All on 4

Tooth loss caused by trauma, periodontitis, tooth extraction or aging can seriously damage your appearance.

Whatever the reason, a lost tooth must be replaced, and dental implant therapy is a long-lasting, functional and aesthetic solution that raises the quality of life, ensures a proper bite and a beautiful smile.

Dental implants are artificial substitutes that are implanted into the jaw bone to replace missing root teeth.

The screw-shaped implant is inserted into the jaw bone where the tooth is missing, and then a superstructure is placed on the implant, on which a prosthetic work in the form of a metal ceramic crown or a zircon ceramic crown is placed.

For completely toothless patients who have lost all their teeth in the upper or lower jaw, it is recommended to make an implant-prosthetic solution for toothlessness. These are prosthetic work on 4 implants (aka ALL ON 4) or 6 implants (aka ALL ON 6).

What is ALL ON 4?

The ALL ON 4 method would literally mean „everything on four implants“. It is a method of making a dental replacement for a toothless upper or lower jaw, which is secured with a screw connection to 4 implants. More specifically, ALL ON 4 represents a bridge fixed with screws on four specially positioned implants. The method was created in the profession's response to inability to directly implant the implants in the back of the jaw.

Implantation of dental implants is followed by temporary prosthetic work which is given to the patient that same day, after the surgery. After 3 months, a permanent bridge is made for the patient. Specifically, that period of three months is required for the coalescence process of the implant with the jaw bone, on which the permanent work is performed.

What is ALL ON 6?

As the name implies, ALL ON 6 represents fixed prosthetic work on 6 implants. As a rule, it is always better to have as many as prosthetic supports as possible, so this method is a great solution for toothless jaws. However, in some situations, due to the small amount or poor quality of the bone, there is a limited number of implants that can be placed.

ADVANTAGES OF ALL ON 4 METHOD:

• Dental implants are a lifelong solution
• Prosthetic replacement is a long-term solution (10 years in average)
• Reconstruction of all teeth of one jaw on 4 implants
• No bone transplant and no additional surgical procedures
• Minimum recovery time
• Top quality of Straumann implants we use in our work
• When required, dental surgery and implant placement are performed at once
• Improving the quality of life
• Eating comfort (no denture drops when talking, chewing or sneezing)
• Hygiene (food does not fall under the denture)
• Restoring of the natural facial appearance and lost chewing function

• Patients who want fixed prosthetic work, and have lost all or most of their teeth
• Patients which have a complete mobile denture for many years
• Patients who have experienced severe bone loss over time, especially in the back of the jaw
• Patients who have very bad teeth which are intended for extraction

ALL ON 4 or ALL ON 6 method is the most common solution for:

1) patients who already have a toothless jaw and cannot wear a full denture (vomiting reflex, denture displacement)

2) patients whose remaining teeth cannot be repaired and included in prosthetic work. In such cases, the teeth are extracted immediately before implant placement

Note: For patients who don't have sufficient bone volume for ALL ON 6, i.e. the bridge on 6 implants, which is always a better solution, the ALL ON 4 method is used.

The procedure is not recommended in the following situations:

• In advanced osteoporosis
• For patients with uncontrolled diabetes
• For patients who have received radiation therapy in the last 6 months, in the head or neck area

Digital image of entire jaw and CBCT image are required to plan the procedure. Such a recording allows precise positioning of the implant with respect to the volume and density of the jaw bone.

If necessary, the remaining bad teeth are extracted and modeling of the jaw ridge is also required. This procedure levels the level of the jawbone, which is essential for the aesthetics and functionality of the implant bridge.

The procedure duration depends on the number of implants, so before the procedure, the surgeon arranges the expected duration of the entire process. The procedure is performed under local anesthesia.

The two implants are mounted vertically into the central jaw part, on the position of the lateral incisors. The backward implants are placed at a 45-degree angle so that the implant protrudes from the jaw in the area of the second premolar. With such oblique positions of the implant placement in the jaw, critical areas with reduced bone volume are circumvented.

Temporary work

After the implant has been placed, temporary work, or a replacement is ready, which is included in the entire planning and preparation process. Temporary work is made of acrylic and is worn for three months, until a permanent prosthetic solution is made on the implants.

Permanent prosthetic replacement

Three months after implant placement, a permanent prosthetic solution begins. This period is necessary for the hard and soft tissues of the jaw to become stable. Temporary work is easily and painlessly removed by removing the screws, and the jaw print is taken for the permanent bridge. It takes several working days to build a permanent bridge. During the construction of the permanent bridge, the patient still wears his temporary work so that at no time he is toothless.

After implant placement, the patient takes an antibiotic as recommended by the dentist. Seams are removed 7 days after the implantation. After a minimum of three months, the stability of the implant is checked. An extension is then placed on the implant to shape the gums, followed by the production of permanent prosthetic work. Until permanent prosthetic work is complete, temporary prosthetic work is worn.

There are no major complications during recovery and the patient is able to function normally throughout the entire recovery time.

Since the bridge is installed with the ALL ON 4 method of a one-piece construction with no gaps between the teeth, the bridge is cleaned as a single unit. Cleaning of the bridge on four implants is specific and therefore different from natural teeth cleaning techniques.

It is cleaned with a toothbrush and toothpaste, and the areas around the implants need to be further cleaned with an interdental toothbrush, about which you can discuss with our dental specialists. Due to the disinfection of the oral cavity, it is recommended to use an oral shower which cleans the basal side of the bridge that rests on the gums.

During regular annual control, as necessary, the bridge can be removed and professionally cleaned.

The prices of dental implants in our Clinic depend on the implant type.

Additional surgical procedures may be required prior to the implant placement to ensure the long-term duration of the prosthetic solution and implants.

The surgical part is charged separately from the prosthetic part, due to the large number of prosthetic options that you can choose from.

After a thorough diagnostic examination, our dentist will recommend the best option.

If you are interested in more information, you can contact us by email at info@bagatin.hr or by phone on + 385 1 4610 225.

In cooperation with banks, the Bagatin Clinic provides the possibility of payment in installments, as well as interest-free payment up to a certain number of installments.