What are All-On-Four Dental Implants?

The technique of All-On Four has taken the dental implant world by storm, but as with any storm, there are dangers.  This technique was originally created to provide a fixed solution to loose fitting or non-functioning dentures for patients who could not afford, or were unwilling to invest time and money for the bone grafting procedures that were required before placing dental implants.

The technique is intended to provide implant supported dentures for people with severe bone loss in the back of the jaw.  This technique is a reaction to the public’s demand for instant gratification, and the desire to spend less and get immediate results.  It represents a departure from established, predictable procedures and compromises the well being of the patients it is supposed to be serving.

When there is insufficient bone to place the necessary implants to support a denture, bone grafting is always recommended.  All-On-Four technique ignores over 25 years of research that indicates the necessity to wait 3 – 6 months for the dental implants to become part of the jaw (this process is called osseointegration) before placing force on the dental implants.  The osseointegration of dental implants is compromised and likely to fail if the dental implants have regular chewing function before the waiting period is complete.

In this technique, four dental implants are placed in the front of the mouth where there usually is more bone.  The back implants are placed at a 30 degree angle, tipping the implants over.  This violates the engineering principle that dental implants function effectively and are stable when forces placed on them are vertical.  With the All-On-Four dental implant technique, the forces are unfavorable for implant survival.  If one of the implants fail in this technique, the entire restoration fails and has to be reconstructed.  Sometimes the loss of bone is so extensive that the patient cannot even wear a denture after this procedure.

Implants are placed only in the front jaw, therefore the jawbone deterioration continues at the back of the jaw, increasing the risk of what is called a facial collapse.  If the jaw becomes too weak, the jaw may fracture due to pressure applied to the front of the mouth when eating.

At Tavormina Dentistry we are all for saving our patients time and money, but not at the expense of their health and happiness.  There are alternatives that might not necessarily cost more than All-On-Four, but which can take more time.