All-On-4 Process

Dr. Keith Phillips walks you through the All-On-4 process here at Implant Dentistry Northwest.

What is a CBCT Scanner?

A CBCT scanner stands for cone beam computerized tomography. It's a little bit different than what you would find in a hospital setting, with a lot less radiation, and gives us the information we need to help plan your dental implant. There is a part that goes around your head and gives us a three-dimensional picture of your head, the bone, the teeth, and the areas of interest that may be used for implant placement. We're also able to assess any localized infections, look at bone loss around teeth, and determine if there is enough bone to place implants. 

What is an Intraoral Scan, and How Do We Use It?

The next part of the digital journey is to take intraoral scans of your teeth and gums. This will give us the information we need as to where the teeth are positioned, your bite, and what we need to do in order to formulate the best position for that dental implant. The intraoral scanner has a small wand that takes pictures of your teeth. This is in lieu of using the alginate impressions we used to have in the old days, so it’s a lot more comfortable. In a matter of a minute or two, we can have all the information we need about your teeth to begin our planning process.

We'll then take both the CBCT scan and the scan of your teeth and merge them together. On the computer, we can digitally filter through different implants to decide what's going to be the proper size and positioning to give you the best tooth for your situation.

How Do We Plan the Implant Placement?

Once we have the scan of your teeth or dentures and the CBCT scan, we merge those together in a special computer program that allows me to plan where we want to place your implants for your All-on-4 restoration. We’re able to visualize where the nerve goes through the jaw because we want to make sure that our implants don't do any damage to the nerve. This gives us great information on how to best place those implants. Then, with either the scan of the teeth or the denture, we're able to align the implants so that they come out in a good position in relation to where we want those future teeth to be. 

What is a Surgical Template?

Once we've gotten our planning done for our implants, we will then design a surgical template that will, at the time of surgery, help direct me as to where to place those implants. With this information, we'll send the data regarding this surgical guide to our 3D printers, and we'll 3D print those so that I'll have that physical guide to use in your mouth at the time of surgery.

Here at Implant Dentistry Northwest, we have all the high-tech equipment to treat you very efficiently. From your initial consultation to the time we do your surgery, it could just be a matter of days before you start your journey in getting new teeth through your All-on-4 procedures. If you have any questions at all, feel free to give us a call at Implant Dentistry Northwest, and we'd be happy to get you in for a consult to discuss what can be done for you.

What are all four dental implants?

All-on-four dental implants, or sometimes referred to as all-on-X, aim to place at least four implants. Sometimes more are needed, depending on your situation. The goal of an all-on-four procedure is to provide someone with failing dentition or no teeth with fixed, solid teeth that work well for chewing food.

What are the pros of getting an all-on-four?

The pros of getting an all-on-four include restoring your ability to chew, improving aesthetics, and boosting confidence in your smile. We've had patients who, after this procedure, become more socially active and able to pursue job opportunities they couldn't before. It offers great benefits for chewing, health, and social interaction.

What would be the con of getting an all-on-four?

The con of getting an all-on-four is primarily structural. Sometimes this restoration requires enough space in the mouth, which may involve removing some bone. If that's the case, the all-on-four might not be the best first option, and we would discuss other options for a conservative approach to restoring teeth, function, and smile.

Who would be a good candidate for an all-on procedure?

A good candidate for an all-on procedure is someone who is missing or will be missing all their teeth due to gum disease or rampant caries. The all-on-four procedure is ideal for transitioning from no teeth to having fixed teeth that function well.

Who would or when would someone not be a good candidate for an all-on-four?

Someone who wouldn't be a good candidate for an all-on-four is someone who lacks adequate bone for implants or has health risks that make implant placement dangerous, such as uncontrolled diabetes or heavy smoking. These factors need to be managed before considering implants.

Are there any anesthesia options available to a patient during an all-on-four procedure?

Anesthesia options range widely. Most patients undergo general anesthesia with certified anesthesiologists for comfort. Options also include oral sedation with pills, IV sedation, or just local anesthetic, depending on your needs and comfort level.

What anesthesia options are available to me during an all-on-four procedure?

Anesthesia options for this procedure range from local anesthesia to general anesthesia. Some patients may only need local anesthesia, while others may require sedation. General anesthesia is common, especially for lengthy procedures, to ensure maximum comfort.

How long does it generally take to heal from getting an all-on-four procedure done?

Healing after an all-on-four procedure is relatively quick. You may experience soreness for a few days, with overall healing taking 6 weeks to 3 months. After 6 weeks, we typically check the implants and, if everything is fine, begin fabricating the final prosthesis. If the bone is less dense, we may wait up to 3 months for complete healing.

How can a patient schedule an appointment to discuss whether or not they're a good candidate for getting the all-on-four procedure?

To see if you're a candidate, it's easy to schedule a consultation with us online. We will assess your oral condition, take a CT scan, and determine your candidacy for this procedure.