All On Everyday (All-on-4® Treatment Concept)
Pulver Oral Surgery & The All On Everyday Concept (All-on-4® Treatment Concept):
Pulver Oral Surgery is dedicated to providing state of the art care in a familiar environment by people our patients know and trust because their general dentist is part of our team. The All On Everyday Concept (All-on-4® Treatment Concept), allows for same day, full mouth fixed reconstruction, safely and efficiently, using traditional referral methods and an Interdisciplinary Approach. Our mission is to provide a world class team of which your general dentist is a part. We provide unprecedented support, education and care as a team.
More than 100 million people in the United States are missing between 10 and 15 teeth. Of the approximately 50 million people who are missing all of their teeth, only 5% of these patients seek care. 57 percent of these edentulous patients are between 65 to 74 years old.
Your general dentist will continue to treat you, the patient, throughout the process. We have had the opportunity to work with many general dentists in Northwest Indiana already and look forward to continuing that partnership as we reach out to extend care to those patients within those practice who may benefit.
All On Everyday (All-on-4® Treatment Concept) consists of the Pulver Oral Surgery team, dental implant representative, our Dental technician, and your general dentist. We are committed to providing the highest standards of care at the forefront of Dentistry. Collectively we represent a tremendous amount of experience and knowledge in providing fixed immediate dental solutions for those patients faced with a terminal dentition or who are currently edentulous. We feel strongly that through sharing, learning and networking we can offer this exciting solution safely, predictably and efficiently to those patients who are candidates. We have developed a method that has streamlined and broken down the learning and treatment process. We are there with you every step along the way.
Why All On Everyday (All-on-4® Treatment Concept) is the Natural Choice:
We are your local Dentists and Specialists who have been serving you and your community. At All On Everyday (All-on-4® Treatment Concept) we have recreated a team approach, common in University Teaching Hospitals, to offer optimal individualized treatment. The benefit of interdisciplinary care, the team approach, has been shown to result in enhanced patient outcomes. We feel it is important for our patients to understand all their options and to develop a clear choice. This allows them to understand and believe in the treatment they choose. We are dedicated to providing safe, state of the art techniques to achieve proven and predictable results.
Through experience, education and Teamwork we have been providing successful same day and staged full mouth restoration for many years. Patients will receive the same customized care you are used to expecting from our office. The All On Everyday (All-on-4® Treatment Concept) system allows for patients to receive a fixed temporary bridge on the day of implant placement. The ability to fix the prosthesis immediately is dependent upon bone density/volume and torque values at the time of surgery. Most importantly your general dentist is a part of the team all the way along. Our patients don’t have to visit corporate centers and work with unfamiliar providers. The benefits of a team approach have proven to far outweigh the single isolated treatment system. Through the experience gained from working with many restorative dentists we have modified and developed a system of care that has allowed many practitioners to become comfortable recommending this procedure to qualified patients with confidence.
What Makes All On Everyday (All-on-4® Treatment Concept) Different:
Our team consists of practitioners with extensive years of experience joined together to share knowledge and systems. Collectively we can enhance patient care and outcomes. We are there before, during and after to manage our patients’ needs and concerns. Together our shared knowledge and experience is greater than any individual.
At All On Everyday (All-on-4® Treatment Concept) we believe that a well-informed patient who understands the consequences of their choices can be presented many alternatives for treatment. The ultimate choice should be tailored to each patient on an individual basis. We feel that All On Everyday (All-on-4® Treatment Concept) brings a local team approach with proven systems to a market previously dominated by one stop shop doctors (no team) and unfamiliar corporate centers. We believe the All On Everyday (All-on-4® Treatment Concept) approach offers you, the patient, the opportunity to change your life through improved oral health, and a new smile.
Cutting Edge Technology: Computer Guided Planning and Placement
Our in office CT scan allows for quick convenient 3 dimensional assessment and planning. This technology takes the predictability and accuracy of implant placement to new levels.
The History of the All On Procedure:
The All On Everyday concept (All-on-4® Treatment Concept) was introduced to provide an efficient graftless fixed restoration for the Terminal dentition or edentulous patient. The concept utilizes just 4 implants, tilting two posterior implants to avoid grafting (Graftless Solution) and in many cases allows placement of a fixed immediate prosthesis. The design allows for greater load distribution utilizing an initial acrylic prosthesis without a cantilever. It offers patients an opportunity to reduce the transition time from a terminal dentition or a complete denture to a new secure fixed oral rehabilitation. The All On Everyday concept (All-on-4® Treatment Concept) allows this procedure to be performed safely and predictably with a team approach through education, support and experience.
FAQ: The All On Everyday Concept (All-on-4® Treatment Concept)
The All On Everyday concept (All-on-4® Treatment Concept) is an innovative method of implant placement that provides a graftless, fixed, immediate full arch restoration in one day. The concept of tilted implants was initially introduced in the early 1990’s. It is much more than a dental/tooth replacement; it replaces form and function. It brings back your smile.
Is it really all done in 1 appointment?
There are a number of initial appointments necessary to prepare for your treatment. After the appropriate planning you receive your implants and new prosthesis on one day.
The majority of our patients leave with a new fixed set of teeth, a new smile and a new attitude on life!
Will I need to see my Dentist again?
Yes it is important to continue to see your dentist for long term care and maintenance. The teeth will not be prone to dental decay however good oral hygiene is still vital to good oral health.
Can I eat whatever I want?
The immediate fixed prosthesis is not reinforced with a titanium substructure. It will be used from 4 -6 months during the healing phase. During this time a soft diet must be followed. Once the final prosthesis has been placed your ability to chew should be back to normal.
Is it a Healthy choice or does it just look good?
It has been shown that securely fixing a denture leads to increased bite force and increased concentrations of Albumin, Vitamin B12 and folic acid within your blood stream. So it doesn’t just look better it improves your health.
What is the difference between an implant supported denture and a traditional denture?
Frequently Asked Questions about Dental Implants
What are dental implants?
A dental implant is a safe, successful and predictable man made “tooth root” constructed of lightweight titanium. It is gently placed into the jawbone where it fuses to the bone. This forms a secure foundation upon which a replacement crown is placed.
What are the benefits of dental implants?
Because your replacement teeth are firmly anchored, there is no slipping and sliding commonly associated with conventional partials and complete dentures. Adjacent teeth don’t have to be filed down resulting in weaker teeth having to provide more support for a bridge. Your biting and chewing function will be fully restored. You will be able to eat your favorite foods again. Best of all you will be able to speak and smile again with confidence.
Are there any benefits for my jawbone and surrounding teeth?
Yes! Without tooth roots to keep the jawbone healthy, it slowly reabsorbs, or shrinks, changing the shape of your jaw and face. By integrating with the jawbone, dental implants keep the bone “alive” and healthy. Once a tooth has been removed the bone slowly begins to dissolve like an ice cube, placement of a dental implant stops this process.
Will my replacement teeth look natural?
The results will likely exceed your expectations in regards to appearance, comfort and function. They will feel and look like a second set of permanent teeth. It has been said that dental implants are the most successful body replacement part known to man.
Who is a candidate for dental implants?
Almost everyone whose jawbone has fully developed is a candidate for dental implants. The main limitation is the amount of available bone. A consultation is necessary to determine if dental implants are right for you. If you suffer from significant general health conditions a thorough medical work up is necessary to determine if you would be a candidate.
Who will perform my procedure?
Dental implant treatment typically uses a team approach involving an oral and maxillofacial surgeon and a restorative dentist.
Can this be done in the office?
Yes! We have assembled a world class team to support you from your initial to final appointment. Our surgical team has been well trained specifically for implant treatment. We adhere to a strict sterile protocol for infection control. Our goal is to create a safe secure state of the art environment for your care.
Is the procedure painful?
With modern anesthesia, you are unlikely to experience any discomfort during implant placement. Afterwards, discomfort will be based on the extent of your procedure. Most patients tell us the benefits of their implant far outweigh any discomfort they may experience. The surgery is quite delicate and the implants placed are tiny, so most patients are very comfortable throughout and after the procedure.
How will I care for my dental implants?
Your new teeth must be cared for and checked regularly, just like your natural teeth. You will be able to brush and floss as recommended by your dentist or dental hygienist.
Initially a soft diet will be necessary. We will provide detailed instruction on care and diet at the time of your surgery.
Is financing available?
Yes, we can help you set up various means of financing. Please inquire at your consultation visit.
What has led to the increased popularity of dental implants?
Recent advancements have led to predictable, safe and successful treatment. The surgery has become less involved and thus more widely accepted. In many cases only one surgical procedure is necessary.
The history and evolution of the current day treatment is quite interesting and well documented.
Dr. Paul Schnitman from Harvard published in the Journal of Oral Implantology (1990) on immediate fixed interim prostheses supported by 3 implants during the healing of the submerged final implants. It was during these studies that it was found that the majority of the immediately placed and loaded implants integrated. These implants were documented at a 10 year follow up study. In 1997 Tarnow, et al., published a study, (International Journal of Oral & Maxillofacial Implants 1997), using a similar methodology placing 5 implants and submerging 5. They illustrated 1-5 year data illustrating that the immediate load of the maxilla was a viable treatment option. Branemark published 10 year survival rates of a fixed prostheses on four and six implants, (Clinical Oral Implants Research 1995). These were not immediately loaded but there was no difference in prostheses survival between the 4 or 6 implant cases. At the time of this study the only implants available were either 7 or 10 mm in length. The TILTED IMPLANT was introduced by Yvan Fortin and Bo Rangert in 1993 in Gothenburg Sweden as part of a graftless solution supporting the Marius Bridge. A retrospective study was done in Clinical Implant Dentistry and Related Research 2002.
Yvan tilted his implants beginning in 1992, Bo, an engineer, began working on the biomechanics of why the concept was working. Initially Yvan was doing a 2 stage procedure. Bo encouraged Paulo Malo to attempt a single staged procedure based on his biomechanical studies and the concept of cross arch stabilization. Mattesson (J Oral & Maxillofacial Surg 1999) published on tilted Maxillary implants without bone grafting in severely resorbed maxillas. Rangert, et al., published on tilting posterior mandibular and maxillary implants for improved prosthesis support, (Int J Oral Maxillofacial Implants 2000).
With knowledge gained by Bo Ranger working with Yvan Fortin the way was paved for immediate loading of tilted implants by Dr. Paulo Malo. Malo tied together the immediate load with the use of 4 implants. The posterior 2 being tilted to bring about the concept marketed today as “All On Everyday”. Dr Malo’s first documented cases with the All On Everyday (All-on-4® Treatment Concept) lower jaw began in April of 1998 and for the upper jaw in February 2001. The All On Everyday concept (All-on-4® Treatment Concept) was introduced by Nobel Biocare in September 2004.
Malo published in the Journal of the American Dental Association (2011), a longitudinal study of the survival of All On Everyday (All-on-4® Treatment Concept) implants in the mandible up to 10 years of follow up. A total of 245 patients with 4 implants each were included in this study. Patient and implant success rates were 94.8% and 98.1% respectively at 5 years and 93.8% and 94.8 % at 10 years. The prostheses survival rate was 99.2 % with up to 10 years follow up. His unpublished maxillary survival rates in 2011 were 98.4% for the implants and 99.7% for the prosthesis. This was at 8 years and included a total of 1014 patients and 4056 implants 64 of which were lost.
If the two posterior implants are torqued in to greater than 35 Newton’s Force the prosthesis can be fixed upon 3 implants. If less than 3 implants are secure to 35 Newton’s Force, or the 2 posterior implants are less than 35 Newton’s Force, a removable prosthesis is used.
The natural progression of the All-on-4® treatment concept and experience illustrates well the importance it has found in our treatment regimens available to restore health and function to the stomatognathic system. Despite its emergence of popularity through corporate centers and mass marketers it must not be overlooked as a safe, efficient and proven treatment modality when considering reconstruction of form and function for our edentulous and terminal dentition patients.
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