All on X Dental Implants
All-on-X stands at the pinnacle of dental implantology, revered for its complexity and transformative results. While it has piqued the interest of many dental professionals eager to expand their expertise, few have taken the leap to perform this advanced procedure.
What holds us back? Is it the perceived ambiguity of the technique, or perhaps the daunting scope of work involved? Let’s peel back the layers of the All-on-X procedure, exploring what makes it both challenging and remarkable. We'll break down the process, addressing common concerns and showcasing how proper preparation can simplify the surgery and minimize post-op complications. Whether you're considering adding All-on-X to your practice or simply curious about this cutting-edge technique, join us as we demystify one of dentistry's most innovative procedures.
What is All-on-X Dental Surgery?
All-on-X surgery is an extensive, highly precision-focused procedure designed for more advanced and experienced dental professionals. As with any dental restoration, achieving a functional and aesthetic outcome is paramount when performing a surgery like this. The reason is because you are essentially starting with a blank canvas, allowing for customization in terms of how many implants you place on the patient’s arch.
Most commonly used for All-on-X cases is the All-on-4 design, where four strategically placed implants support a full arch of prosthetic teeth. However, the 'X' in All-on-X means that the number of implants can vary depending on the patient's bone density, oral health, and specific needs.
Why I don’t use All-on-4
Throughout my many years of placing implants, I noticed a trend of complications whenever I placed only 4 implants during an All-on-X surgery versus using 6 or more. The most prominent issue I encountered was cracks in the fixtures due to stress over time, which eventually led to implant failure (cantilever).
Once I shifted to placing 6 or more implants, I was able to distribute the load more effectively by sectioning the areas and creating bridges instead of relying on one full denture.
The bridges allow the stress of heavy mastication in the posterior of the mouth to be distributed across multiple points of support, reducing strain on individual implants. This technique has significantly improved long-term success rates, minimizing complications like fractures or loosening of the prosthesis. By adopting this approach, I’ve seen a noticeable reduction in failures, leading to better patient satisfaction and fewer follow-up procedures.
What to expect for Post-Op
One of the key advantages of using bridges in these cases is the simplicity they offer during the restoration process. Unlike a full denture, which can be more difficult to manage and less stable, bridges divide the restoration into smaller, more manageable sections. This makes designing, placing, and maintaining the prosthesis much more efficient for both the doctor and the patient. Furthermore, because the restoration is divided into sections, future maintenance becomes more convenient. If adjustments or repairs are necessary, working with smaller, individualized areas is far less complicated than replacing or repairing an entire arch prosthesis.
Final Thoughts
While All-on-4 may work for some patients and practitioners, I’ve found that incorporating additional implants has led to more reliable outcomes in my practice. It’s not just about placing implants but about creating a foundation that will last for years to come. In my experience, using 6 or more implants, along with sectioned bridges, provides the best balance between functionality, durability, and patient satisfaction.
As dental professionals, it’s our duty to seek the best possible solutions for our patients' long-term well-being. In my practice, that means moving beyond the traditional All-on-4 to provide a more robust and sustainable outcome."
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