All-on-4®

You’ve found the world leaders in All-on-4®– Full Arch Implant Bridge Treatment.

All-on-4® is a popular treatment concept where all teeth are replaced using a base of just 4 dental implants. Originally developed for the rehabilitation of patients without teeth, or with teeth that are beyond restoration, extensive marketing has led to All-on-4® being accepted as a “quick and minimally invasive procedure”, with some clinicians using it as a default option that avoids difficult, long treatment plans.

In reality, All-on-4® is a highly complex surgical and prosthodontic procedure that involves the extraction of all remaining teeth (if any) and some surrounding bone and gum, and which should only be undertaken when existing teeth are determined to be unrestorable with absolute certainty.

If this is the case, the All-on-4® concept must be adapted to suit the specific needs of the patient, which includes careful consideration of the number and types of dental implants, prosthetic designs and materials.

While there are many promises made around the ease of this concept, the best option is to trust a highly trained Prosthodontist to ensure your All-on-4® type treatment is suitable, and undertaken with extreme precision to reduce the likelihood of complications.

Reconstructive Dentistry Perth - Centre for Prosthodontics
Reconstructive Dentistry Perth - Centre for Prosthodontics

Our approach to All-on-4®– Full Arch Implant Bridge Treatment.

All-on-4<sup class="sup-para">®</sup> is a treatment option - but not always the best one.

All-on-4® is not a procedure to be taken lightly. Our position is to first investigate other Prosthodontic options with the aim of keeping your existing teeth to preserve your face’s natural structure and reduce complications. With advanced knowledge and experience, it is not uncommon for our Prosthodontists to restore what appear to be failing teeth, sometimes even ones deemed unsalvageable by others.

Even if your existing teeth are terminal, All-on-4® treatment can only be successfully performed if you fall within a stringent set of treatment criteria, otherwise there can be serious consequences, including unnecessary gum and bone removal resulting in damaged eating and chewing functions, smile aesthetics, speech and comfort.

You are thoroughly assessed for suitability.

All-on-4® should not be a default option. To determine whether you are suitable for the All-on-4® implant procedure, we need to perform a detailed analysis of your dento-facial profile, utilising advanced digital technologies like CBCT/CT radiographic scans and intraoral surface scans.

You receive an unbiased understanding of this procedure.

Once we determine All-on-4® is required, we spend considerable time professionally advising each patient on its advantages, disadvantages and long term maintenance needs, so you can make an informed decision free from bias and marketing hype.

All-on-4® – the procedure explained.

If the All-on-4® implant procedure is suitable for you, our team may work in collaboration with highly experienced dental specialists to plan and perform the procedure, which typically occurs over four steps:

Joint Specialist Consultation.

We use advanced digital technologies like CBCT/CT radiographic scans and intraoral surface scans to complete a detailed assessment of the gum and bone tissues, relationship between jaw and lip line during rest and smile, and ideal teeth positions for the construction of digital CADCAM (Computer assisted designed and manufacture) surgical stents. This ensures accuracy, precision and safety.

Surgical Procedure.

This involves the extraction of remaining teeth, smoothing of the jaw bone (where necessary) for a stable platform, and the surgical placement of dental implants using CADCAM surgical stents.

Prosthetic Procedure – Instant or Immediate Implant Bridge Installation.

This involves the installation of your full arch implant bridge (your new teeth) onto the new implants. This will take place either at the time of implant surgery or approximately 1 week afterwards. Your implant bridge will be constructed with high strength acrylic or ceramic material with a customised underlying titanium metal alloy or zirconia framework.

Final Prosthetic Checks and Refinement.

After your procedure we carefully monitor your gum and bone healing, implant bridge stability and oral hygiene care. Once healed, your implants are clinically and radiographically checked for osseointegration (merging with surrounding bone).

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FREQUENTLY ASKED QUESTIONS

When is All-on-4<sup class="sup-para">®</sup> the right procedure?

All-on-4® may be suitable when patients are without teeth or when remaining teeth are determined unrestorable or hopeless with absolute certainty. Outside of this, our goal is to explore other Prosthodontic options that aim to restore existing teeth with minimal surgical intervention. If patients are suitable for the All-on-4® option, a detailed assessment must take place to fully customise a treatment plan to meet your specific treatment needs.

What are the risks associated with All-on-4<sup class="sup-para">®</sup>?

When all clinical steps are completed correctly, All-on-4® treatment can be an excellent, long-term solution for the replacement of missing or extremely damaged teeth. Of course, all dental implant procedures carry a certain level of anaesthetic and surgical risks which are generally well managed with standard measures but, in exceptional cases, we will collaborate with our medical colleagues (i.e. Anaesthetist, Oral and Maxillofacial Surgeon) to reduce these risks even further. Patient selection and cooperation are also keys to success, as there are patient related risk factors which our Prosthodontists will have less control of. These may include compromised medical health (i.e. poor management of diabetes), medication use (i.e. bisphosphonates for osteoporosis), exposure to cancer radiotherapy, poor compliance in periodontal disease treatment and home plaque control, smoking habits and excessive bite forces. With careful planning and meticulous techniques, our Prosthodontist will weigh up risks and benefits and guide you through the treatment process.

I’ve been told All-on-4<sup class="sup-para">®</sup> surgeries take a single day - why do yours take 6 months?

In special selected cases, All-on-4® treatment can be a “one day turnaround” procedure. For instance, utilising Audentes All at Once® technique, tooth extractions, implant placements and instant installation of a final permanent full arch implant bridge can be done. However, careful medical screening, detailed assessment with digital CBCT/CT scans and intraoral surface scans, smile and bite design, construction of surgical stents and final permanent full arch implant bridge, informed consent and maintenance protocol must be prepared prior to the day itself. As it is a highly complex procedure, our Prosthodontists will always take this conscientious approach and act in your best interest, making one day completion highly unlikely at our clinic.

Why should I choose a Prosthodontist to complete my All-on-4<sup class="sup-para">®</sup>?

Given the complexity of All-on-4®, it is not taught to general dentists as part of their university undergraduate dental training program or degree. As such, very few general dentists will offer this treatment option to their patients and the majority will refer to dental specialists (i.e. Prosthodontists, Oral and Maxillofacial Surgeons and Periodontists). Prosthodontists have undertaken a minimum of 3 years full-time specialist dental training on complex implant dentistry, in addition to general dentist qualification. With over 90 years of combined dental experience and specialised dental training from US, UK, Australia and South Africa, our team will complete ‘All-on-4®’ with as few future complications as possible.

DO I NEED A REFERRAL TO VISIT THE CENTRE FOR PROSTHODONTICS?

No, you do not, however we do recommend seeing your dentist before booking an appointment with our team.

HOW MUCH WILL MY TREATMENT COST?

Until we have a full plan in place we unfortunately cannot give cost estimates, as all our work is completed bespoke for each patient. However, all costs associated with your treatment are provided in detail before any work begins. Click here to find out more.

Our Prosthodontists.

Choose the team who teach at the most
prestigious institutions worldwide.

Dr. Janice Kan

BDSc Hons (WA) DCD Pros (Melb) FAANZP FITI FADI FICD MRACDS (Pros)

Registered Specialist Prosthodontist

Dr. Tom Elliott

BDS (Bristol) MFDS (RCSEd) MClinDent (KCL) MRD Pros (RCSEd) DCD Pros (UWA) MRACDS (Pros)

Registered Specialist Prosthodontist

Dr. Armand Putra

BDSc (Qld) MSD (Washington) Grad Cert Pros (Washington) CDT FAANZP FACP Diplomate of American Board of Prosthodontics

Registered Specialist Prosthodontist

Dr. Hezel Cohen

B.Ch.D (Stell) Cert. Pros. (Kings) DCD Pros (Melb) FAANZP MRACDS (Pros)

Registered Specialist Prosthodontist

Dr. Adam Hamilton

BDSc Hons (WA) DCD Pros (Melb) FAANZP FRACDS

Registered Specialist Prosthodontist

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NOT SURE WHAT TREATMENT YOU NEED?

While you can access our services without a referral, we strongly suggest you speak to your dentist first. Our team are available to help discuss your options.