Detailed Procedure Guide: All-On-Four® Dental Implants
What are All-On-Four (AO4) dental implants?
All-On-4 (AO4) refers to a comprehensive dental implant program that completely replaces bad teeth with dental implants.
With the All-On-Four treatment concept natural teeth are surgically removed and replaced with four implants and a hybrid-type bridge.
Even though this procedure is the pinnacle of dental implant treatments, it is not without risks and potential complications. It’s an involved, aggressive treatment, which also happens to be the most widely marketed procedure in implant dentistry.
Prospective patients should understand that All-On-4 is not simple or easy; in fact, it’s the most complex implant treatment in dentistry.
All-On-Four procedures must be methodically planned and it’s imperative that there is a “plan B” in place before treatment gets underway.
What is the process for All-On-4 dental implants?
All-On-Four (AO4) is often marketed as “teeth in a day.” It’s a streamlined implantation procedure in which only four implants per arch are needed (or eight implants for replacement of all teeth).
The process begins with a dental exam and evaluation, including an assessment of your functional needs and aesthetic desires. The initial consultation is a good chance for you to ask questions about treatment options, and for your implant dentist to develop a personalized treatment plan.
At this stage your dentist will use state-of-the-art diagnostic imaging tools to help discern whether you possess adequate bone density and bone volume for this procedure.
In some cases, preparatory dental work may be needed prior to All-On-4 dental implants.
How do you determine if you’re a good candidate for AO4?
It’s easy to say you want all of your teeth out in favor of implants, and it’s a perfectly understandable sentiment. But the decision to pull all of one’s teeth should never be made quickly or taken lightly. You should have in-depth discussions with your implant dentist to make certain all potential issues are addressed before treatment gets underway.
At Implant Evolution we believe a second and even third opinion may be warranted when considering a major implant procedure like AO4.
But in general, you may be a good candidate for dental implants if you demonstrate:
- Good oral health
- Are healthy enough for surgery
- Are a non-smoker
You may be a good candidate for All-On-Four if:
- You are frustrated by loose dentures
- Are facing the loss of all of your teeth
- Are in need of a bone graft
- Are looking for a cost-efficient implant treatment option
Average cost for All-On-4 Dental Implants
According to Implant Evolution’s research, the cost of All-On-Four dental implants ranges from $18,000 to $30,000.
Specific charges and procedures vary according to the implant dentist and the scope of treatment, but All-On-Four can be very cost-efficient, as it requires fewer dental implants as compared to traditional full-mouth reconstruction.
Bone density requirements and required scans
Complex dental implant cases require bone that is adequate in both quality and quantity. Both All-On-4 and larger implant-supported bridges must have sufficient bone foundations to support the entire structure. Without adequate bone, dental implants do not hold and bridges may come out, leading to catastrophic failure.
Implant dentists routinely use technologies such as CBCT scans and computer-generated surgical guides to develop the best possible treatment plan, ensuring the best possible outcome for this complex procedure.
Anesthesia: Can you be put under sedation for All-On-Four?
Yes. For involved or extensive implant procedures like All-On-Four, most patients take advantage of some level of sedation, which makes the process easier to tolerate and less painful.
Even though sedation is usually not necessary, it does lead to a more pleasant experience and often a better outcome.
Is AO4 a same-day procedure?
Yes and no. There is an abundance of marketing that makes it seem like AO4 is a one-day procedure. While this sounds appealing, it is important to know that this is not always the case.
Moreover, you should understand that All-on-4 implants are not without risks, which should be discussed with your implant dentist.
All-On-Four can also require a certain amount of flexibility and patience, especially if certain steps need to be redone or if implants need to be replaced.
Preoperative instructions and advice
Your implant dentist will provide you with detailed instructions in advance of your All-On-Four surgery, which will likely incorporate some or all of the instructions listed below:
- Brush your teeth prior to your appointment
- Wear loose-fitting and comfortable clothing
- Do not smoke or drink alcohol for at least 24 hours before your appointment
- If you are having general anesthesia, do not eat or drink anything for at least eight hours prior to surgery
- Arrange for a responsible adult to accompany you to your dentist’s office, one who can drive you to and from your appointment and wait in the waiting room during your procedure
- Use the restroom before your surgery, if necessary
- Take care of all financial arrangements before your surgery
Recovery from this procedure is generally well-tolerated and post-operative pain can be controlled with medication.
Post-surgery tips and advice for proper healing
After All-on-4 dental implants and hybrid bridges are installed, it is very important that you follow all postoperative instructions, including specific instructions for brushing, flossing and rinsing.
Typically implant dentists also advise that:
- A responsible adult stays with you for at least 12 hours following surgery
- You rest at home for three days following surgery
Smoking is also strictly prohibited and you must stay on a soft diet for several weeks to limit the occlusal stresses placed on the implants. Examples of acceptable foods include:
- Scrambled eggs
- Pancakes or waffles
- Pasta or macaroni
- Apple sauce
- Cooked fruit
- Broiled fish
- Boiled chicken
- Mashed potatoes
- Protein shakes
- Ice cream
Your dentist may also advise that you refrain from exercise for the first week following surgery, as an elevated heart rate may delay healing.
Duration of recovery
The recovery period after All-On-Four can be longer and involve more discomfort than other implant procedures, although pain and swelling generally lessens within three days of surgery, with progressive improvement thereafter.
Additionally, significant bone reduction may be required and this trauma can add to the recovery timetable.
Proper upkeep after AO4
Long term care of AO4 hybrid bridges can be more difficult as compared to other implant restorations. The reason for this is that hybrid bridges prohibit easy access to the implants themselves. This makes routine care more challenging for the average person.
Alternative treatment options
If you’re in need of a complex implant treatment like All-on-4 dental implants, you may also be a good candidate for alternative treatments that deliver complete oral health via procedures that are not as involved or costly.
Keep in mind that implant dentists often differ on their specific treatment suggestions. And because the decision to do All-On-Four is so significant, Implant Evolution feels strongly that a second and even third opinion is warranted when considering this avenue.