All-on-4® Treatment Concept and Full-Arch Dental Implants in Worthing
If you are missing most or all teeth in one jaw, an assessment can compare fixed full-arch bridges with removable implant options. The clinic provides the Nobel Biocare All-on-4® treatment concept. This is one possible full-arch plan; suitability, implant number, the provisional restoration and treatment stages depend on clinical assessment.
Call 01903 821822 to arrange a full-arch implant assessment.
“Teeth in a Day” Explained: When a Same-Day Provisional Bridge May Be Suitable
Which treatment replaces which teeth?
Dental implants can support different restorations, depending on how many teeth need replacing.
One missing tooth
One implant can support an individual crown. See dental implants for one or several missing teeth.
Several missing teeth
An implant-supported bridge may replace several neighbouring teeth. It is different from a full-arch bridge because it replaces part, rather than all, of the dental arch.
Implant-retained removable dentures
An implant-retained denture clips or attaches to implants but is removed by the patient for cleaning. See our implant-retained removable denture options.
Fixed full-arch implant bridges
A fixed full-arch bridge replaces a complete arch of teeth in one jaw and is attached to several implants. It is not removed by the patient, although a clinician may remove it when clinically required.
All-on-4® treatment concept and other full-arch plans
The All-on-4® treatment concept uses four implants to support a full-arch restoration. Other full-arch plans at the clinic sometimes use more than four implants. The number and position are based on the restorative plan, available bone and anatomy, bite and implant stability.
We use NobelActive® implants with TiUltra™ or TiUnite® surfaces, selected according to the individual clinical and restorative plan.
Who may be assessed for full-arch treatment?
Full-arch implant treatment may be considered when most or all teeth in a jaw are missing, failing or cannot predictably be restored. It is not right for everyone. Suitability depends on oral and general health, gum health, available bone, smoking, medications, bite forces, the condition of any remaining teeth and the ability to clean and attend maintenance appointments. Assessment may show that retaining teeth, a conventional denture or an implant-retained removable denture is a better option.
Assessment and treatment planning
Your assessment includes your concerns and goals, medical and dental history, the condition of your teeth and gums, your bite and the available bone. Appropriate X-rays are required. CBCT is used selectively when clinically indicated and may be taken at the Worthing practice or arranged externally. We will explain which teeth might be retained or removed, the proposed implant and restoration plan, reasonable alternatives, material risks, likely stages and maintenance needs.
Dr Amir Mostofi principally carries out the surgical and restorative stages of implant treatment, with other team members involved where appropriate.
The practice accepts implant referrals from other dentists.
Expected treatment stages
Assessment and imaging
The clinical and restorative plan is agreed before surgery. Further dental or gum treatment may be needed first.
Implant placement
For treatment of one arch, the surgery-day appointment usually takes approximately 6–8 hours. This is a planning guide rather than a guaranteed duration. The time required varies according to extractions, implant number and position, additional procedures and how the provisional restoration is provided.
Provisional restoration
A same-day provisional fixed bridge is usually planned, but is provided only in selected clinically suitable cases where patient criteria are met and adequate implant stability is achieved. If those criteria are not met, a removable provisional restoration or delayed fitting may be advised. Immediate loading is not guaranteed. A provisional restoration is not the definitive bridge.
Healing and review
Healing normally takes several months and varies according to the jaw, the procedure and individual healing. The timeline may change if healing is not as expected.
Definitive bridge
The definitive bridge is planned after healing and review and may differ from the provisional restoration in fit, shape and material. It still requires daily cleaning, professional maintenance and possible future repair or replacement.
Bone grafting and sinus augmentation
Planning for the All-on-4® treatment concept can sometimes use available bone in a way that means bone grafting is not needed, but graft avoidance is only a possible advantage in selected cases and cannot be guaranteed. Bone grafting and sinus augmentation are provided at the Worthing practice when clinically indicated. Assessment and imaging determine whether grafting, sinus augmentation, a different implant plan, a removable option or no implant treatment should be considered.
Risks and alternatives
Implant treatment involves surgery. Possible risks include pain, swelling, bruising, bleeding, infection, delayed healing, altered sensation, implant failure, gum or bone problems and technical complications affecting screws or the bridge. Further procedures and ongoing maintenance may be needed. Risks vary by site and medical history and will be discussed before treatment.
Reasonable alternatives can include retaining or restoring suitable teeth, removable denture options, an implant-retained removable denture, a different fixed implant plan, delaying treatment or not proceeding with implant surgery.
If an existing implant or bridge becomes loose, painful or swollen, see urgent implant problems.
Recovery and diet
Many patients allow approximately one to two weeks away from work, but this varies according to the extent of surgery, the nature of their work and their recovery. More extensive procedures may require longer.
A soft diet is usually advised for approximately 8–12 weeks, depending on the treatment, implant stability and healing. Patients should follow individual instructions and should not return to harder foods until advised.
Cleaning and long-term maintenance
Maintenance is tailored to risk and clinical findings and is generally scheduled once or twice a year at the practice. Fixed bridges require daily cleaning around the implants and beneath the bridge. We will demonstrate suitable cleaning methods.
Bridge removal is not automatic and is carried out only when clinically indicated. Bridges are not routinely sent to a laboratory for maintenance. Screws, components and bridge materials can wear or break and may need repair or replacement.
Provisional and definitive bridge materials
PMMA may be used for both provisional and definitive bridges at the clinic. Zirconia is not routinely provided as a definitive material, but it may be considered where requested and clinically appropriate after discussion of its benefits, limitations and maintenance requirements.
Sedation
If you are anxious about treatment, ask whether clinic-based sedation may be suitable. Availability and suitability are confirmed after assessment.
Written estimate
After assessment, we will provide a written estimate for the proposed treatment.
Arrange a full-arch implant assessment
We see patients from Worthing and surrounding areas of West Sussex.
Call 01903 821822 to arrange a full-arch implant assessment.
Book an implant assessment online.
Nobel Biocare, NobelActive, TiUltra, TiUnite and All-on-4 are trademarks of the Nobel Biocare group.