Fixed teeth in a day

Fixed teeth in a day, sometimes referred to as ‘Same-day teeth’ or ‘All-on-4’, is a treatment technique whereby a whole arch of failing or missing teeth is replaced with dental implants in a single visit.  A minimum of four dental implants are placed into the top or bottom jaw and a full arch of fixed replacement teeth is attached to the implants on the same day.

The patient benefits from having temporary natural-looking teeth fitted to the implants later that same day (immediate loading), which remain in place while the implants fuse with the jawbone.  A durable, definitive set of teeth are then fitted three to six months later, after the healing period.

Same-day teeth are a convenient alternative to conventional dentures, which can cause problems with oral function and self-confidence.  Unlike dentures, same-day teeth are fixed and are unlikely to need relining or adjusting over time.

Contents

• Am I suitable for teeth in a day?
• How do same-day teeth differ from conventional dental implants?
• How do I find out if I am eligible?
• What to expect on the day of the procedure
• Benefits of fixed teeth in a day
• Find out more

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Am I suitable for teeth in a day?

If you are living with uncomfortable dentures, loose or missing teeth, or struggling with a failed crown or bridge, fixed teeth in a day could be an option for you.

You may be suitable for treatment if you:

• wear loose dentures that are affecting your quality of life
• have severe periodontal gum disease and tooth loss (your gum disease will need treating first)
• have no teeth at all (edentulous)
• have a failing bridge and don’t like the thought of wearing dentures
• want fixed teeth throughout your treatment
• are limited to eating soft food by ill-fitting dentures, loose and missing teeth

How do same-day teeth differ from conventional dental implants?

The same-day technique provides patients who have failing teeth, or total tooth loss, with a full arch of fixed, temporary teeth straight away.  This first set of teeth is designed to help speed up the healing process and ensures patients can eat and be free from their dentures on the day of implant placement.  They are replaced with a permanent restoration a few months later.

The replacement teeth are usually supported by a minimum of four dental implants.  The number of implants used will depend on the needs of the patient and whether a fixed denture or a bridge is required.  The implants are strategically placed in areas of the jaw where the bone is denser and stronger.  The dental implants placed at the back of the mouth, may be positioned at an angle of up to 45 degrees to maximise the use of available bone.  This may reduce the need for bone grafting and helps to provide optimum support and full stabilisation for your new set of teeth.  Tilting the implants also helps the implant dentist avoid vital structures, such as the sinuses and nerves.

How do I find out if I am eligible?

It’s important to understand that the same-day technique is not suitable for everyone.  Patients considering the treatment may find it helpful to first attend a FREE initial consultation, a service which many of the clinics featured on click4teeth.com offer.

If your dentist thinks that you are a possible candidate for fixed teeth in a day, the next step is a full, clinical evaluation to establish that you are eligible for the procedure.  For this consultation, dentists will usually charge a fee.  It will involve a complete examination of your mouth and teeth.  Diagnostics such as X-rays, a CT scan, measurements of bone density and impressions will be taken.  Many dentists use a cone beam computerised tomography (CBCT) scan and specialised software, so that they can prepare a digital 3D treatment plan.

A CBCT scan is used to plan the treatment thoroughly in advance.  The CBCT scan data is converted into a three-dimensional virtual model and, with CAD/CAM planning software, it ensures optimal, precision placement of the implants.  The configuration and position of the implants in the jawbone is important.  Once connected together with a metal framework, such as a denture or bridge, the positioning of the implants allow for an accurate distribution of biting forces.

Dr Colin Neil of Confident Dental Implants Centre, Stroud says, “For it to be possible to attach teeth to the implants on the same day, it is important that the implants have sufficient stability.  Sometimes it may be necessary to extract teeth and allow the sockets to heal, with or without bone grafting, before the implants can be placed.  During this time a temporary restoration can be provided.  However, in many cases, with thorough planning and the latest techniques, I find it can be predictable and preferable to provide fixed provisional implant teeth on the same day as extraction.”

The findings from the clinical examination will be explained by your implant dentist and you will be given a written, fully-costed, individual treatment plan.  Following this assessment, if no bone grafting or further treatment is required, the next step will be to book your surgical appointment. 

What to expect on the day of the procedure

Morning:  On the day of treatment, any remaining teeth with a poor prognosis are removed.

A minimum of four dental implants are placed in the jaw in the positions determined by the CBCT scan.  With a straightforward case, a bone graft will not be needed if you have sufficient bone in your jaw. 

You can choose to have local anaesthetic, light sedation or intravenous sedation (IV), to ensure that you are relaxed and comfortable throughout surgery.

Abutments, which are posts attached to the implants, are fitted and the impressions are taken.  These impressions are used by the dental technician to design your new teeth.

Lunchtime:  You remain at the surgery and rest after the implant procedure.  A dental technician will make a set of provisional teeth, designed to fit your implants. 

Afternoon:  A few hours later the custom-made temporary teeth are attached to the newly placed implants.  You are never without any teeth during the treatment and the provisional restoration will look very natural.

Some precautions are needed after surgery to allow the implants to integrate successfully with the jaw bone.  Your implant dentist will explain how to look after your new teeth and you will be asked to attend a post-operative review. 

The final restoration:  Follow-up appointments will be arranged to check all is well with your new teeth.  After approximately three to six months the implants should have completely fused (osseointegrated) with the jaw bone.  Depending on your treatment plan, your dentist may take new impressions in order to create a final, stronger set of fixed teeth.  You will then attend an appointment to exchange the temporary restoration for a final fixed bridge of teeth, which will be designed to ensure the fit is correct.

Benefits of fixed teeth in a day

The same-day technique makes it possible for a patient to enjoy the benefits of dental implant treatment immediately after placement.  The advantages of same-day teeth are:

• they are a fixed replacement for dentures in 24 hours or less
• they involve only one surgical procedure which minimises the number of appointments
• only 4-6 implants are used to support a whole arch, which can be more affordable than a full arch of individual dental implants
• they are easy to maintain and unlike conventional dentures, they won’t come loose, slip or rub against the gums
• the patient is able to smile with confidence and eat a soft diet straightaway
• patients have fixed teeth throughout the entire process
• because the implants are placed at an angle, longer implants can be used for increased stability and this can avoid the need for extensive bone grafts

After tolerating an old, loose upper full denture for many years, a 69-year-old female patient consulted Dr Colin Neil.  Dr Neil explains, “We considered all the options and she decided to proceed with an ‘all-on-4’ type approach.  The implants were placed according to a 3D CT scan taken at a previous appointment.  This meant that on the day of surgery, the implants could be safely positioned with excellent stability and the temporary teeth could be fitted later that day.”

Dr Neil’s patient was thrilled with the outcome.  She says, “I only wish I had had this done sooner.  I had been worried about the surgery, but the sedation Dr Neil provided really helped me to relax.  It was wonderful to wake up with fixed teeth.  I can already enjoy food and smile for photos when I travel to Italy with my husband.”

Find out more

If you are eligible for the same-day implant technique, you can arrive at the surgery with failing teeth in the morning and leave by mid-afternoon with a full set of natural looking teeth.  You are never without fixed teeth throughout the treatment process and you won’t be troubled by gaps, or by loose and uncomfortable dentures.

Dr Graham Browning of South Coast Dental Specialists concludes, “Our patients like the fact that they come in with loose teeth or dentures and leave with fixed teeth.  One of our patients said that at last he has got the teeth he has always wanted!  Our five year follow-up shows that the full arch bridges we use are long lasting and require minimal maintenance.  It is important, though, that the patient sees the hygienist four times a year and that we remove the bridge annually to clean it.”

This article was written with advice from:

Dr Graham Browning

Dr Colin Neil