All-on-4 Dental Implants

Philadelphia, Main Line, and Ardmore, Pennsylvania Cosmetic Dentistry

It’s estimated that over 35 million Americans have lost all of their teeth. Many of these people have tried wearing dentures, but dentures have their drawbacks: slipping, the inability of the wearer to sense food temperatures, the continuing loss of underlying jawbone mass, and the fear to eat certain foods, among other issues. Replacing all of the missing teeth with dental implants would be a great solution, but the cost is prohibitive for most people. So, many people simply suffer through embarrassment, nutritional deficiencies, and decreased quality of life that is part of living without their teeth.

But now Dr. Marshall, who has extensive training and experience placing dental implants, has a new option, All-on-4 dental implants. This is a hybrid between implants and dentures. The All-on-4 method uses just four implants on the top arch and four on the bottom arch to anchor full sets of top and bottom false teeth. Because the false teeth are now anchored solidly by implants, the wearer can eat normal foods again and can show the world a perfect smile. This changes everything for our patients from Philadelphia, Main Line, and Ardmore.

What are All-on-4 dental implants?

Using dental implants to anchor dentures isn’t new, but it has typically involved six to eight implants on each arch. These implants were placed vertically into the jawbone.

Dr. Marshall’s All-on-4 method requires only four implants per arch. This is possible thanks to the two back implants on each arch. Instead of being placed vertically, these back implants are placed at a 30 to 45-degree angle from the biting plane. Doing this usually precludes the need for bone grafting. Patients who have been missing their teeth for some time usually have lost some degree of jawbone mass, and vertical implant placement often requires grafting to build the bone back up. After the back implants are placed at an angle, the front two implants are placed vertically. This is possible because there is usually less bone loss toward the front of the jaw.

Next, a prosthesis with 10-14 teeth is permanently attached to the four implants on each arch. For these prostheses, the patient can choose between porcelain or composite resin. Most patients opt for porcelain because of the way it closely resembles the translucence and appearance of natural tooth enamel. Plus, porcelain provides a more durable, virtually stain-free prosthetic.

What are the benefits of All-on-4 dental implants?

For a person who has been missing all of his or her teeth, the life changes made by All-on-4 implants are hard to sufficiently detail. Instantly the patient can smile confidently, eat a normal diet again, speak more clearly, and feel a real boost in self-confidence.

These are the benefits associated with the All-on-4 implant system:

  • Eat a normal, diverse diet without worrying — Because your new teeth are fully anchored into your jawbone, you can now return to a normal diet.
  • Return to a confident smile — Your new teeth will function, feel, and look just like natural teeth. Your smile will be back.
  • Acquire a complete set of fully functioning teeth in a short amount of time — The All-on-4 implant procedure takes around 2.5 hours per arch, and you will have temporary functioning teeth the same day (they will be replaced with your permanent teeth when your implants have fully healed and solidified).
  • Chew and bite with confidence — Your anchored new teeth will give you a bite force with 70 percent more power than dentures.
  • Teeth for life — Your four or eight implants are permanent, and your new teeth can last the rest of your life.
  • Implants without painful bone grafts — If you’ve lost jawbone mass you won’t need to suffer through the bone grafting often required with traditional implants.
  • Put an end to further bone loss — Your implants will now transfer bite force energy down into your jawbone. This energy triggers the jawbone to continually create new bone cells, the key to healthy bone mass.

Would All-on-4 dental implants work for me?

There are very few limits for a person to be an All-on-4 candidate. Ideally, the patient should be missing all or the majority of his or her teeth. Age is not a factor.

What is the All-on-4 implant procedure?

Another amazing thing about this method of implant placement is that it can be done in most cases in just a single day in our beautiful Ardmore offices. The first step, if necessary, is for Dr. Marshall to remove any remaining damaged teeth. We’ll also thoroughly clean out and remove any diseased gum tissue. From there the actual placement of your implants takes just two and a half hours per arch.

We begin the process with a CT scan of your jawbone. This shows Dr. Marshall the overall condition of your jawbone and lets her plot the best locations for the eight implants. Next, a computer simulation of your mouth is created, and the implant locations mapped out. We’ll also take impressions to create your temporary false teeth.

For the actual placement, we can use local or general anesthesia (your choice). We place the two back implants at an angle and the front implants vertically. The implants get their name from the titanium “implant” that is screwed down into the jawbone. For the angled implants, Dr. Marshall will drill a tiny hole to start the implant. The vertical implants are usually placed in sockets formerly occupied by the natural tooth roots. After the implants are placed, a post, called an abutment, is attached to each implant. The final step is to attach a temporary set of teeth to the four posts top and bottom. You’re done for now. Since the implants are not fully integrated, at this point you’ll eat a soft diet.

A period of 3-6 months, depending on how fast your jawbone grows, is then allowed for the implants to fully become accepted by the jawbone, which grows around them. When Dr. Marshall feels the implants are fully integrated into the jaw, she replaces your temporary prostheses with your permanent teeth. Now, you’re good to go. You can eat what you want and show your beautiful new teeth to the world.

What is my recovery process?

After we place the implants and attach the temporary prosthesis, you will return home and allow the incisions to heal. We’ll provide pain medication, antibiotics, and anti-inflammatory medications, but your recovery will not involve an undue amount of pain. Your newly placed implants are delicate at this time, so a soft diet will need to be followed (but odds are you’re used to that if you’ve been missing all of your teeth). You’ll also need to avoid strenuous exercise for a couple of weeks.

Your jawbone then begins to bond onto the bases of the titanium implants, growing around the implants and making them a part of the bone. This process varies by the patient but usually takes between 3-6 months. Over this period, you’ll periodically come back to see Dr. Marshall so she can check your progress and adjust your temporary bridges if needed.

How are All-on-4 dental implants different from traditional dentures?

The difference is the anchoring. Dentures usually adhere to the gums through a combination of suction and pressure from the surrounding tissues. This is why they can slip when talking or chewing and why certain foods need to be avoided.

All-on-4 dental implants anchor a top and bottom set of false teeth. Because they don’t sit on the gums, as traditional dentures do, we call these prostheses not dentures. The implants attach to the prosthesis in four spots that span your arch. These give your false teeth incredible strength, allowing you to eat whatever you want without any fear of your teeth slipping.

Plus, traditional dentures don’t stimulate the jawbone under your gums. This allows the jawbone to continue to deteriorate (this process begins as soon as a tooth is missing). This problem makes it necessary to refit dentures periodically. Implants send the energy created by biting and chewing down through the implant into the jawbone. This energy is delivered into the jawbone just as a natural tooth does, and it triggers the body to continually create new bone mass to ward off deterioration.

How are All-on-4 implants different from traditional implants?

People think All-on-4 implants are completely different than traditional implants, but they aren’t. The back two implants typically are different in that they are placed at an angle rather than vertically. The other four implants are placed vertically and are traditional implants. Yes, All-on-4 is done in a single session, but the process of the implants becoming integrated into the patient’s jawbone is the same process for a single implant or for All-on-4.

Of course, instead of attaching individual artificial teeth to the implant bases/posts, with All-on-4, Dr. Marshall attaches the full-arch prostheses to the top and bottom implants. This allows us to replace all of the patient’s missing teeth using just eight implants to anchor to two full arches.

Will my new teeth look natural?

Your new teeth will be a part of your jawbone (thanks to the implants) and will look, feel, and function just like real teeth. We take great pride in the prostheses we provide and guarantee you’ll love your new teeth and your new smile!

Contact Us For A Consultation

Want to know more about All-on-4 dental implants or interested in setting up a consultation? Contact us today at (610) 649-0696

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