All On Four Dental Implants
Oral and dental health is a dynamic process that determines the general quality of life of an individual, affecting many areas from nutrition to speech, from aesthetics to psychological state. Total edentulism (complete tooth loss) resulting from caries, gum diseases (periodontitis), or traumas is a serious problem for patients both functionally and socially. The disadvantages of removable complete dentures (false teeth) used for years in the treatment of this condition, such as retention problems, falling out while speaking, causing sores, and low chewing performance, have pushed scientists to seek new solutions.
Developed as a result of this search and based on biomechanical principles, the All On Four Implant technique has taken its place in the literature as a revolutionary treatment protocol offering fixed tooth comfort to fully edentulous patients. Following current implantology practices in the Thrace region, Kırklareli Dental Clinic Atlas Sea Dental applies this advanced surgical technique with the discipline of sterilization and precise planning.
What is the All On Four Implant Technique?
All On Four (Quadruple Implant System) is a surgical and prosthetic procedure based on screwing a fixed prosthesis on the same day onto only four dental implants placed at specific angles in fully edentulous jaws. The basic philosophy of this technique is to avoid anatomical risk zones (sinus cavities and nerve canals) by using the anterior region where the jawbone is most dense and of high quality.
The biomechanical structure of the system is as follows:
- Anterior Implants: Two implants placed in the front part of the jawbone at a 90-degree right angle to the bone.
- Posterior Implants: Two implants placed in the back part of the jawbone at angles of 30 to 45 degrees (tilted).
This tilted placement increases the contact surface of the implants with the bone and allows the use of longer implants. It also provides the necessary support (cantilever extension) for the prosthesis without entering anatomical spaces in the posterior region.
Why All On Four? Advantages and Biological Gains
In traditional implant treatments, 6 to 8 implants are generally required to make a fixed prosthesis for a fully edentulous jaw. However, if bone resorption (atrophy) is excessive in the posterior regions, advanced surgical procedures such as sinus lifting or bone grafting (adding bone powder) are needed. These procedures both prolong the treatment period (6-12 months) and increase the cost. However, the All On Four Implant technique eliminates the need for these advanced surgeries by using the existing bone with maximum efficiency.
The biggest advantage for patients is the possibility of “Immediate Loading” (Same Day Teeth). Immediately after the surgical procedure, temporary fixed prostheses are screwed onto the implants. In this way, the patient can come to the clinic without teeth and leave with fixed teeth on the evening of the same day. Immediate restoration of chewing function directly increases the patient’s nutritional quality and self-confidence. Kırklareli Dental Clinic Atlas Sea Dental physicians state that this technique is an ideal solution especially for patients who cannot use removable dentures, have a gag reflex, or cannot wait for long treatment periods due to intense work tempo.
Who is it Suitable For? Indications and Evaluation
All On Four Implant treatment is suitable for patients whose general health condition is appropriate for the surgical procedure and who have total edentulism problems (or whose teeth all need to be extracted). However, not every patient may be a candidate for this treatment.
- Bone Volume: Although it offers a solution to patients with bone resorption, a certain amount of bone volume and density is required in the anterior region where the implants will be placed.
- Systemic Condition: Special evaluation is required for patients with uncontrolled diabetes, those using bisphosphonate group drugs, or those receiving radiotherapy from the head and neck region.
- Parafunctional Habits: In patients with severe teeth grinding (bruxism) habits, sometimes 6 implants (All on Six) may be preferred instead of 4 to balance the load on the implants.
In Atlas Sea Dental clinical protocols, a treatment decision is not made without detailed radiological examination (Tomography).
Treatment Process and Clinical Stages
This treatment requires a multidisciplinary approach. Surgical and prosthetic stages proceed in synchronization with each other. Within Kırklareli Dental Clinic Atlas Sea Dental, the process usually follows these steps:
- Radiological Analysis and Digital Planning: The foundation of a successful operation is flawless planning. The patient’s jawbone is measured in millimeters with 3D Dental Volumetric Tomography (CBCT). The angle, depth, and position at which the implants will be placed are determined virtually in the computer environment. At this stage, “Surgical Guides” are produced, aiming for an error-free operation.
- Surgical Operation: The procedure is performed under local anesthesia. If any, teeth that need to be extracted (hopeless) in the patient’s mouth are extracted. In the same session, 4 implants are placed in the jawbone at the planned angles. A standard All On Four Implant surgery takes an average of 1-2 hours per jaw. The patient does not feel pain during the procedure.
- Temporary Prosthesis Application (Same Day): After the implants are placed, the force of the implants holding onto the bone (primary stability) is measured. If the values are suitable (35 Ncm and above), pre-prepared temporary fixed prostheses are screwed onto the implants. These prostheses allow the patient to spend the healing process comfortably.
- Healing and Osseointegration: There is a waiting period of 3 months for the biological fusion of implants with the bone. During this period, the patient feeds on soft foods with their temporary prostheses. Bone cells adhere to the implant surface, creating a solid structure.
- Permanent Prosthesis Stage: At the end of 3 months, the ossification of the implants is checked radiologically. Temporary prostheses are removed, and precise impressions are taken for the patient’s permanent aesthetic prostheses (Hybrid prostheses, Zirconium or Titanium bar systems). In the laboratory stage, aesthetic (white) and gum (pink) aesthetics are designed as a whole.
Post-Treatment Care and Nutrition
Slight swelling and pain in the first days after the operation are normal and controlled with medication. However, the issue patients should pay the most attention to is nutrition.
- First 3 Months: While temporary prostheses are attached, a “soft diet” should be applied so that excessive load is not placed on the implants. Grilled meat, hard fruits, or nuts should be avoided; easy-to-chew foods such as pasta, fish, vegetable dishes should be consumed.
- Hygiene: The underside of All On Four Implant prostheses should be cleaned every day with special dental floss (superfloss) and oral irrigators. Food accumulation between the prosthesis and the gum can lead to infection around the implant (peri-implantitis).
Materials Used and Prosthesis Options
Prostheses used in the All On Four system are different from classic porcelains. Usually, structures called “Hybrid Prostheses,” mimicking both teeth and lost gum tissue, are used.
- Acrylic Hybrid Prostheses: Acrylic teeth arranged on a titanium bar. They are more economical and absorb force (shock-absorbing property).
- Zirconium Hybrid Prostheses: The pinnacle of aesthetics and durability. They are stain-resistant, translucent, and tissue-friendly. Kırklareli Dental Clinic Atlas Sea Dental patients can choose between these materials according to their aesthetic expectations.
Differences Between All On Four and Removable Dentures
Removable dentures transmit chewing force to the gum; this causes pain and bone resorption over time. Chewing performance is about 20-30% of natural teeth. All On Four Implant prostheses transmit force directly to the bone, stop bone resorption, and increase chewing performance to 90-100%. Also, while removable dentures covering the palate reduce the sense of taste, the palate is open in All On Four prostheses, and the patient fully feels the taste and temperature of the food they eat.
Pricing and Cost Factors
The cost of this treatment varies according to the implant brand used, whether a surgical guide is used, and the material selected in the permanent prosthesis (acrylic vs. zirconium). Although it may seem costly compared to removable dentures at first, the price/performance ratio is very high considering the lifelong comfort and bone protection it provides. Also, eliminating additional costs such as bone powder and sinus surgery balances the total treatment budget.
Regional Access and Health Tourism
The Thrace region has become a center offering services at European standards in dental implantology. Atlas Sea Dental provides services within the scope of health tourism not only to the people of Kırklareli but also to patients coming from surrounding provinces and abroad. The fact that the treatment involves a small number of sessions (Surgery day and prosthesis delivery 3 months later) is a great advantage for patients coming from out of town. Kırklareli Dental Clinic Atlas Sea Dental optimizes the treatment process according to the patients’ travel plans, ensuring time management most efficiently.
The All On Four Implant concept in dentistry is a scientific miracle that offers patients the opportunity to realize their “fixed tooth” dream even in cases of total edentulism seen as hopeless. This technique, which bypasses anatomical restrictions, maximizes patient satisfaction while reducing surgical risks.
A healthy diet, clear speech, and a confident smile are the foundations of quality of life. Getting rid of the functional and psychological trauma created by total edentulism is possible with correct planning and expert hands. Kırklareli Dental Clinic Atlas Sea Dental physicians aim to manage biological and aesthetic limits in the best way by evaluating each patient individually. Remember, you can regain the life energy you lost with your teeth with the correct implant treatment.
