All-on-4®: Why Do I Need Additional or Longer Implants

If you want to replace all of your upper or lower teeth, or you’re looking for a more permanent alternative to dentures, full mouth dental implants (including All-on-4®) can be a convenient option for supporting a full arch of teeth on just four implants.

Most people with a healthy jaw bone are suitable for standard All-on-4® treatment. However, if you have gone without teeth in the upper jaw for some time, bone quality may have deteriorated and be too soft or thin to support standard length implants. Longer or additional implants can offer increased stability and predictability to support an implant bridge.

To discover your options for restoring your smile, book a consultation with Perth Dental Implant Centre today.

How do I know which implants I need?

Your dentist may identify your needs and discuss your options after taking a 3D bone scan of your upper jaw bone. A treatment plan will be prepared and presented and will explain that full arch surgery involves placing between four to six dental implants per arch.

If your dentist reviews your x-rays and suspects that your jaw requires additional support in the form of an extra implant or longer implant, they will advise you in advance. However, in some cases this may only become apparent during surgery when the dentist can physically access the jaw and determine bone quality.

If you do need longer implants to support a bridge of teeth, such as pterygoid or zygomatic implants, these will be positioned in different ways than shorter implants, but the procedure is otherwise the same. Your custom-milled PMMA bridge is fitted the next day after surgery*

All-on-4 technique

During surgery, your dentist places two implants at the front of the mouth and two at the back of the mouth on a 45 degree angle, so to avoid nerves and sinuses. This trademarked protocol has a 98% success rate*, providing a long-term teeth replacement solution.

Additional dental implants

While full arch treatment involves using a minimum of four dental implants per jaw, additional implants may be necessary to help stabilise an implant bridge. The length of conventional implants placed in the upper jaw is between 8mm–15mm, pterygoid and zygomatic implants are longer in length.

Pterygoid implants

These longer implants are between 15mm–20mm and are placed in the pterygoid process of the sphenoid bone. This is where the jaw bone meets the base of the skull. This can offer more support to an implant bridge as the bone is very dense and resistant to gradual bone loss over time.

Zygomatic implants

These are the longest implants, measuring 35mm–55mm, which are placed in the zygomatic bone in the upper part of the cheek bone.

Zygomatic implants can be a good option in clients who have suffered from severe bone loss. The procedure may involve the assistance of a specialist oral and maxillofacial surgeon.

Contact our team to find out about your All-on-4® options at Perth Dental Implant Centre.

What are the advantages of using longer implants?

Your dentist will explain why longer dental implants could be the best option for your situation. This could include:

No need for bone grafting

To support conventional implants, a smaller jaw may need to be built up with a bone graft. Longer implants avoid the need for this procedure and its associated risks and healing time.

High success rate

These implant options are clinically proven to provide stable and long-lasting results, with a success rate of over 94% for pterygoid implants* and over 97% for zygomatic implants**.

*Araujo, R., Ferreira, J., Camila Lopes Cardoso, Froy, A., Rosenvaldo Moreira Júnior and Marcos Martins Curi (2019). Clinical outcomes of pterygoid implants: Systematic review and meta-analysis. 47(4), pp.651–660. doi:https://doi.org/10.1016/j.jcms.2019.01.030.

** Goiato, M.C., Pellizzer, E.P., Moreno, A., Gennari-Filho, H., dos Santos, D.M., Santiago, J.F. and dos Santos, E.G. (2014). Implants in the zygomatic bone for maxillary prosthetic rehabilitation: a systematic review. International Journal of Oral and Maxillofacial Surgery, 43(6), pp.748–757. doi:https://doi.org/10.1016/j.ijom.2014.01.004.

Full arch dental implants (All-on-4®) in Perth

If you want to know more about pterygoid and zygomatic implants or other options for replacing teeth, book a free consultation with our experienced dentists at Perth Dental Implant Centre.

References

1. Ferro A, De Araújo Nobre M. All-on-4 concept using TiUltra surface implants and Multi-unit Xeal abutments: Pilot study report. Clin Oral Implant Research 2021; 32(S22):59.
2. Araujo, R., Ferreira, J., Camila Lopes Cardoso, Froy, A., Rosenvaldo Moreira Júnior and Marcos Martins Curi (2019). Clinical outcomes of pterygoid implants: Systematic review and meta-analysis. 47(4), pp.651–660. doi:https://doi.org/10.1016/j.jcms.2019.01.030.
3. Goiato, M.C., Pellizzer, E.P., Moreno, A., Gennari-Filho, H., dos Santos, D.M., Santiago, J.F. and dos Santos, E.G. (2014). Implants in the zygomatic bone for maxillary prosthetic rehabilitation: a systematic review. International Journal of Oral and Maxillofacial Surgery, 43(6), pp.748–757. doi:https://doi.org/10.1016/j.ijom.2014.01.004.
4. Rompen E, Domken O, Degidi M, et al. The effect of material characteristics, of surface topography and of implant components and connections on soft tissue integration: a literature review. Clin Oral Implants Res 2006;17(Suppl 2):55-67.
5. Rompen E, Fabbri G, Staas T, et al. Clinical investigation of the On1 two‐piece abutment concept – preliminary results. Clin Oral Implants Res 2018;29(Suppl. 17):319