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All on 4 Implant Supported Snap in Denture or Fixed Denture
The term All-on-4, also known as All-on-Four, refers to 'all' teeth of an arch being supported 'on four' dental implants for total rehabilitation of the edentulous (toothless) patient. It consists of the rehabilitation of either edentulous or dentate (some teeth remaining) maxilla and / or mandible with fixed or removal prosthesis. The four implants support a fixed prosthesis with 10 to 14 teeth.
The All-On-4 solution, with the latest technology in computer aid design/Mill (cad/cam) has evolved including the All-on-bar concept, which is adding a milled titanium bar structure to the dental implants, which helps them working together to protect the implants from failure, even if the hybrid bridge is broken. This concept helps the clinician provide a better long-lasting solution, instead of a conversion-denture which is a chair side repair and modified denture. The All-On-Bar reduces the appointments, eliminating the Denture Conversion technique, by replacing it with a long lasting hybrid. Some patients keep this option as their final due denture to a lower budget or because the space is limited for other final solutions.
Pmma or Denture teeth over the titanium bar wears out over time and need replacement, this is a controversial topic since the Pmma has the advantage of being shock absorbent. This helps the implants receive less stress during mastication forces but keeping a solid structure on the inside. Many professionals think this is a better solution, keeping in mind that the bridge can be switched to a new one a few years after.
Another option is to use a Porcelain Fused to Metal (PFM) full arch bridge to connect the implants together. The Bridge is cemented to the abutments and access holes are covered with white composite so that no metal is showing. The PFM bridge does not wear out as PMMA does.
