"All-on-4" a.k.a. "Teeth-in-a-day"
The “All-on-4” or “Teeth-in-a-Day” technique is based on the founder of dental implants, Professor Bränemark’s, method of using just 4 implants to support a full set of teeth. From the 1960’s onwards the technique has been refined and the “All-on-4” technique as we know today was refined and marketed globally by Professor Palo Malo in Lisbon, Portugal. The procedure enables people who are either missing all of their teeth, or have broken/failing teeth, to have a bridge with 12 teeth fixed to 4 implants. The technique is also referred to as "ProArch", "Teeth-in-a-day", and "Same-day-teeth", etc.
The process firstly involves a planning phase where we obtain 3-Dimensional bone scans to assess the volume of bone present. A mock-up of the final set of teeth is then made with your input as to colour/shape/size of teeth. This is tried in and only once you are happy with the look of the teeth, we are then
ready to proceed. Surgery starts first thing in the morning and any remaining teeth are removed from the jaw before placing 4 to 6 dental implants into the bone. Impressions and records are then taken and sent straight to the laboratory to be worked on by a skilled dental technician. A metal-reinforced high-impact acrylic temporary bridge is then ready to fix onto the implants by late afternoon on the same day as the surgery (hence "Teeth-in-a-day"). In order to allow the bone to fuse to the implants it is then very important that a soft diet is maintained for the first 3 months after surgery. Four to six months after the fitting of the temporary bridge new impressions and records are taken of the healed site to enable a CAD-CAM titanium frame bridge with either acrylic or porcelain teeth depending on the patient's wishes and budget to be constructed and fitted. With this bridge the patient can eat as they please and enjoy their new set of teeth!
The advantages of this technique are:
By angling the two back implants we avoid the need for invasive sinus grafting surgery.
The process was designed to be cost effective as it usually only requires 4 implants to support the bridge. Conventionally this process may have required 8 to 10 implants plus bone grafting.
The speed of the process is very exciting for both us and patients. Imagine going from no teeth to a fixed set of teeth in a day!
Success rates of this procedure have been quoted in the dental literature to be 95-percent at 10 years after surgery.1 This is a greater success rate than anything else we can offer in dentistry!
The limitations of this technique are:
Due to the cantilever effect on the implants it is only possible to replace 12 missing teeth. If you are very keen to replace all 14 missing teeth in each jaw then additional implants will be required, although most people very happily manage with 12 (4 incisors, 2 canines, 4 premolars and 2 molars).
It is important that you understand that like any dental prosthesis these bridges won’t last forever, even though the implants might. Due to your increased chewing efficiency you will gain from your fixed teeth, over the years the acrylic will wear or chip. Like driving a luxury car, maintenance should be expected and after 5+ years in function the bridge may need some servicing.
If you are interested in this treatment option please do not hesitate to arrange a consultation with Dr Mallorie to discuss the process further and if you decide to move forward with treatment you will be refunded the consultation fee in full - in other words you'd have had the consultation for FREE
Malo, P., et al., A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc, 2011. 142(3): p. 310-20.