What is it?
Teeth-in-a-day, also known as All-on-Four, is a very successful and very well researched technique for permanently replacing all the teeth in an arch (or jaw). It involves placing four implants in specific locations, and requires little or no bone grafting. The teeth are then fastened to the implants and are only removed by the dentist when needed. Because the implants are all connected to each other with a rigid framework, they support each other with sufficient strength to allow for immediate placement and use of teeth. Thus, in one day, a patient can go to sleep for the procedure and wake up with the implants in and then have the temporary teeth firmly placed. This is by far the most comfortable, least painful, and most economical way to replace a full arch and still have the function of natural teeth.
Do I really get new teeth in just one procedure?
Yes. The teeth that are firmly connected to the implants on the day of surgery are temporary but are capable of normal chewing and are designed to last several months through the healing phase. After the healing phase of usually four months, a final bridge is fabricated. This final bridge (or hybrid) has a metal core that provides long term strength. The temporary does not have this metal core, but has excellent strength for the healing time. The temporary allows time for final reshaping of the bone ridges that occurs. As a result, by the time the final is constructed, there is little change expected so the final teeth are more accurate.
How long is the procedure?
The surgery generally takes about 2 to 3 hours during which time most patients opt to be asleep. Following the surgery, the teeth are fitted to the implants which takes about an hour. The teeth are then taken to the lab where they are adapted firmly to the implant model. This takes another 2 – 3 hours. During this time, the patient may stay in our office or welcome to rest at home. The patient then returns to the office and the teeth are connected to the implants.
Is it painful and what can I expect from recovery?
This is a surgery; however, it is consistently one of the least painful surgeries commonly performed. The rigid design of the teeth attached to implants prevents the teeth from moving and rubbing on the gums. It also provides a protective cover over the surgery area. Implants have no nerves and are thus not sensitive or painful. Although pain medications are prescribed, the overwhelming majority of patients only take them for one to two days and then usually only because they are afraid it might start to hurt rather than there being very much actual pain. Some swelling and bruising is possible but generally minimal.
How soon will I be able to eat without limitations?
Patients are able to eat normal foods as soon as the numbness wears off from the surgery (generally about 4 to 6 hours). It is generally best to stick with food that can be chewed fairly easily to avoid overloading the muscles during healing. After the initial healing phase, patients are able to eat anything that they could generally eat with natural teeth. These dentures are as close to having natural teeth as you can find and will retain over 95% of your bite strength. This means not worrying about not being able to chew anything you normally could chew.
What are the benefits of implant retained teeth over traditional dentures?
Although there are various forms of implant retained or implant supported dentures, the strongest are the permanently attached or screw retained. These are completely stable with the strength of natural teeth. Traditional dentures are held to the ridges with suction or denture adhesive and generally move around quite a bit. The most successful traditional dentures are upper dentures which have between 10% and 20% the function of natural teeth. Lower dentures have considerably less function and stability than uppers. Upper dentures have to cover the roof of the mouth which changes the way food tastes and causes frequent gagging. Implant retained teeth do not need to cover the roof of the mouth and thus feel more natural and do not generally change the taste of food. The constant movement and instability of traditional dentures make them prone to rubbing painful sores on the gums. This is not a problem with Implant teeth. Denture instability often requires the denture teeth to be made shorter and wider in order to maintain some stability. Much like snow shoes, they spread out the forces. This also however causes loss of vertical dimension which is the normal height of the face. This loss of vertical height causes the person to over-close causing increased wrinkling around the mouth, nose and chin. It also decreases the normal tooth show that make a normal smile, and instead creates a buried smile in which no teeth are visible. Nothing says “I’m wearing dentures” more than a smile with little or no visible teeth. This problem is eliminated when firmly attached teeth are made to the correct vertical height and tooth show. The teeth look natural and never move.