YOUR IMMEDIATE TEETH WITH HIGH IMPACT ACRYLIC
The teeth that are fitted immediately after surgery are constructed from a highly aesthetic and resilient acrylic material. The processing of this material makes it conducive to a quick turnaround using the All On 4 Clinic’s restorative protocols, and this is the only choice for immediate teeth. The bridge is reinforced internally with metal bar support, and is designed as the permanent restoration with optimal aesthetics and function, but this does not mean it will last a lifetime. Over time some wear occurs and this varies from patient to patient. On average, the acrylic teeth require replacement every 3-5 years.
This timeframe is only a guideline and it is not unusual for our patients to have worn their original restorations for 7 years or longer without requiring replacement. Replacing the acrylic bridge does not mean re-doing the entire All On 4 treatment from the start. The process of replacing the teeth is uncomplicated and does not require any additional surgery. However, the acrylic material, whilst intended as the permanent bridge, has a finite physical tolerance, and in certain patients, such as heavy grinders or those in whom the improvement to their biting force is beyond the tolerances of the acrylic material resulting is excessive wear or signs of stress, an upgrade to a stronger material such as Zirconia may be required at an earlier time, or at some time in the future.
TITANIUM & ZIRCONIA SOLUTIONS
All On 4 Plus® has changed the way we practice implant dentistry allowing us to offer fixed replacement teeth permanently anchored to dental implants, all within 1-2 days.
The immediacy of the process is facilitated by our innovative clinical procedures, an on-site laboratory and constructing the bridge from a high-impact acrylic material, which can be processed within one day. However, whilst our processes enable us to deliver the final aesthetics and function within such a short timeframe, the acrylic material naturally ages and wears and can lose its aesthetic appeal over time. As a guideline, it needs to be replaced within 5 years on average, unless signs of wear or fracture appear earlier, which often indicates that the improvements to the forces of the bite offered by the fixed replacement teeth are beyond the tolerance of the acrylic material in your mouth.
The picture set below illustrates the visual appearance of the original high impact acrylic bridge on the left, and the way it looks on an x-ray on the right:
For improved durability and longevity of the restoration the All On 4 Clinic offers various options depending on need. By wearing the immediately fitted high impact acrylic teeth our clinicians are able to monitor the performance over time and make better decisions when deciding when and what style of future restoration would work best for the longer term. In some cases there is a need for stronger teeth, whereas in other situations it is the base structure needing strengthening.
Older methods of reinforcement or strengtheining in dentistry involved the use of a cast gold substructure to support the teeth. Today’s technology allows the use of zirconia or titanium substructures instead. These materials are more biocompatible and are precision milled, leading to superior adaptation over the implants and improved tissue health. Titanium substructures may be used to support acrylic teeth or zirconia-ceramic teeth, whereas the zirconia substructure is designed especially for direct layering of ceramic teeth for improved light transmission and long-term natural aesthetics.
When its time to replace the original acrylic bridge, there are a number of options that can be considered. The frame or body of the new bridge construction can be either titanium or zirconia, and the teeth can be either acrylic or porcelain. However, whenever acrylic teeth are fitted, there is still the issue of wear and ageing over time.
The picture set below illustrates the visual appearance of a milled titanium frame with acrylic teeth on the right, and the way it looks on an x-ray on the left:
The picture set below illustrates the visual appearance of a milled titanium frame with porcelain (PFM) teeth on the left (note it is on a model before the gum material has been applied), and the way it looks on an x-ray on the right:
Zirconia, on the other hand, is a material with physical properties like steel, but a colour which makes it conducive to creating highly aesthetic restorations. It is also a highly biocompatible material, and helps facilitate better hygiene because plaque does not adhere to zirconia to the same degree as acrylic. Acrylic is a more porous material, whereas zirconia is very dense. This means that the zirconia will not absorb the mouth fluids, resulting in a more hygienic, fresher smelling restoration.
For optimal aesthetics, unlike options with a titanium frame, porcelain can be layered directly onto the zirconia to individually characterise the aesthetics.
The picture set below illustrates the visual appearance of a milled ZIRCONIA bridge on the right, and the way it looks on an x-ray on the left:
By far the biggest advantage of zirconia is its likely performance over time, as well as the weight and texture feeling more like natural teeth. Zirconia is CAD-milled to duplicate a template of a wax set-up that has been tried in your mouth to fine-tune the aesthetics and arrangement of the teeth. Using new techniques where we can colour the zirconia after its milled, we can achieve high aesthetics from a monolithic block, even without layering of any other material, resulting in optimal durability.
All-On-4 Clinic Patient Booklet
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