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Teeth in a Day, All on 4, Implant Bridges and Implant Supported Dentures

Have you been told that your mouth is in terrible shape and that you’re going to lose all if not most of your teeth? Is your gum disease so serious that even if you can save your teeth your smile is unattractive from all the gum damage? Are you already missing all your teeth and hate your dentures or false teeth? If so, maybe a dental implant supported denture (overdenture or implant denture) or implant supported bridge may be your best option.  Dr. Tony Kim at the Honolulu based Dental Day Spa of Hawaii Specialty Group can help with all your dental implant secured teeth options.

In these techniques, usually 4 or more implants are placed in the arch that needs teeth replacement.  A removable implant denture which snaps onto a bar which is connected to implants allows for easy cleaning of the denture since it is removable but offers security with the snap on connectors.  Implant bridges can be designed which are screwed directly into the implants and are not removable.  Both designs allow for excellent speaking and chewing compared to regular traditional dentures.  The cost of implant dentures or implant bridges can vary from an inexpensive car all the way to a fancy luxury car.  With proper planning, it’s possible to walk in with horribly damaged and diseased teeth and walk out that same day with a perfect beautiful smile.  Because there are so many different options, it’s best to come in for a complimentary consultation at the office.

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This is a picture of a case I completed awhile back.  These teeth are attached to dental implants.  As you can see, dental implants can give you natural looking teeth with the proper techniques, and artistry.  The choice of labs is critical to delivering the best results.

Review of ways to replace all teeth:

  1. Traditional removable full dentures is the most common and quickest way to replace all your teeth.  Complete dentures are bulky, can affect speech due to a covered palate, may require sticky adhesives, are removable, less durable, but are most affordable.  However, we can make them look beautiful and with a good lab, you can make them look like real teeth.  I’m sure you’ve seen some sets of false teeth that look very fake and there are other sets of dentures that you would have never guessed that they were false.  We only work with labs that use the best quality teeth and make realistic beautiful smiles.
  2. Dental implant retained dentures (overdentures) are less bulky than traditional dentures but still large.  If less than 4 implants are placed on the top then the implant denture must cover the palate just like traditional dentures.  If at least 4 implants are used then a horseshoe shaped overdenture can be made which is partially covers the palate.  Both options are more stable than traditional dentures, and have snaps that need replacement every 6 months or so, and are made of the same acrylic material as traditional dentures.  The plastic teeth can wear down in a few years but can be easily replaced by a lab in a few days.
    • In this technique, dental implants are placed in strategic areas and then when healing is complete (usually 4-6 months) then an implant bar attached to all implants and the denture which snaps onto the implant bar is fabricated.  During this treatment, a temporary denture is used to evaluate esthetics, bite and functionality.
  3. All on 4 or implant bridges require at least 4 implants on the arch that needs teeth replacement.  This option is for those who don’t want to take out their teeth.  They are screwed into place and give the maximum amount of security and comfort.  Some disadvantages are that they may be more difficult to clean than removable denture options.  They also can take more time to finish and cost more than the removable options.  There is another section on advantages of implant supported bridges (all on 4) below after this video.

Here is an animation that covers implant retained dentures (overdentures):

Advantages of the All on 4 Full Arch Replacement

The All on 4 bridges (teeth in a day) allow you to get teeth attached the same day dental implants are placed.  With proper planning, you can have fixed teeth during the entire process from start to finish.  However, not all patients can have this procedure done so come in for a free consultation at Dr. Kim’s Honolulu dental implant office.

  • much less bulky then traditional dentures and implant supported overdentures
  • don’t cover the palate so speech is better than with other options
  • are permanently screwed into place so are securely fixed
  • can be made of the same materials as cosmetic crowns and bridges so can be lifelike
  • require fewer implants than other full arch implant restorations
  • can avoid bone grafting and sinus lifts in certain circumstances (requires more data to see if you qualify)

Because they are screwed in you can not remove them by yourself.  This option allows those who can not easily get more than 4 implants in one arch to still replace all the teeth that arch.  The all on 4 technique uses special angles on certain implants to avoid certain procedures but still have some strict requirements so you’ll need a consultation and an exam to see if you’re truly a candidate for this procedure.

Disadvantages of All on 4

  • The primary disadvantage for the traditional All on 4 treatment (with only 4 implants used per arch) is that the denture or bridge requires a minimum of 4 implants for proper support.  If one of the implants is lost, then the entire restoration can be compromised.  While most of the All on 4’s have long term success, just realize that the fixed implant denture can fail if an implant comes out.
  • All on 4 implant bridges/dentures cost much more than traditional removable dentures.  Because there is so much more involved with fixed versus removable, this fact can’t be avoided.
  • It takes much longer for the final prosthesis to be completed.  Because of the implant surgeries involved and possible grafting too, it takes months of healing before the final implant denture or implant bridge can be made.  In certain circumstances, a fixed temporary bridge or denture can be attached to your implants while you wait for full healing this is on a case by case basis.

All on 4 is good for clients that:

  1. Know they are going to lose all their teeth and don’t want dentures.
  2. Have dentures and want something more secure and smaller.
  3. Have implant dentures and want something more secure and smaller.
  4. Already have several dental implants and are experiencing severe problems with surrounding teeth.
  5. Clients who are going to get dentures but are curious about their options.

Implant Bridges on More Than 4 Implants

There are implant bridges that can be attached to 5 or more implants which can be a very nice restoration but could require extra bone grafting and sinus grafts.  This type of full mouth bridge attached to many implants would be the very best but can require more time, preparation, procedures and cost.  But having more than 4 implants per arch does allow you for more future protection.  Although dental implants have over a 95% long term success rate, there is a chance that one may fail over time.  If a dental implant faiels and you have more than 4, there is a chance that some minor modifications to the existing bridge will make it still usable.  For all on 4 clients, if one implant is lost then you will have to wait until a new implant is placed before a new implant bridge is made.  This option is for those who are willing to invest the time and go through the preparation to get the ultimate implant restoration possible.  The drawback would be that more bone would be required for this technique which may take additional time and expense but the reward would be a more a solution more engineered for longer term success.

As you can see there are several options possible.  There are more options not discussed here if you still have teeth remaining.  There are too many implant options and combinations so if you’re not sure if any of these options are the correct fit for you but still want to know if dental implants can help you, then come in for a free no pressure consultation at Dr. Kim’s Honolulu cosmetic and implant dental office.

Implant Dentures on Locator Abutments

It’s possible to make an implant overdenture which snaps on a special abutment called a locator.  Locators are directly attached your dental implants and stick out slightly of the gums.  There are special housings designed into the denture which snap onto these locator attachments for a stronger attachment to the denture versus suction or using denture adhesives.  Only two implants per arch are necessary for this type of implant overdenture versus designs which require bar attachments.  So this helps make this option more affordable and may be able to use your existing denture in certain circumstances.

Some drawbacks are that a full size denture is still required.  This design still relies on tissue support, otherwise there will still be significant rocking of the denture during chewing.  In fact, when only two implants are used, there will most likely still be some noticeable movement of the denture when eating or speaking.  Because of this movement, there is an increased chance of developing sore spots from rubbing.  Also, the areas of bone without implants will suffer continued bone loss which will lead to a less comfortable fit as time passes.  Relining the dentures may help as this occurs.  And the main disadvantage is that these designs are still removable versus fixed designs.