All-on-4 or All-on-8

Patients who no longer have their own teeth often want fixed teeth again that feel like their own, look like their own, and provide the same comfort when chewing.

In this article, we will discuss the concepts of All-on-4 and All-on-8. Both methods aim to provide a fixed restoration for an edentulous jaw, but they differ significantly in many ways.

All-on-4 – Fixed denture

All-on-4 is a dental concept for edentulous patients in which a fixed denture is anchored on four implants. For this, only dental implants made of titanium can be used. All-on-4 is not possible with ceramic implants.

All-on-4 procedure

Toothless patients receive four dental implants in each jaw. A horseshoe-shaped denture is firmly attached to the inserted implants with screws. The screw-retained prosthesis remains immovably anchored in the jaw and can only be removed by a dentist.

Advantages

• Low cost, as few implants are used
• Shorter surgery time than with eight implants
• Bone augmentation can often be avoided due to the oblique position of the implants and the prosthesis.

Disadvantages

• Only titanium implants can be used.
• Unfavorable load on the bone.
• Bone resorption continues to occur between the implants.
• Food residues may get stuck under the prosthesis, which greatly affects hygiene. This can result in bad breath, gingivitis and periimplantitis.
• A gap between the fixed denture and gums can cause a difficulty in speaking. An unwanted hissing sound may occur.
• The horseshoe-shaped prosthesis blocks the entire jaw. Physiological movements in the area of the bone sutures are no longer possible.
• The aesthetics are limited and the restoration often looks unnatural.
• The screw-retained prosthesis leads to an unnatural feeling of having a foreign object in the mouth.

Do we recommend the All-on-4 concept?

No. In our opinion, the All-on-4 method has too many disadvantages for patients.

We do not offer this concept in our dental practice.

To avoid the disadvantages and to restore an edentulous patient without compromise, you need at least eight dental implants per jaw,

Even the All-on-6 concept is not sufficient to achieve a permanent, satisfactory solution for the patient.

All-on-8

All-on-8 stands for the restoration of an edentulous patient with eight implants per jaw. This type of restoration can be performed with titanium or ceramic implants.

All-on-8 procedure

A total of 8 ceramic implants are placed in each edentulous jaw. Immediately after the implants are placed, the patient is given fixed temporary dentures made of composite, which should not differ visually from the patient’s natural teeth. After about three months, the long-term temporaries are replaced with ceramic bridges.

Advantages

• The All-on-8 is possible with ceramic implants, which is preferable in terms of biocompatibility and health.
• This results in a balanced load on the bone and an even distribution of forces on the implants.
• Since there is no need for a fixed denture, there is no blocking of the bone sutures.
• The concept can be implemented just as quickly as the All-on-4 concept. The patient gets fixed teeth in one day.
• There is much less bone resorption because the bone is stabilized by the eight implants.
• The laboratory-made ceramic bridges offer excellent aesthetics and a natural appearance.
• Ceramic bridges do not cause a foreign body sensation in the mouth, as is often the case with fixed dentures.
• Due to the graceful and anatomically correct shape, there is no restriction during speech
• The patient is provided with a gap-free complete-ceramic denture, which offers ideal hygienic conditions. The connection is made by cementation, as with a natural tooth, and not by screwing.
• Better longevity and prognosis

Disadvantages

• The more implants are placed, the higher the price. Therefore, the patient has to calculate for higher costs.
• The operation lasts longer than with four implants per jaw.

Do we recommend the All-on-8 concept?

Yes. In our opinion, All-on-8 offers many advantages compared to All-on-4, which contributes to a significant increase in quality of life.

With a high level of experience in the treatment of edentulous patients, we can perform the All-on-8 method quickly and effectively. The patient receives the laboratory-produced, fixed long-term temporary restoration on the same day and goes home with natural looking teeth.

Some patients without teeth want every missing tooth to be replaced with a ceramic implant. Such a procedure would result in the placement of 12 or 14 dental implants per jaw. In this way, chewing comfort and aesthetics can be improved even further. Since all areas of bone and gum are supported by an implant, the best possible result can be achieved in this way.

Special form of All-on-8 – One implant for each tooth

At least eight implants per jaw are required to ensure a high-quality, fixed dental restoration.

At the patient’s request and if the jawbone allows, any lost tooth can be replaced with a ceramic implant. This allows the original anatomical situation to be restored perfectly and without any compromise.

From the point of view of anatomy, stability, chewing comfort and aesthetics, this procedure is superior to all others. All areas of the jawbone and gums are supported by the ceramic implants, just as nature intended with one’s own teeth.

The only downside is the high costs. This is because such a procedure would result in the placement of 12 or 14 dental implants per jaw.

FAQ about All-on-4 and All-on-8

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