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CLINICAL TREATMENT

All on Four & Six Implants

Full-arch fixed teeth restoration utilizing angled implant mechanics and immediate loading protocols.

The All-on-4 and All-on-6 treatment concepts represent a revolutionary surgical and restorative solution for patients suffering from complete edentulism (tooth loss) or those with severely decayed, failing teeth that are terminal. Traditionally, restoring a full arch of missing teeth required inserting 8 to 10 implants throughout the jaw, often necessitating extensive, painful, and costly bone grafting (such as sinus lifts or block grafts) to build up bone in the posterior (back) regions. The All-on-4/6 technique bypasses these limitations. By placing only 4 or 6 implants at precise strategic angles (tilting the posterior implants up to 30 to 45 degrees), we utilize the denser bone available in the anterior (front) region of the jaw. This angled positioning maximizes bone-to-implant contact, avoids critical anatomical structures like the maxillary sinuses in the upper jaw and the mental nerve in the lower jaw, and provides sufficient stability to support a fixed, functional temporary bridge within 24 hours of surgery. Understanding the biomechanics and structural components: - Tilt and Angle: The key to the All-on-4/6 concept is the angling of the rear implants. By tilting them, we create a wider tripod effect, spreading the biting forces evenly across the entire arch and reducing the length of cantilever (unsupported) extensions on the final bridge. - Immediate Loading Protocol: On the day of surgery, Uzm. Dt. Yusuf Kurt surgically places the implants and attaches multi-unit abutments. A customized, screw-retained temporary bridge is fabricated and fixed onto the implants on the same day or the next morning. This provides immediate aesthetic and chewing function, allowing patients to discard their loose dentures. - The Permanent Restoration: After an osseointegration period of 3 to 4 months, the temporary bridge is replaced with a permanent prosthesis. This final bridge is custom-designed using CAD/CAM technology and can be made of zirconium crowns fused to a titanium substructure or metal-acrylic hybrids, depending on patient preference and bite forces. Who is a candidate for All-on-4/6? This treatment is ideal for patients who currently wear loose full dentures, individuals with advanced periodontal disease whose teeth can no longer be saved, or patients who have experienced significant bone loss in the back of their jaw. By eliminating the need for complex bone powder graft surgeries in most cases, All-on-4/6 drastically reduces healing times, decreases overall treatment costs, and restores a permanent, non-removable smile that looks, feels, and functions exactly like natural teeth.

Full-Arch Treatment Stages

3D Tomographic Diagnostics & Guided Planning: We perform a high-resolution 3D CBCT scan to examine bone density, height, and nerve paths. Using specialized virtual planning software, we design the exact entry points, angles, and depths for the 4 or 6 titanium implants.

Surgical Implantation & Abutment Fitting: Under local anesthesia, the remaining terminal teeth are extracted, and the 4 or 6 titanium implants are placed. Multi-unit abutments are secured to the implants, and an intraoral scan is captured to fabricate the immediate prosthesis.

Immediate Temporary Bridge Attachment: Within 24 hours, our dental laboratory fabricates a custom acrylic temporary bridge. This bridge is screwed directly onto the implants, immediately restoring chewing ability, phonetics, and smile aesthetics.

Osseointegration & Final CAD/CAM Prosthesis: After 3 to 4 months of healing, the temporary bridge is removed. We capture final high-definition digital scans to mill the permanent prosthesis (e.g., E-max or Zirconium crowns on a CAD/CAM milled titanium bar).

Key Advantages of All-on-Four & Six

Fixed Restoration: The prosthesis is screwed directly onto the implants, meaning it never slips, clicks, or falls out, unlike removable dentures.

Immediate Chewing & Social Function: Patients leave the clinic with fixed, functional teeth, allowing them to speak, smile, and eat soft foods on day one.

Bypasses Bone Grafting: Angled placement avoids areas of severe bone loss, eliminating the need for extensive bone grafting or sinus lifts in most cases.

Preserves Facial Proportions: Restores the natural support to the lips and cheeks, preventing the aged, collapsed appearance associated with tooth loss.

Easy Maintenance & Durability: Designed with medical-grade titanium and high-end ceramics, providing a long-term, structural solution for edentulism.

Post-Operative Recovery & Hygiene Guidelines

To ensure the implants heal safely and protect your new bridge, adhere to these care instructions: - Nutrition (First 3 Months): During the osseointegration phase, the bone is actively fusing with the titanium. You must consume a soft diet (soups, pasta, fish, scrambled eggs, mashed potatoes) to avoid applying excessive force to the healing implants. Avoid hard, crunchy, or chewy foods (nuts, tough meats, raw carrots). - Oral Hygiene Routine: Keeping the area beneath the bridge clean is critical to prevent peri-implantitis. Brush the prosthetic teeth twice daily using a soft toothbrush. You must use a water flosser (Waterpik) at a low pressure setting to flush out food debris and plaque from underneath the bridge margins daily. Use specialized thick floss (Superfloss) threaders to clean around each implant post. - Avoid Habits: Do not smoke, as nicotine constricts blood vessels and significantly increases the risk of implant failure. Avoid carbonated drinks. - Clinical Maintenance: Visit our clinic for professional cleanings and evaluations every 6 months. We will inspect the bridge, verify the torque of the screws, and ensure the surrounding gum tissue remains healthy.