The All-on-4® treatment concept is a technique for the total rehabilitation of the edentulous patient or for patients with badly broken-down teeth, decayed teeth, or compromised teeth due to periodontal disease. It is performed by placing four implants in either arch with the distal-most implants being placed in a tilted position to increase support for a fixed prosthesis. This tilted placement allows patients to undergo prosthetic surgery without first requiring a bone graft as it utilizes already available bone. In addition, with the All-on-4® technique, the prosthesis is usually placed immediately on the day of surgery, though patients must first be carefully evaluated to ensure they meet the criteria needed for immediate implant loading. The patient benefits of All-on-4® include no need for bone grafts, immediate function and aesthetics of the prosthesis, fewer surgeries, reduced healing time, and less expense. All-on-4® is a registered trademark of Nobel Biocare.
Glossary
Allogeneic Graft
Allogeneic grafts, or allogenic bone grafts, are becoming more popular in the field of implant dentistry. In cases where a patient does not have sufficient bone density for an implant, a graft may be necessary. There are many different types of grafts available, and the treating periodontist selects which graft is the best choice for the patient’s unique needs. An allogenic bone graft is done using human bone, but unlike other types of bone grafts, the bone is not harvested from the patient receiving the graft. Instead, it is donor bone, typically harvested during other surgeries, such as hip surgeries. The bone is cleaned, sanitized, and meticulously prepared for donation. Because of this, allogenic bone cannot grow new bone by itself, like other types of bone grafts. Instead, it is used as a framework for the patient’s existing bone to grow around to fill the area.
Allograft
An allograft is a type of graft which utilizes tissue from genetically dissimilar members of the same species. Four types of allograft exist: frozen, freeze-dried bone allograft (FDBA), demineralized freeze-dried bone allograft (DFDBA), and solvent-dehydrated mineralized allograft. Allograft bone is processed and prepared by tissue banks. In dentistry, allografts such as bone grafts are used to build up the bone where an implant or prosthesis will be placed. Some patients have insufficient bone due to disease or other health concerns and therefore do not have the proper foundation for an implant. A bone allograft ensures a stable structure for the placement and success of dental prosthetics. Bone used in allograft procedures generally comes from human cadavers that have willingly donated their bodies for such purposes. Due to its source, allograft material is strictly regulated by both the American Association of Tissue Banks and the US Food and Drug Administration
Alloplast
Patients without sufficient bone mass for an implant may require a bone graft to complete nthe dental implant procedure. A bone graft can decrease the risk of implant rejection or failure, and can position the implant so that it is both functional and aesthetically pleasing. Different graft materials are available, one popular choice being an alloplastic graft. Alloplastic grafts are not made of bone like other types of grafts. Instead, the bone graft material alloplast is usually made from hydroxyapatite, which is a natural mineral that is the primary component of bone. This is considered a synthetic bone graft, however, it is used more frequently than other types of bone grafts due to the material’s superior hardness, osteoconduction, and compatibility with natural bone. Hydroxyapatite is non-carcinogenic and non-inflammatory, making it an extremely safe material to use. The patient’s natural bone grows around the material, building up the implant site.
Alloplastic Graft
A bone graft is often needed for patients who have suffered bone loss and don’t have enough jaw bone in the area where the implant will be placed. In these cases, bone grafts are typically necessary. This allows a periodontist to place the implant in a way that will be cosmetically pleasing and functional, as well as reduce the risk of implant failure. An alloplastic graft is generally the most frequently used type of bone graft in the implant industry because the material used has excellent hardness and osteoconduction, making it very compatible with the patient’s own bone. The material used for alloplastic grafts is a type of glass made from a naturally occurring mineral in bone called hydroxyapatite. This material is both non-inflammatory and non-carcinogenic, which makes it safe for the patient and particularly effective for bone grafting. Although other types of grafts are available, alloplastic grafts tend to elicit the best results.