All on 4 Treatment Concept by Nobel BioCare

On a daily basis, new technology is introduced to improve the quality of our patients’ lives and optimize their dental health. For over sixty years, dental implants have dramatically increased treatment options for those who have lost one or more teeth due to accidental injury or dental disease. And, when there is adequate bone volume, there are instances when Dr. Hochberg can place a dental implant at the time the tooth is removed. Other patients, when the bone surrounding the tooth is of insufficient volume to support an implant, benefit from the placement of a bone graft; the graft helps augment existing bone. In a few months, the new bone will mature and strengthen, ultimately providing enhanced support for the dental implant. In turn, the implant is restored with a dental implant crown. The excellent news – a missing tooth, or teeth, can be replaced without involving adjacent teeth.

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However, until the past decade, the treatment options were more complicated for those already wearing a denture as well as for many patients whose remaining teeth cannot be restored and require extraction, becoming edentulous (missing all teeth in the upper, lower or both arches). The reason? More often than not, there is inadequate bone to support dental implants. Why does bone volume decrease? When the tooth’s roots are no longer in the bone to stimulate bone and bone growth, keeping the tissue healthy, the bone resorbs. Since 700BC, the solution was a removable denture. However, dentures are not the optimal prosthesis. They can be uncomfortable, slip, loosen, and requiring adhesives. Patients report that dentures irritate the roof of their mouth and complain that speaking and eating is challenging. A new approach to address lessened bone volumes while still providing the benefits of dental implants, was developed in the late 90s. Nobel Biocare, along with Dr. Paulo Malo, an alternative to traditional non-implant supported removable dentures, the All-on-4® treatment concept, became available.

This approach is viable due to a different method that is utilized to place the posterior implants. Instead of implanting these implants vertically, which requires adequate bone volumes typically lacking in most edentulous patients, they are placed at a 45-degree tilt. This technique exposes a greater amount of the implant to be exposed to the remaining bone and better anchors the back most implants. Also, as these implants are fabricated out of titanium, they naturally fuse to the remaining bone.

According to Nobel Biocare’s continuing research results, this approach has been successful for “hundreds of thousands”. To determine if this is an option for you, Dr. Hochberg will complete a comprehensive examination, typically along with a 3D CBCT (CAT scan). He will evaluate the findings of the scan and discuss your treatment needs and expectations. If you are a candidate, 4, or sometimes 6, dental implants are placed in the arch; these implants will be secured to an upper or lower (or both) prosthesis.

The best news – not only does the placement of dental implants into the jaw helps to prevent further loss of bone in those sites, but you will leave our office smiling with confidence and ready to eat your favorite foods in comfort.