Is All-on-4 procedure the same procedure as Teeth-in-a-Day/Teeth-in-1-Day ?
Not always. It is usually marketed like this. Most of the time it is the same procedure when the procedure gives the patient a full set of teeth. When all the bad teeth are extracted from one arch, implants are placed and a full set of teeth is attached to the implants, the two names can be used interchangeably. But when only a few teeth in one arch are replaced by implants in one day, the procedure can be called Teeth-in-a-Day, but cannot be called All-on-4. In other words, when replacing a full set of teeth the same day, All-on-4 and Teeth-in-a-Day are the same, but when replacing only a few teeth the same day, we do it using Teeth-in-a-Day procedure.
Do I need General Anesthesia for Teeth-in-a-Day/All-on-4 ?
Not necessarily. Most of these procedures are done under local anesthesia. The surgical part of the procedure in itself does not take too long. It depends on the number of teeth that need to be extracted and the amount of bone that needs to be flattened/shaved. If the patient is very scared and feels they cannot take the procedure just with local anesthesia, he/she can have the general anesthesia/conscious sedation. But this adds to the cost and the time of the procedure. When the anesthesia and the surgical part are done in an oral surgery office, usually the surgeons send the patient to the restorative dentist to attach the teeth to the implants. That adds time and expense. The most efficient way is to do the procedure under the same roof, preferably by the same person. If it is done by the same doctor, there’s lower cost, more efficient treatment and less chance for miscommunication and errors.
What type of implants are used for All-on-4/Teeth-in-a-Day?
These procedures were researched and then patented by the oldest implant company in the world, Nobel Biocare. They developed and patented the surgical and prosthetic protocol for those procedures. The typical type of implants used is Nobel Speedy and Nobel Active. Since the procedures became so successful, other implant companies tried to copy the model and they developed some similar protocols. But Nobel Biocare is still the company which provides the most implants for these procedures and has the most research on the subject.
What is the warranty on Teeth-in-a-Day/All-on-4 ?
I offer craftsmanship warranty for as long as I am in practice. Anything that happens to the implants or prosthesis, I fix or replace for free. I am looking to practice at least another 30 years. Nobel Biocare also offers a Lifetime Warranty on their product.
Is osteoporosis a contraindication for Dental Implants?
No, it is not a contraindication as long as the osteoporosis was not treated with bisphosphonates. Previous use of bisphosphonates(especially intravenous) may delay the healing after implant surgery and prevent the full osteointegration( connection of the implants to the bone). It occurs especially in the mandible(lower arch).
I’ve been told by other dentists that I do not have enough bone to have implants and I need a ton of bone grafting. How do I know I have enough bone for this procedure?
Most of the bone loss occurs in the back area of the jaws, so if you plan to have implants in the back area, you may have to go through a bone grafting procedure. But all-on-4 procedure uses the front bone of the jaw(denser and higher quality than the backbone) and tilts the implants towards the back, so while the implants are “rooted” into the high-quality bone, they support the back teeth also. 80% of patients who were told that they cannot have dental implants because of thin bone, can have this procedure done.