During the All on 4 procedure, you will be sedated (if necessary) and your mouth will be completely numb. Because of this it is important to remember that it is very difficult to adjust your bite perfectly after the surgery. If the bite is not adjusted properly you could apply to much pressure on one side of the prosthesis leading to temporary fracture or dental implant failure. This is due to the excessive micro-movement of the implant and provisional prosthesis.

There is a misunderstanding of how dental implants heal around the bone when “immediate loading” an All on 4 is performed. The healing process of “immediate loading” dental implants is more mechanical than biological. In other words, the way the implants are placed, the type of provisional that is fabricated, and the amount of force applied will play a huge role in the outcome of the procedure.  

Let’s say for example:  You have an accident and you break your arm. You must see a doctor and most likely the doctor will reposition the bones into the right place and will place a cast around your arm. The purpose of this cast is not just to get autographs. The goal is to achieve immobilization of the two bone segments. Only when the two bone segments are immobile, (no mobility) the bone will heal and mature correctly without future problems. If the cast gets soft with water or breaks because too much pressure is applied there will be micro-movement of the bone and the two segments will not heal properly. In conclusion, the bone doesn’t heal when there is movement and the same thing happens with dental implants.

Now imagine that cast is your temporary prosthesis and the implants are the broken arms it’s made to protect and immobilize. You don’t want any mobility around your implants or temporary prosthesis. If too much pressure is applied on just one side of your jaw the temporary could break and promote micro-movement of your dental implants. Too much pressure overall could cause your implants to fail altogether.

So it’s easy to see why the overall pressure applied to your All on 4 prosthesis plays a big role in the outcome of an “immediate loading” and that is why a soft diet is recommended for 4 months. In some cases we may recommend a liquid diet for the first 2 months and then a soft diet for the following 2 months just to minimize pressure against the temporary prosthesis. Every case is different.

The Importance Of Try-Ins Of Your Teeth Before Finalizing Your All On 4

Let’s face it you are not going to do this procedure multiple times in your life. Nor would you want to. With that being said, we want to do this right the first time so that you will be only seeing your dentist for regular checkups after. After the placement of your dental implants and your restorative dentist decides the time is right, the process of making your final prosthesis will begin.  However, we highly recommend you try a prototype of your final prosthesis first.

In “old school” techniques, this step was not available due to the lack of technology. Thanks to our new technology CAD/CAM and 3D printing we are able to design your simile according to your facial structure. QDT Dental provides an in-house laboratory so there is no miscommunication and we do not lose vital information during the process. This way we have the ability to develop a resin prototype of your teeth with our Dental 3D printer and try-in your teeth the same day. This prototype is an EXACT replica of your final prosthesis. You will be able to see and feel the shape, length and thickness of your teeth. You will be able wear and show what your new smile will look like to your close friends and family members. You can wear the try-in for 1 week, 2 weeks, or even as long as 1 month.  During this period, you will be able to make changes to your prototype.  We will make any necessary modifications in our system and print a second or even a third prototype until we achieve your desired results.

Once you are 100% happy with the prototype we then can start fabricating the final prosthesis made with your choice of acrylic or zirconia. Since everything is done and saved in our system, your final prosthesis will be exactly as the prototype printed before.

So thanks to today’s technology, especially in the field of 3D printing and CAD/CAM, patients are now able to see and wear their final prosthesis, essentially taking them for a test drive. These past inabilities often lead to unhappy patients in terms of esthetics, phonetics and mastication. For example, teeth that were too long or in the wrong position would cause speech problems making it difficult for the patient to pronounce the letters “S” and/or “D”.  Neuromuscular problems would also arise; this was due to the patients’ bite not being verified before making the final prosthesis. Especially when working with one arch of zirconia material opposing natural dentition.

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