I've let my Teeth Go. Have I 'missed the boat' to be able to get a nice smile?

We have been asked this question on many occasions, but to date, we are proud not to have had to turn anyone back. Our procedures allow us to address even the most severe problems in an efficacious manner using All On 4 Plus or Zygoma Plus treatments, and we aim for our patients to feel as though the process was uncomplicated. We always say that the best After's often come from the worst Before's.

I've worn a denture for 40 years and have been told I don't have enough bone for dental implants. Is All On 4 Plus something to consider?

Tooth loss and wearing a denture for many years can certainly result in advanced atrophy of the bone where there is no more jawbone left to insert dental implants. In some cases, we can offer some alternatives with All On 4 Plus, but in the most severe situations, we can avoid relying on the jawbone for support, and instead insert longer implants into the underside of the cheekbones for the necessary support of fixed replacement teeth, just like All On 4.

I cannot bite into an apple. Will this change with All On 4?

Absolutely, this is the aim of the treatment. At the All On 4 Clinic, we want to ensure that you can smile and function with confidence. To us this means you being able to bite, taste, and chew all types of food, including apples, carrots, nuts, steak, crusty bread, just as you would do with natural teeth.

Am I asleep for the procedure?

Part of our approach is to ensure that the treatment is as pain-free as possible and that you are relaxed. In most situations, the treatment is performed under General Anaesthetic where you are completely asleep or IV Sedation where you are in a twilight state. If you have special needs or requests, be sure to raise them at your consultation and we will plan your treatment accordingly.

How long does the immediately fitted FINAL acrylic All-On-4 bridge last?

The bridge that is inserted immediately after your surgery is constructed to a very high standard and is designed as the FINAL bridge in terms of Aesthetics, Function, Speech, and Comfort. However, this does not mean that it will last you for life. As a guideline, we estimate that on average the bridge would last for three to five years before needing replacement. However we do have patients who have worn their original bridge well beyond that, and we also have a similar percentage of patients where it did not last as long. The nature of the bite is different in every person, and when the forces are beyond the physical tolerance of the acrylic material, an upgrade to a stronger material such as Zirconia is typically required. This does not mean that the entire treatment needs to be re-done. We only replace the prosthesis itself, the top part that fits on the implants, and the cost to upgrade is only a fraction of the original cost of the treatment.

I am considering having immediate teeth replacement with All On 4 Plus®, can I elect to have a zirconia bridge instead of high-impact acrylic?

The simple answer is no, for three main reasons. Firstly, after your implant treatment, your jawbone must adhere itself to the titanium implants through a biological process known as osseointegration. One of the reasons that we prefer to use an acrylic material for the construction of the bridge that is fitted to the implants is because it is more forgiving on the bite and can absorb some of the forces. With Zirconia, because of its high rigidity, it would transfer the impact of the bite more readily through to the implants, which could potentially disturb the process of integration. The second reason is that the Zirconia can take a number of weeks to complete, and we would not dare to ask our patients to be without any teeth whilst waiting for the zirconia production. Thirdly, wearing the acrylic bridges affords us the opportunity to re-assess the aesthetics and function once you are fully recovered and eating all types of foods. If there are any changes required, we can incorporate these into the design of the new zirconia bridge. The original acrylic bridge will always serve as a spare set in case we need to do any sort of adjustment to the zirconia bridge in the future.

I have had my acrylic bridges now for 5 years and I love the look, can the new zirconia bridge be shaped similar to my old implant bridge?

Absolutely. If you want an exact replica, we can CAD-cam your original bridge and convert it to monolithic zirconia. However, we usually prefer to do another template and try it in your mouth. Sometimes there are improvements that we make that you may not otherwise have considered but might ultimately prefer.

How long will the zirconia bridge last?

We estimate that the zirconia bridge, especially the monolithic version, will last 10-15 years. It is possible that it could last well beyond that, but it is also possible that it will last less. The main unknown is not so much the durability of the material, but whether there is any question as to the health of the supporting implants over time. In our 6-year follow-up of Zirconia at the time of this publication we have not seen any sort of adversities.

I have had bone grafting, how long before I can upgrade?

If you had undergone bone grafting, this often indicates that you had poor quality or quantity of bone at the time of your initial surgery. As such, before we proceed to a long term definitive solution such as Zirconia, we need to ascertain whether the number of existing implants that you have will be sufficient for the long term. We do this by monitoring the performance of the implants after 12 months in function, and where necessary, we might need to place additional implants before considering an upgrade.