Loss of natural teeth due to various causes such as tooth decay, gum disease, tooth extraction, and oral accidents often affects daily functions such as chewing food and speaking. More importantly, it leads to a loss of confidence in one’s smile, which negatively impacts overall quality of life. In addition to removable dentures, dental implants are another option to replace lost natural teeth, both in terms of function and aesthetics. Currently, there are several types of dental implants available, such as single-tooth implants, implants for multiple missing teeth, and full arch implants. The choice of which type of implant to use depends on the specific dental issue and various factors in each patient, such as the number, position, and condition of the remaining teeth, as well as the supporting bone structure

Removable full dentures for the entire arch have several limitations, such as requiring multiple visits to the dentist, making it difficult to achieve a secure fit. Additionally, the gums and bone change shape over time, which means the denture base needs to be adjusted for a tighter fit. As a result, dentures may become loose and cause discomfort, leading to noise while eating or speaking. Patients also need to cut food into small pieces before chewing with dentures. When dental implants are used in conjunction with dentures, they make the dentures more secure, which increases confidence in speaking and chewing food

• Advantages: Dentures fit more securely.
• Limitations: Removable dentures require caution when chewing food.

• ข้อดี ทดแทนฟันทั้งขากรรไกร รากฟันเทียมรองรับสะพานฟันเซรามิกได้มั่นคงแข็งแรง ฟันปลอมชนิดติดแน่นทำความสะอาดได้เหมือนฟันธรรมชาติ
• ข้อจำกัด กระดูกต้องเพียงพอและสมบูรณ์ในการฝังรากเทียม

For replacing all missing teeth, whether in the upper or lower jaw, fixed dental implants help replace the lost teeth, slow down the bone resorption around the implant site, and maintain the original facial structure. With today’s advancements in dental technology, the ‘All-on-4, All-on-6 dental implants‘ technique has been developed. This technique involves placing four implants into the jawbone per arch (or possibly six, depending on the bone quality and the dentist’s discretion) to support a full set of fixed dentures or a bridge. Screws are used to secure the dentures or bridge to the implants, preventing them from shifting or wobbling, unlike removable dentures. This is an effective way to replace missing teeth.

1. Pre-implant Evaluation: Before starting the treatment, the dentist will take a medical history, examine the gums, assess the supporting bone structure, and perform a scan of the oral cavity using X-rays (X-RAY), 2D panoramic radiographs (Panoramic Radiograph), or 3D CT scans (CT SCAN). These images help to evaluate the amount of bone available, important structures, and the position of the nerves involved, allowing the dentist to plan the implant placement.
   
2. Dental Implant Placement Procedure: The dentist will perform the implant procedure using CT-guided surgery, with the help of Smile Design software (both 2D and 3D) to plan the exact position for implant placement. The dentist will make an incision in the gums, drilling down into the jawbone to create space for All-on-4 implants. Four implants are placed: two in the front and two at the back, angled at 45 degrees to ensure stability and support the prosthetic teeth. While placing implants straight is ideal, in the upper jaw, the presence of the sinus cavity (which is air-filled and lacks bone) requires implants to be placed at an angle to avoid perforating the sinus. The choice between straight or angled implants depends on the dentist’s evaluation and the patient’s health condition.
   
3. Placement of Dentures or Bridge on the Implants: Once the implants are securely placed, the dentist will fit a temporary set of dentures or a bridge onto the implants on the same day. The material used is acrylic, which is adjusted to fit the mouth and bite properly. After six months, once the gums and bone have fully healed, the dentist will schedule a follow-up appointment to assess the healing progress. If the patient desires stronger material, such as titanium-reinforced acrylic or zirconia (Zirconia), the dentist can discuss the appropriate options for durability and the patient’s dental health.

The materials for making dentures are available in 3 types:

1. Acrylic with special reinforcement
2. Acrylic with enhanced strength
3. Zirconia (Zirconia)

The dentures placed immediately after dental implants are usually made from acrylic with special reinforcement. They are lightweight and have less biting force to help reduce the stress on the newly placed implants, allowing the bone to integrate with the implants. The patient can continue using the first set of dentures if they are still functioning normally. However, in some cases, it may be considered to switch to dentures made from Zirconia after 6 months or more of implant placement, as zirconia is stronger and more durable. The dentist will recommend the choice of denture material based on the patient’s usage and individual needs.

Additionally, the dentist will recommend the use of 4 or 6 implants, depending on the bone factors, biting force, and the type of dentures chosen. Normally, the upper jaw requires more implants than the lower jaw.

• Replace teeth and use them immediately. Patients can receive both implants and dentures on the same day, provided that it is suitable. This can be done in appropriate cases, depending on the discretion of the experienced dentist, considering the condition of the oral cavity, jawbone, and other factors that vary among individual patients.
• Requires less surgical time, quick recovery, and reduces the number of visits to the dentist.
• No more issues with loose or shifting dentures, as they are fixed dentures.
• Strong and provides a natural feel during use, such as chewing and speaking.
• Reduces the complexity of bone grafting procedures.
• Effectively restores lost teeth, enhances appearance, and boosts confidence.
• Lasts for many years, potentially a lifetime, with proper care.
• This highlights the benefits of the All-on-4 dental implant technique, including its quick procedure, effective restoration of teeth, and long-term durability. Let me know if you need further assistance!

• Those who have few remaining teeth or have lost all teeth, either in the upper or lower jaw.
• Patients who need to extract all their teeth but still want fixed dentures.
• Those who need multiple dental implants.
• Patients who cannot place implants in the back teeth areas.
• Those who have lost bone support but do not require additional bone grafting, or require minimal bone grafting.
• Those who have issues with crowns or bridges, including loose teeth that need to be extracted.

However, this treatment may not be recommended in cases where there is significant bone loss, and the decision to use All-on-4 implants depends on the dentist’s discretion.

Since All-on-4 implants are fixed, they do not need to be removed for cleaning like removable dentures. Patients can brush their teeth as usual, effectively replacing the need for dentures. However, patients must clean them every day by using a water flosser to rinse under the dentures and using special Superfloss twice a day to ensure that no food particles are trapped. If cleaning is not done properly, bacteria can accumulate around the implants, causing gum inflammation, bone resorption, and eventual loss of the implants. Additionally, regular dental visits are very important to check the stability of the screws and perform thorough cleaning. Typically, the dentist will schedule check-ups every 6 months or as needed.

• Specialized dentists who are skilled and experienced
• Modern tools and technology with international standards
• Personalized treatment planning
• High-quality implants and prosthetic materials that meet international standards