Full Mouth Dental Implants
Full mouth dental implants is the most effective treatment for patients with an absence of a full set of natural teeth in their mouth. Full mouth dental implants treatment never involves replacement of every tooth with implants instead its a term used for implants supported full bridge or full denture.
An implant is a treatment in which an artificial tooth root called an implant body made of a strong material such as metal is embedded in the mouth and an artificial crown is placed on top of it.
The problem of missing all teeth can be solved in two ways. The first is to install a removable denture, the reliability and functionality of which is in doubt. Or you can go a more correct way and carry out a complete prosthetics based on implants. At the same time, a non-removable structure is fixed on the titanium roots implanted into the jawbone, which protects the bone tissue from further atrophy, looks aesthetically pleasing and will never fall out of the mouth. That is, beauty, convenience and health benefits are guaranteed to you!
What are Full Mouth Dental Implants?
Full Mouth Dental Implants Treatment Options
Treatment Options for Lower Jaw
Treatment Options in Upper jaw
All-on-4 Treatment Option
Bone Grafting in Full Mouth Dental Implants
Which Implant to choose?
What are Full Mouth Dental Implants?
The essence of the method is to install individual crowns on the implants, a complete or bridge prosthesis in the absence of teeth on both jaws or on one. They are attached to titanium roots using abutments, bars or special micro-locks. The factors influencing the number of implants for fixing the prosthesis are the indications for implantation and the patient's budget. To replace each missing tooth with a separate crown on the implant, too much bone volume and flawless condition of soft tissues are required, which is quite rare. Therefore, in most cases, with complete edentulousness, the technology " All 0n 4", Which allows you to fix the covering prosthesis on 4 implants. However, the best option for full implantation from a medical point of view is the implantation of 6-8 implants in each jaw.
Full Mouth Dental Implants Treatment Options
More and more patients turn to the dentist in order to restore all teeth, or full teeth of one jaw in mouth. Conventional removable dentures, clasp dentures and extended metal-ceramic bridges do not meet high requirements for convenience, aesthetics and durability. All these goals can be achieved with the help of dental implants.
The method of implantation of a jaw in the absence of full teeth is significantly different from implantation in the absence of only a few teeth. For example, it is an obvious fact that you do not need to install 32 implants to restore all your teeth.
Treatment Options for Full Mouth Dental implants are,
Prosthetics on implants in the absence of full teeth can be divided into 3 types: removable, fixed and conditionally removable. Removable prosthetics on implants is suitable for those patients who have already used a removable prosthesis, but have not been able to get used to it. Any option of removable prosthesis on implants will greatly improve the quality of life of such patients.
However, if you have never used a removable denture, then psychologically it will be difficult to get used to such a design. In this case, the best option would be fixed or conditionally removable prosthetics on implants. Conditionally removable means that the prosthesis is fixed with screws. It can only be removed by a dentist, the patient uses it as his own teeth.
Treatment Options for Lower Jaw in Full Mouth Dental Implants
The structure of the lower jaw is denser than the upper one, therefore, in most cases, 2 to 6 implants are enough to restore all teeth. The integration period of implants in the lower jaw is 3 months.
For lower jaw option of treatment in full absence of teeth are,
1. Removable prosthetics on implants in the lower jaw are performed on 2-4 implants. The most common option is to install 4 implants with ball attachments (or locators). The advantages of this method are good fixation of the prosthesis, easy oral hygiene, simplicity of design, and, as a consequence, its inexpensiveness. A removable prosthesis on 2 implants with attachments is used in cases where there is not enough bone tissue to install 4 implants, the fixation of the prosthesis in this case is worse.
The disadvantages of this method of treatment are that the prosthesis distributes the load not only on the implants, but also on the gum. Under the pressure of the prosthesis, the gums atrophy; therefore, it is necessary to relocate the prosthesis on average once a year. The fastening on the attachments is also weakened, it is necessary to periodically replace the holding matrices. The service life of the prosthesis itself is about 5 years.
2. The second variant of a removable denture on the lower jaw is a prosthetic of the lower jaw on a bar with 4 implants. In this case, the load is distributed mainly on the implants and much less on the gums. The fixation of the denture is very tight, the denture feels almost like its own teeth. The prosthesis itself is made of plastic. It completely restores aesthetics and chewing function. The fact that the denture is removable simplified oral hygiene.
A plastic prosthesis is not as rigid as a metal-ceramic or zirconium one, so it is easier to get used to it for those people who have problems with the temporomandibular joint. The disadvantage of this method of treatment is that a properly manufactured bar prosthesis is comparable in cost to a fixed structure.
One of the main conditions for the long-term functioning of such a prosthesis is that the bar connecting the implants must be very precisely connected to them. For this, multi-unit abutments are used, which ensure an accurate connection of the implant to the bar, the bar itself must be manufactured on a milling machine. Unfortunately, patients are often offered a bar prosthesis made without multi-unit abutments, or made by casting rather than milling. In this case, the bar will be fixed to the implants with tension, which will lead to a negative result, possibly even to the loss of implants due to their overload.
Fixed prosthetics of the lower jaw is performed on 6 implants with classical implantation. It is also possible to restore teeth on 4 implants using the all-on-4 technique, in which case 2 out of 4 implants are placed at an angle of up to 45 degrees. The technique has its pros and cons.
Fixed prosthetics completely mimics your own teeth and is the easiest to tolerate psychologically. For the period of implant integration, the patient uses a temporary removable prosthesis, or dental implantation is carried out with a simultaneous load of a fixed plastic prosthesis.
The service life of a plastic prosthesis is 1 year. It can be replaced with metal-ceramic or zirconia after complete healing of the implants. On the lower jaw after 3 months. The implants themselves are not affected.
In the case when a permanent prosthesis is made on screw fixation, we are talking about conditionally removable prosthetics on implants. Partially removable means that only a dentist can remove the prosthesis. The patient cannot remove it on his own, it feels and functions like his own teeth.
The advantages of screw fixation are that the prosthesis can be removed if necessary. Unlike cemented prosthesis, which cannot be removed without sawing. However, the complexity of the design, and as a consequence, the cost, increases.
Treatment Options in Upper jaw for Full Mouth Dental Implants
The bone tissue of the upper jaw is less dense than that of the lower one, therefore, for complete prosthetics on implants of the upper jaw, more implants are needed - from 4 to 8. The healing of implants on the upper jaw occurs within 6 months.
Removable prosthetics of the upper jaw are performed on 4-6 implants. A covering prosthesis with ball attachments can be placed on 4 implants. The covering prosthesis has the same boundaries as a conventional removable denture, it completely covers the palate. For the manufacture of a prosthesis on the upper jaw without a palate, 6 implants must be installed. Ball attachments, locators or a beam can be used as connecting elements. The best fixation of the prosthesis is achieved on the bar. However, the cost of such a prosthesis is comparable to that of a fixed construction.
For fixed prosthetics of the upper jaw, it is necessary to install from 6 to 8 implants. It is also possible to install a fixed prosthesis on the upper jaw on 4 implants using the all-on-4 technique.
Installation of 6-8 implants in the classical way is the most studied and reliable option for implantation of the upper jaw. The number of implants is determined by the presence of bone tissue and the shape of the upper jaw. During the healing of the implants, the patient uses a temporary removable prosthesis, or implantation is carried out with a simultaneous load of a non-removable plastic prosthesis.
The service life of a plastic prosthesis is 1 year. It can be replaced with metal-ceramic or zirconium after complete healing of the implants. On the upper jaw after 6 months. The implants themselves are not affected.
As well as the lower jaw, it is possible to make a permanent screw-retained structure on the upper jaw - conditionally removable prosthetics. Only a dentist can remove a screw-retained prosthesis. The patient uses it like his own teeth.
The advantages of screw fixation are that the prosthesis can be removed if necessary. Unlike cemented prostheses, which cannot be removed without sawing. However, the complexity of the design, and as a consequence, the cost, increases.
Various implantation options in the absence of teeth. 8 implants in the lower jaw, 6 implants in each jaw, 8 implants in the upper jaw
ALL-ON-4 Treatment Option of Full Mouth Dental Implants
The All-on-4 technique was developed by Nobel Biocare. It implies the installation of 4 implants per jaw with simultaneous loading with a fixed screw-retained prosthesis. The 2 extreme implants are placed at an angle of up to 45 degrees, which allows you to bypass anatomically difficult places: the maxillary sinuses in the upper jaw and the nerve exit site in the lower jaw.
Initially, the All-on-4 technique was positioned as minimally invasive, without bone grafting. However, for successful functioning, it is necessary to install long enough implants, because 4 implants must carry the load for the entire dentition. Unfortunately, not all patients have the required height of the alveolar ridge. Installing shorter implants may lead to the fact that due to the increased load, one of the implants will not take root. And then all-in-four will turn into nothing in three. That is why patients are offered "all-on-4 modifications", for example, All-on-6 (all-on-six implants), because installation of an additional 2 implants significantly reduces the risks.
3-6 months after the implantation according to the All-on-4 technique, gaps appear between the prosthesis and the gum, because for this, the gums are remodeled after implantation. It is necessary either to reline the existing prosthesis, or replace it with a permanent one - metal-ceramic or zirconium.
BONE GRAFTING FOR JAW IMPLANTATION
The more implants are installed, the more likely it is that the available bone tissue will not be enough for the installation of implants and it is necessary to carry out its augmentation. Bone deficiency can be in thickness (very thin bone), or in height (close to the maxillary sinus in the upper jaw, nerve in the lower jaw).
With a slight shortage of bone tissue in thickness, it is possible to simultaneously perform bone grafting with the installation of implants. It is also possible to perform sinus lifting (a type of bone augmentation with an insufficient distance to the maxillary sinus) with the simultaneous installation of implants.
With a large deficit of bone tissue, first operations are performed to build it (open sinus lifting, bone block harvesting and replanting), and after 3-6 months, implantation. In this case, the total duration of treatment can be from one to one and a half years.
HOW TO AVOID BONE GRAFTING?
There are proven techniques that allow you to reliably restore teeth on one or both jaws without additional bone augmentation surgeries.
First of all, it should be said about the positions in which the implants are installed.
In total, a person has 32 teeth, 16 teeth on each jaw. The 2 extreme teeth are wisdom teeth, they do not carry a functional load, therefore they are not restored during prosthetics. Of the remaining 14 teeth (7 on each side), the sixth and seventh teeth are the most problematic in terms of restoration (counting from the center). They are located close to the maxillary sinus in the upper jaw and to the nerve in the lower jaw. Just to restore the sixth and seventh teeth, it is necessary to carry out long-term osteoplastic operations.
According to the recommendations of the International Association of Implantologists ITI - International Team for Implantology , in the absence of teeth, it is necessary to restore the dentition up to the sixth tooth inclusive (12 teeth on each jaw). This method completely restores both the function of the jaw and the aesthetics of the smile. At the same time, additional risks associated with the close location of anatomically important formations (maxillary sinuses and nerve) are avoided.
In this case, the implants are installed in the anterior part of the jaw, and the extreme ones in the area of the fifth teeth (the so-called protocol of the University of Frankfurt ). In the future, a one-piece fixed prosthesis is installed on them. Combining all implants into a single design compensates for lateral chewing loads and ensures full functioning of the entire jaw on only 6 implants on the lower jaw and 6-8 on the upper.
Another problem is the lack of bone thickness ( thin bone ). To avoid bone grafting in this case, it is possible to use thin implants. However, not all systems guarantee that their thin implants are able to withstand the stress of a full jaw prosthesis. Such guarantees are given by German implants Ankylos , and Straumann has developed a special alloy of titanium and zirconium, which allows thin implants to function without bone augmentation, it is called Straumann Roxolid.
And the last, with a deficiency of bone tissue both in height and width, a possible solution is to install short and thin implants, but in larger quantities. Instead of 6 standard ones - 8 short ones. In this case, the total length of the implants will be equal.
WHICH IMPLANTS TO CHOOSE?
Today there are more than 3000 implant systems in the world. However, not all of them can boast of a long history of observations and clinical trials around the world. There are also some implant systems, which, despite their reliability, are not very common in Russia. This can lead to difficulties in terms of delivery of the original components of the implant systems.
It is worth choosing only the generally recognized implant systems, which are used by different, independent doctors. Otherwise, the patient runs the risk of being in a situation where no one can help him.
An important point when choosing an implant system is the type of implant-abutment connection. How long the implant will last depends on it. Tapered implant-abutment connection with platform switching effect is considered to be the most reliable today. It is able to withstand heavy loads, compared to a flat connection, is tight and does not cause bone resorption around the implant.
The engraftment of implants is influenced by the purity of the titanium from which they are made. The most common is Grade 4, a commercially pure titanium. Grade 1,2,3 alloys are even cleaner. Grade 5 - less pure, contains impurities of vanadium and aluminum.
The surface of each implant is a unique patented technology, because it is on the surface of the implant that osteointegration occurs - the fusion of the implant with the bone tissue. Serious manufacturers of implants conduct a lot of research, proving that their implants are integrated not only in standard situations, but also, for example, in people suffering from diabetes mellitus or bleeding disorders.
The following systems meet all these requirements: Straumann (Switzerland), Ankylos (Germany), Astra tech (Sweden), Nobel biocare (USA / Sweden). Osstem implants (South Korea) can be distinguished from inexpensive systems. They have established themselves worldwide as a reliable and cost-effective implant system.
How Much Full Mouth Dental Implants Cost
Despite the seemingly high cost of implantation in the absence of teeth, it may be more profitable than restoring already hopeless teeth. In addition, the lifespan of the implants is unlimited. Treatment is carried out in stages and is paid for too.
So, the price of jaw implantation in the absence of teeth depends on the type of construction (removable, non-removable) and the implant system.