All on 4 implant - as the name suggests , all the teeth of a jaw is supported by four implants. All on 4 is the system which is used when there is less bone available in back side of either jaw. Less bone or Atrophic jaw is a condition in which due to bone loss the back side of jaws do not have adequate bone to place implants. in such cases bone grafting is the option, but with All on 4 implant system , without graft and waiting period of 6 months, immediate implants can be placed and fix teeth can be given within 5 to 7 days.
In All on 4 system, 2 implants comes in centre of jaw and in straight position whereas other 2 implants are tilted at sides of jaw to avoid sinus perforation. Due to this tilt of 2 implants , the head of the implant reaches to the level of 2nd premolar or 1st molar tooth.
In upper jaw which is called Maxilla - tilted implants are placed in the bone adjacent to the maxillary sinus and in lower jaw which is called mandible - tilted implants are placed 3 to 5 mm away from mental nerve. The tilt of the implants ranges from 17 degrees to 45 degrees , depending upon the bone level.
Indication of all on 4 implants:
- less bone in the region of molars teeth in both jaws
- adequate length and width of bone in the region of front side of both jaws
- medically compromised patient in whom extensive surgery of graft is not advised
- immediate replacement of fix teeth
Contraindication of all on 4 implants:
- those who do not have bone available in front region till 1st premolar region , in such cases zygoma implant may be the option along with all on 4
- good bone available in both jaws on back side
- patients with heavy bite force
- big jaw sizes , which require more teeth for chewing
benefits of all on 4 implants:
- Fast work
- fast recovery
- immediate fix teeth replacement
- affordable cost
- less invasive procedure
Drawbacks of all on 4 system
- less number of implant to support teeth
- only 24 teeth in the final prosthesis
- 2nd sitting after 6 months for final teeth set
- less chewing efficiency with 24 teeth
Available system in all on 4 implant per jaw with cost:
- noris medical - 3300 USD
- osteem - 3600 USD
- noble biocare - 4600 USD
What is better then all on 4 if not indicated for you ?
- Basal implants
- All on 6 implants
- All on 8 implants
- Zygoma implants