All on 4 Implants

[Davesgone]

Had a Dr ask me today if I do......All on 4 Implants".... Can anyone enlighten me on how this system works?

 

[Car 54]

I believe it's an immediate load tech. where the 4 implants are placed at a slight angle forward at about the 1-2nd bi area and forward. I guess the angle helps for more implant surface area for immediate load ability?

 

[AJEL]

Ivoclair has a course on this in Fl, I believe the initial portion is 2 weeks. You can get some idea by going to one of the LMT Lab days the all on four is an all day clinc. Spectrum has a good all day course given at same time as LAB day, you will have to decide if you are dong the removable or fixed portion it is 0700-1800 .

 

[Davesgone]

Ivoclair has a course on this in Fl, I believe the initial portion is 2 weeks. You can get some idea by going to one of the LMT Lab days the all on four is an all day clinc. Spectrum has a good all day course given at same time as LAB day, you will have to decide if you are dong the removable or fixed portion it is 0700-1800 .

Thanks Ajel!

 

[cadfan]

All on 4 is a concept to keep it easy , very often their is less bone in the molar region and you need a sinuslift and additional bone thats why they insert the implants in the molar region often high angled so only 8-9 mm bone is enough because they are more vertical inserted and therefore longer !! but if one fail you fail.Less implant are cheaper but higher risk.

 

[lcmlabforum]

Not something for the novice, high stakes procedure and things can go wrong with unhappy DDS and unhappy patient all
blaming you, rightly or not . . . even in the best of preparations.
LCM

 

[BlakeHarting]

It's a procedure where 4 (or more) implants are placed and a fixed denture, or full-zirconia, restoration is made and screwed into the mouth. It's very difficult, drawn out, and expensive. We just started designing and milling these out of zirconia on our VHF mill running 3Shape software.

 

[kcdt]

You better be at "A" game if you get asked to do any clinical conversions.

 

[grantoz]

Plastic is not the answer for these cases long term .If you want unhappy people ie patient and doctor sell them the acrylic option and tell them its a long term solution.Hell even if you call it a long term temp you will get grief i have been remaking other peoples resin solutions in zi for quite a while now.Same old story patient thought it would last longer hell i paid $25000 for this thing and i have replace and or repair it every few years . I have heard the patient say this time and time again. This technique is not for the faint hearted but when done well is very satisfying.

 

[kcdt]

Plastic is not the answer for these cases long term .If you want unhappy people ie patient and doctor sell them the acrylic option and tell them its a long term solution.Hell even if you call it a long term temp you will get grief i have been remaking other peoples resin solutions in zi for quite a while now.Same old story patient thought it would last longer hell i paid $25000 for this thing and i have replace and or repair it every few years . I have heard the patient say this time and time again. This technique is not for the faint hearted but when done well is very satisfying.

I hear that PEAK frames are the new bleeding edge....
Most prothodontists I know aren't all that excited about zirconium. No options for repair if something breaks down.
FWIW the acrylic over frame has been around since Branemark. It still has the best track record.

 

[grantoz]

you can repair zi if you know how you can reline it also.I now have full arches coming up that are 10 years old no problems.the peak option has some good things going for it but not long term.Its a great healing temp solution hensc why implant companies are making temp abutments out of it .BUT AND A BIG BUT THEY ARNT MAKING PERMINANT ABUTMENTS OUT OF IT NOT EVEN FOR SINGLE TOOTH RESTOS i think this says it all the implant companies would be all over it ,easy to mill or inject cheaper all the way to make even if the material itself is more expensive.

 

[AJEL]

PEEK is still in FDA trials, the companies cannot make permenant abutment until it has full FDA Certification. PEEK is currently permenant for frameworks but only 13 months for below tissue level.
It may not bee that the implant companies dont want to be all over it, they may be rgulated to holding back.fwiw mho

 

[grantoz]

peek has been around in europe quite a time now years in fact most the implant companies and manufacturers of peek come from europe they still dont do it for permanent solutions on a regular basis.I want an easy to manufacture reliable bone like material that lasts a life time as much as anybody but peek and the things they stick to it aint the savior that every one is hoping for.Its not the messiah, just a naughty boy.

 

[JMN]

Went to Nobels class, took 3 typed pafes of notes, wish I'd recorded it. You must be good chairside, with pretty modelwork, and a good relationship with the doc(s) iinvolved. zYou will be on stage for over 2hrs while the pt naps and doc watches over your shoulder from time to time. Call your rep and get in a class, and get them to come along on the first one even. This is a real technique sensitive deal, and it can get royally out of whack fast. And you know who's fault it will be.

 

[cdtwade]

Be sure to charge enough to save for a legal defense fund.

 

[Car 54]

Both "Funny" and "Agree" also..but at least you'd be, "riding the cusp, soaring the heights of new technique". Yeah, right, don't we all want to be the firsts ones doing it, or buying it, only to learn and hear of the nightmares later, I don't think so.

 

[Thedentureman]

All I do is the all on four. One of the biggest things you want to keep in mind is, when the surgeon asks you a question you better have the right answer.

 

[pdent]

All I do is the all on four. One of the biggest things you want to keep in mind is, when the surgeon asks you a question you better have the right answer.

Dentureman- How did you get started doing all on four cases? I've taken a couple of courses with Tom Wade and I feel like I'm ready to dive in.

 

[Thedentureman]

The first thing I did was volunteer at the free clinic downtown. I did that for two years just to get my hands wet. Then I went chair side with a Periodontist for a year. Became a member of the ACP technicians alliance just to see how the pros do it. And then I thought I was ready.

So my only advice to you is take it slow and make sure the patient comes first. And never cut corners or use cheap products.

 

[pdent]

The first thing I did was volunteer at the free clinic downtown. I did that for two years just to get my hands wet. Then I went chair side with a Periodontist for a year. Became a member of the ACP technicians alliance just to see how the pros do it. And then I thought I was ready.

So my only advice to you is take it slow and make sure the patient comes first. And never cut corners or use cheap products.

Thank you for the advice!