All on 4 vs. Full Mouth Reconstruction

When in need of dental implants, it can be hard to differentiate between some of the procedures that are available to you.  However, if you are in a position where you are in need of multiple tooth extractions and implants in different locations in the mouth, or are entirely edentulous to begin with, it is important to weigh the pros and the cons of electing to go with the all-on-four procedure instead of the full mouth reconstruction procedure.  Here at Trust Implants, we encourage patients to undergo full mouth reconstruction rather than the all-on-four procedure for various reasons.

To start off, let’s discuss the basics of all-on-four.  The term “all-on-four” refers to all of the teeth being supported on a total of four dental implants.  In this procedure, four implants are placed in areas of higher bone density, such as the anterior maxilla.  These four implants will support a fixed prosthesis with ten to fourteen teeth that are usually placed within twenty-four hours of surgery.  All-on-four is considered to be a graftless protocol, which means that no bone reconstruction or restoration is done prior to the placement of the implants.

While all of this may sound like the perfect solution, and although many dentists, oral surgeons, and prosthodontists advertise this as being the best protocol around, there are many risks and complications that are likely to come along with getting the all-on-four procedure done.  As with any other surgery, there are general surgical complications that can arise, along with risks of implant failure, the breaking of restorations, or difficulty adapting to restorations.  However, the risk of breakage and loosening here is extremely high, being that the whole prosthesis is only supported by four implants total.  Whenever there is a complication or a breakage, the entire prosthesis needs to be removed in order to tackle the problem.  Being that the entire prosthesis is anchored by only four pieces per top and bottom, any problems that demand its removal will absolutely require that the whole thing be taken out – even if the problem is only occurring in the back of the mouth, or with one small section of the jaw or gums.  So, think of it like this: having a problem with what could be one tooth’s worth ends up requiring you to go back to where you were when you started – no teeth at all.

In contrast, full mouth reconstruction uses much more than four implants on both the top and the bottom of the mouth, allowing for much higher stability in the structure of the mouth.  Additionally, full mouth reconstruction also involves bone grafting prior to the procedure.  This is an essential component for people who are edentulous or need to have all of their remaining teeth removed; bone grafting restores the strength of the jawbone, preventing it from disintegrating over time.  With all-on-four, even though you have implants and prostheses in, there is no bone grafting that was done, so it is very likely that the maxilla and the mandible will begin to lose their structure (and thus, their function) over time.  Full mouth reconstruction has little to no problems with prostheses loosening, as well.  Being that there are more anchors throughout the mouth, the odds of the prostheses coming loose are much less than with the all-on-four.  This will ultimately make for fewer follow-ups, less complications, and less hassle in the long run.

As many people like to say, including us here at Trust Implants, it is better to do it right the first time than to do it the quick and easy way and have to follow up with complications later on.  With Trust Implants, you will have no problems with your prostheses coming loose or completely coming out due to improperly anchored implants or general lack of implant anchors.  We always advise our patients to undergo full mouth reconstruction rather than all-on-four for this very reason.  We want to see you thrive with your new smile, not continuously calling the office or having to come in to have adjustments made or more implants put in.  Once you have been given your new smile, your only job should be to enjoy it and use it to its full potential – not to worry about if it’s functioning properly or causing your jaw to disintegrate.

So, if you are currently in the process of trying to find the best place to receive your implants and are throwing around the idea of getting the full mouth reconstruction procedure done, look no further.  Dr. Willardsen of Trust Implants is here to offer a free consultation and introduce you to all of the great things full mouth reconstruction can do for you and your smile.  Contact us today to receive an introduction to our team and services and, ultimately, take the first step into the next chapter of your life.