expensive for patients missing multiple teeth than replacing each tooth.
If you are considering your tooth replacement options, you may wonder how long does All On 4 procedure take. Our comprehensive step-by-step guide answers your questions, so you can decide whether an All On 4 dental implant procedure is the right solution for your oral health and smile goals.
How Long Does All On 4 Procedure Take: Initial Consultation
At Casey Dentists, we strongly believe patients should be as informed as possible before undergoing any surgical procedure. To begin your journey to full-mouth restoration, you will meet your dentist for a consultation.
During this visit, your dentist performs a comprehensive oral examination to determine if you are a candidate for the All On 4 dental implant procedure. This may include taking X-rays and 3D images of your mouth, although this can also be done after any necessary tooth extractions.
To determine if you are a good fit for the All On four dental implant procedure, your dentist evaluates your remaining teeth and gums and assesses your medical history to see if you fit the following criteria:
- You are in good enough health to withstand the rigours of surgery
- You are facing the loss or removal of all your teeth or a complete arch of teeth
- You have poor bone density due to tissue resorption
How Long Does All On 4 Procedure Take: Preparatory Treatments
Before continuing to the next step in the All On Four dental implant procedure, you will have to address any underlying issues preventing implant installation. All On Four dental implants are ideal for patients with low bone density, so patients do not typically require bone grafts; however, several other procedures may be necessary.
If you are suffering from gum disease, your dentist may prescribe periodontal therapy to reduce the likelihood of developing peri-implantitis (bone or gum loss affecting dental implants). To eliminate gum disease, your dentist may perform a scaling and root planing (SRP) procedure on the affected teeth that aren’t being extracted to remove bacteria and treat your infected gums with antibiotics.
If you have significant soft tissue loss, you may need a gum graft to supplement the tissue to ensure it can support All On Four dental implants and the bridge.
If you have damaged teeth or tooth roots, those teeth will need to be removed to make room for the All On Four dental implants.
The amount of time this step takes can vary depending on the nature of the preparatory treatment. If you need to have several teeth pulled, you may need to wait for one to four months after extraction for the gum tissue and bone to heal and regenerate before moving on to the next step in the dental implant procedure.
Your dentist will make an impression on your mouth during this step to ensure your implant is ready once you recover.
How Long Does All On 4 Procedure Take: Embedding the Implants
Once your mouth has been prepared for the surgery, you will visit the dentist to have the All On Four dental implants posts installed.
Before beginning the All On Four dental implants post-placement surgery, your dentist administers local anaesthesia to reduce the amount of discomfort you experience during the procedure. They may also use oral or inhalation sedation to augment the local anaesthesia, depending on the level of anxiety you report.
Then, your dentist installs the first two implant posts where your natural lateral incisors would be located. The following two implant posts will be installed in the posterior molar region and placed at an angle up to 45°.
By placing the rear implant posts at an angle, your dentist ensures that the implants provide a stable foundation for the prosthesis, eliminating the need for a bone graft. Angling the rear implants also helps avoid puncturing the sinus cavity for maxillary All On Four dental implants, which can cause severe complications.
Once the implant posts have been placed, your dentist may provide you with temporary prosthetic teeth. These temporary teeth allow you to eat and protect your implants while you heal.
How Long Does All On 4 Procedure Take: Osseointegration
The next step in the All On Four dental implants procedure is osseointegration. During osseointegration, the jawbone fuses to the titanium implant post.
Titanium is a unique, biocompatible material that can integrate with bone tissue. The titanium posts are also coated in a biofilm containing a growth factor that accelerates the fusion process.
This portion of the All On 4 dental implant process is the most important because poor osseointegration is the leading cause of implant failure. It can take four to nine months for the process to complete. The osseointegration process is broken into three distinct stages:
1. Initial Healing
Once the titanium implant posts are placed in the bone, your body adjusts to the presence of the posts and begins to regenerate and heal. The pressure from the insertion of the dental implant triggers osteoclast cells. These cells stimulate the release and deposit of minerals and proteins that begin to form a bone matrix.
2. Immature Bone Growth
Over the weeks and months after the initial healing process, immature bone tissue forms around the titanium implant post. This process begins to lock the implant into place in the bone permanently. Since this bone growth is immature, it does not resist stress as well as fully-matured bone tissue does.
3. Mature Bone Growth
In the final step of the osseointegration process, the immature bone formed in the previous step begins to undergo the bone remodelling process. During this process, the weaker, immature bone tissue is replaced with strong and durable mature bone. The mature bone allows the integrated implant post to withstand the forces exerted while eating.
How Long Does All On 4 Procedure Take: Adding the Abutments
Once the osseointegration process is complete, and the titanium post is permanently fused with the jawbone, your dentist adds the abutments. Abutments are the portion of the implant that acts as a base and connects the prosthesis and the implant post. This step is often relatively brief and can sometimes be completed in the same visit as the bridge placement.
How Long Does All On 4 Procedure Take: Placing the Bridge
Once the abutments are placed, your dentist places the bridge. Your dentist may immediately load the bridge or delay placement. Immediate loading means the bridge is placed on the implants within 72 hours of surgically embedding the posts. This is suitable for patients with minimal jawbone resorption.
Delayed loading refers to placing the bridge after osseointegration is complete, making it ideal for patients with significant bone loss or reduced immunity. Studies have shown no statistical differences in the All On Four dental implants success rate between immediate and delayed loaded implants.
When you are ready for bridge placement, your dentist creates a custom-fit bridge that looks and functions like natural teeth. They will then place the bridge in your mouth, attaching it to the abutment.
Once the bridge is placed, the All On 4 dental implant process is complete.
All On 4 Implant Recovery
Once the All On 4 dental implant process is complete, your implants will look and function like your natural teeth, restoring normal eating and speaking.
One of the biggest benefits of All On 4 dental implants is the reduced need for maintenance compared to other tooth replacement options like removable dentures.
To keep your All On 4 dental implants clean and healthy, follow these guidelines:
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Brush
Brush your All On Four dental implants regularly. Most dentists recommend using a soft-bristled or electric toothbrush to brush all surfaces of each tooth at least twice daily for at least two minutes with fluoride toothpaste. Rinse your mouth thoroughly after brushing.
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Use a Waterpik
Use a Waterpik twice daily to remove plaque and food debris from between the teeth on the artificial bridge. You can also use a sulcus brush or a floss threader to clean underneath the bridge where it meets the soft tissue.
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Rinse
You should also rinse your mouth regularly to rid your teeth of food debris and bacteria. Many dentists recommend rinsing the mouth after each meal and after consuming any non-water drink. You should also rinse with mouthwash after brushing and flossing. You can use water, a saline solution, or mouthwash to rinse.
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Regular Dental Visits
You will need to regularly visit the dentist to ensure no complications arise with your All On Four dental implants. You should plan to visit the dentist once every six months for a routine checkup and to have your All On four implants professionally cleaned.
All On 4 Implant Complications
As with any medical procedure, the All On Four dental implant procedure presents a small risk of complications. While the procedure is generally successful (many dentists report a success rate in excess of 94.8% after 10 years), it is important to be aware of the potential complications that may arise, including:
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Broken Implant
While the risk is small, there are circumstances in which All On Four dental implants may break. The bridge can break due to trauma or incorrect installation. There is also a small risk that the implant posts break. This is more common in implants that use lower-grade titanium or in patients who grind their teeth regularly. To avoid this, your dentist may instruct you to sleep with a night guard if you grind your teeth.
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Peri-Implantitis and Gum Recession
In some cases, the gums may recede and expose the implant post or abutment. Your dentist may perform a gum graft to cover the exposed portion of the implant.
Some patients may also suffer from peri-implantitis, an infection that causes inflammation in the gums and bone of a patient who has an integrated dental implant. This condition can lead to bone loss and reduce the implant’s lifespan.
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Infection
As with any surgical procedure, there is a small chance that you will suffer from an infection due to the procedure. Most commonly, this occurs immediately after the procedure. Proper oral hygiene and regular checkups from the dentist can help prevent infection.
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Osseointegration Failure
If the osseointegration process fails to occur, it can leave the implant without a solid connection to the bone. This is the leading cause of implant failure and will require your dentist to take immediate corrective action, such as a bone graft, to allow for the osseointegration process to take place. If you are not a good candidate for the corrective procedure, your dentist may need to reevaluate your treatment plan.
Get Quality All On 4 Implants at Casey Dental
All On 4 dental implants are an excellent option for patients with many missing or decayed teeth. The implants allow patients to restore their previous chewing function, prevent or reverse bone loss, and increase self-confidence by providing a natural, healthy smile.
If you are missing several teeth and are unhappy with your smile, call Casey Dental on (07) 4801 7035 to schedule an All On Four dental implants consultation today.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
All-on-4 Implant Treatment: Common Pitfalls and Methods to Overcome Them
https://pubmed.ncbi.nlm.nih.gov/27548398/
Safe Approach in All-in-Four Technique
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333602/
Biomechanical Evaluation of Bone Atrophy and Implant Length in Four Implants Supporting Mandibular Full-Arch-Fixed Dentures
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103878/
Dental Implants: A Review
https://pubmed.ncbi.nlm.nih.gov/26995275/
Dental Implants
https://pubmed.ncbi.nlm.nih.gov/29262027/
Peri-Implantitis: Etiology, Diagnosis, and Treatment
https://pubmed.ncbi.nlm.nih.gov/24654366/