The ALL ON 4 PLUS concept is an outcome-based treatment planning philosophy for full arch rehabilitation with dental implants.
Bone atrophy is a natural phenomenon that occurs after the extraction of teeth, which is exacerbated over time due to wearing of a denture. Patient with advanced atrophy of the jaw due to many years of denture wearing sometimes do not have the necessary minimum volume or quality of bone required to have dental implants. The situation may be the same even when there are teeth still present, and when these are affected by severe infections or gum disease that cause the destruction of the jawbone. Such patients may often be deemed unsuitable for conventional treatment with dental implants.
“Many of our patients at the All On 4 Clinic have been told elsewhere that they were not suitable for dental implants.”
Zygomatic, also known as ‘Zygoma’, are longer than standard dental implants that instead of relying on jawbone, transverse the poor area of your upper jaw to anchor into the underside of the cheekbones from the inside through the sinus space.
This approach is used for severely resorbed upper jaws and is designed to facilitate immediate rehabilitation with ﬁxed replacement teeth. The zygoma implants are inserted in the back section from within the mouth, along with one or more additional regular implants in the front part of your jaw, or in the most sever of cases two zygomatic implants may be placed on each side, which is referred to as Quad Zygoma (see below).
An alternative to Zygoma Implants is bone grafting. A method that we used in the past involved getting this bone from the hip. However this method has been associated in the literature with significant risks and higher failures. A more common approach that we use today is Sinus Grafting using a bovine bone mineral. The surgical clinicians at the All on 4 Clinic have performed many hundreds of these procedures with highly favorable results. However in patients who have advanced bone atrophy and who are not suitable for All On 4 Plus, this often means that the grafts must be allowed to consolidate before the new bone can be relied upon for the placement of dental implants. The consolidation period is often in the vicinity of 9 to 15 months depending on the size of the grafts. During this period the patients would need to wear a denture, if they haven’t already been wearing one.
TRADITIONAL ZYGOMATIC IMPLANTS
The main advantage of Zygomatic treatment is the immediacy of the process, which is similar to the All On 4 Plus process. However traditional methods have been associated with increased risks that included sinusitis and oro-antral fistula (an open communication between the sinus and oral cavity) because of the thinness of the bone and the implants being placed through the sinus space and are susceptible to bacterial cultivation that has led to those risks. From a practical and clinical perspective, due to anatomical and technical limitations, the results were often compromised compared to the grafting option or All-On-4 Plus® in terms of strength and durability, hygiene, aesthetics and comfort.
NEW ZYGOMA Plus ™
A new approach used at the All On 4 Clinic, Zygoma Plus, draws on our experience in sinus augmentation and involves overcoming the anatomical limitations of the jawbone by reconstructing the area as required, which is done simultaneously with the placement of the Zygomatic implants.
Our technique is a combination of various proven methods that have been put together to help improve the outcome and reduce the risks. The technique involves displacement of the base of the sinus area so as to improve the restorative space, and also incorporates simultaneous bone grafting.
The main beneﬁts compared to the traditional approach include:
- It facilitates more accurate positioning of the implants, which is more conducive to optimizing the restorative and aesthetic outcome compared to the traditional approach.
- Because the implant is surrounded by graft material, and there is a graft medium between the sinus space and the oral cavity, which acts as a buffer, thus helping reduce the associated risks when the implants are otherwise exposed in the sinus space.
The illustration below compares the two methods:
With our Zygoma Plus solution we have been able not only to provide a fixed and permanent alternative to an upper denture in cases with advanced atrophy, but also one that is immediate and with results that are aimed to be comparable to our All On 4 Plus dental implants treatment in terms of appearance, comfort and function.
For more information please make email us today or call 1300 255 664 to make an appointment for a consultation with one of our implant dentists.