All on 4/5/6 Implants
Teeth in a Day
At Coolum Beach Dental, we can provide for you a fully fixed alternative to wearing loose uncomfortable dentures. You may have heard of the term “All On Four”; this term refers to the replacement of ALL teeth ON FOUR dental implants. It is a modern technique where the back implants are tilted 45º to provide the required support for total rehabilitation of the mouth.
The action of tilting the back angle of the of implants helps overcome bone deficiencies often found in the back of the jaws and most often avoids the need for bone grafting. Because fewer implants are used by comparison to older methods, there are fewer complications presented in the quest of achieving an optimal result. It also allows for simpler long-term maintenance and uncomplicated cleaning.
At Coolum Beach Dental, we offer the “Plus” treatment of All On Four; where we place one place or two extra implants to support the fixed bridge. This addition results in the greatest possible stabilization of the bridge, and because we are dedicated to achieving a fully functional and quality outcome, we offer this service at no extra charge.
Typically a patient will receive 6 implants in the upper jaw, and 5 implants in the lower jaw. The reason we believe this is a superior treatment to the normal four relates to the find line presented with just four implants.. if one of the four implants should fail, then the entire prosthesis (bridge) fails… “all on four”, then presents “an all on nothing” situation.
Were we are unable to place the 6 upper implants immediately due to lack of bone density in the sinus area, the patient can still have 4 implants placed and immediately leave with a fixed teeth bridge. The patient will then have the future option of a sinus bone grafting and implant placement in the future. This still provides them the opportunity of extending their permanent bridge in the long term, thus completing the ultimate 6 implant retained bridge.
Dental implants have been around for quiet a while, they are small titanium fixtures that are inserted into the jawbone to support a prosthetic tooth or a ‘Bridge’ which is a segment of multiple teeth in a row. These fixtures form the foundation for the prosthetic replacement of natural teeth that have failed or fallen out in the mouth.
When we replace a full set of teeth; this is often referred to as full arch rehabilitation, whether in the upper or lower jaws or both. When a full arch rehabilitation is instigated we do not need to place an implant under every tooth, just 2 implants at the front of the arch and 2 implants at the back. These implants are set at an intended angle, and together these form the required foundation to support the prosthesis.
By placing the implants at an angle, we are able to avoid the parts of the jawbone that may be in typically poor health exhibiting poor quality bone density. This not only means that we can avoid the need for bone grafting, but we can also trust these implants to and reliably support the prosthesis fitted.
At Coolum Beach Dental we will always recommend patients have the 6 implants on the upper jaw, and typically 5 implants on the lower jaw because we want our patient’s to have the highest quality outcome, offering the utmost of comfort, workability and long term success.
Immediate Replacement Teeth
The Treatment of the “All Four/5/6 concept” involves the immediate fitting of the prosthesis to the fixtures, also known as Immediate loading. It sounds simple because when done properly, this is exactly what it is. We aim for our patients to experience a seamless process to achieving a wonderful new smile, that not only looks amazing but if functional and strong… a solution to last the distance.
While the treatment is very straightforward, this it is not a simple procedure. It requires a highly advanced surgical procedure, when performed by experienced dental professionals has remarkable outcomes!
Course of Treatment
Step 1. Consultation with the Experts. The first step is to make a consultation with one of our trained professionals. Over the course of your consultation our Dentist will examine your mouth, explore all your treatment alternatives and help you determine the most appropriate solution to fit your individual needs and expectations. If the Dentist identifies that you may be a viable candidate for the “All On 4/5/6 treatment” option, then viable options will be explored that preferably avoid the removal of any of your own teeth where possible.
Further investigations will be carried out to check your bone density, this is achieved by a special x-rays called a cone-beam CT (CBCT) scans is needed to complete your diagnosis. The over all bone density in your jaw will indicate if your current situation has the ability in terms of strength and stability to support the implants and bridge successfully. The health of your bone will ultimately determine your suitability for any sort of treatment, and plan the positioning of the fixtures.
At Coolum Beach Dental we have our own in-house high-resolution state of the art ,CBCT X-ray machine, we can conduct your scan on site, which allows for a direct diagnosis of your bone’s condition.
Appointment Duration: 30-60 minutes. Approximate Fee: $150 maximum out of pocket
Your Treatment Plan
Once the Dentist has assessed your health, x-rays and clinical situation, you will be given a treatment plan, which outlines all the treatment stages as well as the costs involved. All of this is covered under your initial consultation fee. There are no hidden costs or extras. At Coolum Beach Dental we pride ourselves on having affordable and transparent treatment costs outlined in writing for our patients to consider. We listen to our patients, ensure they fully understand every option available and help them to make a decision that is right for them. No treatment will proceed until all these steps have been fulfilled.
Mock-up and Pre-operative Work-up
Should you decide to proceed with the oral rehabilitation involving any of “all on 4/5/6 “ treatments, you will need to attend the clinic for photos, models and other recordings as required. The reason so much information is gathered is to enable the dentist to plan the optimal way in which to create a solution that is pleasing in appearance and superior in function.
Appointment Duration: 30-60 minutes. Costs included in your overall treatment plan.
Fully Guided Implant Surgery
Your Implant surgery and tooth fixation is all completed in the same day.
Where treatment requires tooth removal, this is completed and then the area is cleaned and primed for the next stage of the surgery. The jawbone is then prepared to accept the fixtures and these are inserted according to the work-up along with any repair or reconstructive work as may be required. The area is closed with dissolvable and non-dissolvable sutures.
Reshaping of the Jawbone and Gum Surgery
When teeth are lost the gums begins to shrink; this is due to the underlying bone undergoing natural atrophy and resorbs. Dental problems such as prior infections, gum disease, trauma or other degrading conditions of the teeth may lead to the need to have the affected teeth removed, or sometimes they may just fall out. In positions where teeth are missing; it commonly causes the related jawbone to have defects and often created an uneven surface on the jawbone.
Sometimes your dentist may recommend the re-shaping of the jawbone with a procedure called alveolectomy, or alveoplasty, removes the rugged areas of the jawbone to leave a flatter surface and more favorable surroundings for dental implants. By removing the rugged areas, we also eliminate the parts of the jaw that are most susceptible to reabsorption. This enables the Dentist to place the dental implant into the deeper (healthier) bone which results in a more stable outcome; the overall health and quality of the implant placement is superior for long term success.
Apart from improving the conditions for the placement of the fixtures, the re-shaping of the bone also improves the amount of space that is available for the construction of the teeth, which improves our ability to design a restoration that is more durable and aesthetically perfect. The additional space also helps ensure that the transition between the prosthesis and natural gums remains hidden. The re-contouring of the jawbone also creates a flat interface of the prosthesis to sit against the natural gums. Having a smooth unified surface make the area much easier for the patient to keep clean and maintain good dental hygiene.
Same Day Tooth Placement / Teeth in a Day
At Coolum Beach Dental, we have a Dental Technician on-site during the day of surgery; this allows us to take immediate impressions on the day, and have the Technician create your new smile immediately.
The Technician will use all the information gathered prior to the surgery to create your perfect smile. You will have already seen an example of the exceptional work undertaken by the technician because we use the same technician who created your “wax-up” model from your earlier appointment. This ensures your technician personally knows and understands every detail of your unique case!
Our fully guided implant placement information is also given to the technician, so that he can plan the final prosthesis before the surgery even begins.
You will be able to have an immediate try of of your new smile approximately 1 hour after the completion of your implant placement. This allows the Dentist to check for correct bite and for you both to make any final improvements to your new smile.
Final Bridge Placement
A final acrylic, metal reinforced bridge is placed onto your new implants, this occurs approximately 3 hours after your surgery is completed.
This is a full day treatment, and will not have to comeback subsequent days for more visits and try in appointments. Your smile is absolutely complete and you will have your new smile immediately, it is truly amazing!
After Your Surgery
Hygiene and Diet
In the immediate period after your surgery you can expect to have swelling, bruising and maybe some pain or discomfort. Your Dentist will prescribe you medication, but it is not uncommon for patients not to feel the need to take the pain medication. As the teeth are not removable, brushing and cleaning follows the same principles as if they were your own healthy natural teeth, just a standard toothbrush twice a day.
Whilst it is common for patients to describe their teeth as feeling instantly solid and fully functional, it is important to stay on a softer diet (ﬁsh, pasta, eggs, stir-fry, etc.) for the initial 3 months of healing so as not to disturb the biological process of osseo-integration.
At 3 weeks after your surgery, once the swelling had subsided, and you have become more accustomed to your new teeth, a member of Coolum Beach Dental will show you simple additional methods to effectively clean your new replacement teeth. These include water flosser, bridge floss, and brushes with specialised tips.
Review, Adjustments and Maintenance
Four months after your surgery your dentist will see you for review to verify that the implants have integrated and to ﬁne tune your teeth as required. At this time it is also possible to remove the bridge to re-line its surface, or to make adjustments that require processing in the laboratory. Should your work require processing in the laboratory, we will aim to have ypur new smile back in place within a few hours. This review and any laboratory adjustments are part of the package and an extension of our service to you.
Once we conﬁrm that the implants have integrated, at the 4 months review, you can start eating all types of food, even biting apples, nuts, crusty breads, chocolate and steak. Future maintenance is often uncomplicated and involves regular attendance for scale and cleans, as with natural teeth, x-rays every 2 years, and may at times require certain repairs. All repairs to your bridge are included for a period of 2 years.
Indication-Specific Restorative Upgrades (When Required)
The replacement teeth that are fitted immediately on the day of the surgery are designed with the final aesthetics and function, and as the permanent restoration. However in certain cases the improvements in the forces of the bite may be beyond the tolerance of the material used to make the immediate bridge. However, when that is the case, before deciding on any course of action, it is important to diagnose the weak areas of the bridge and the direction of the forces so as to have a better understanding of what type of treatment or restorative upgrades would be required for longer term function.
Your Immediate Teeth with High Impact Acrylic
The teeth that are fitted immediately after surgery are constructed from a highly aesthetic and resilient acrylic material. The processing of this material makes it conducive to an immediate turnaround, and this is the only choice for immediate teeth. The bridge is reinforced internally with metal bar support, and is designed as the permanent restoration with optimal aesthetics and function, but this does not mean it will last a lifetime. Over time some wear occurs and this varies from patient to patient. On average, the acrylic teeth require replacement every 3-5 years.
This timeframe is only a guideline and it is not unusual for our patients to have worn their original restorations for 7 years or longer without requiring replacement. Replacing the acrylic bridge does not mean re-doing the entire All On 4 treatment from the start. The process of replacing the teeth is uncomplicated and does not require any additional surgery. However, the acrylic material, whilst intended as the permanent bridge, has a finite physical tolerance, and in certain patients, such as heavy grinders or those in whom the improvement to their biting force is beyond the tolerances of the acrylic material resulting is excessive wear or signs of stress, an upgrade to a stronger material such as Zirconia may be required at an earlier time, or at some time in the future.
Coolum beach Dental Protocol, strongly advises that the acrylic bridge, is replaced with a milled titanium bridge, with acrylic teeth not later than 2 years after original implant placement. Zirconia bridge options are also available.
When its time to replace the original acrylic bridge, there are a number of options that can be considered. The frame or body of the new bridge construction can be either titanium or zirconia, and the teeth can be either acrylic or porcelain. However, whenever acrylic teeth are fitted, there is still the issue of wear and ageing over time. This however is a cheaper option and easily repaired. If a zirconia bridge fractures, then the entire bridge will need replacement. Most of our patients prefer the hybrid bridge (titanium base and acrylic teeth) due to these risks.
- Improved Longevity
- Improved Comfort
- More Natural Feel
- Stable Aesthetics
- Improved Hygiene
All On 4 Dental Implants costs and price comparison:
The cost of All-On-4 dental implants to replace a full set of upper or lower teeth at Coolum Beach Dental starts at AUD$15,600.
This is using a standard process involving an initial provisional set of teeth constructed using a denture-like prosthesis adapted over the implant fixtures, performed at Coolum Beach Dental. However, there are pitfalls and some potential issues inherent to these provisional methods. This is offered as a budget option and requires future conversion to a final restoration (bridge) at an additional fee.
The price for an upgrade from our FINAL teeth option is $9500, and is only available at this price for patients who undertake their original surgical treatment, within 5 years of their original treatment.
Maintenance charges of the original bridge are free for the 1st 2 years after the surgery. After that the patient is responsible for maintenance fees.