Fixed Detachable All-on-4 Screw Retained Denture

The All-on-4 treatment concept was developed to provide edentulous patients with an efficient and effective restoration using only four implants to support a full-arch prosthesis. Although named All-on-4, the procedure can be fabricated on more than 4 implants. Our All-on-4 (or more than 4) screw retained restorations are fabricated utilizing a milled titanium bar and premium grade resin teeth. The premium grade teeth are required because fixed detachable dentures take much more load than a standard removable denture. Our fixed detachable All-on-4 screw retained denture features all inclusive pricing which includes the modelwork, soft tissue, baseplate + rim, titanium wrap around milled bar, denture try in and processing utilizing premium grade resin teeth.

All-on-4 restorations allow various loading approaches: immediate loading, early loading, or delayed loading. We can fabricate interim dentures (temporary dentures) prior to surgery for the patient to wear while the screw retained restoration is being made.

We, at Global Dental Solutions, utilize the NobelProcera Implant Bar, by Nobel BiocareĀ®, as well as other brands, such as Preat, for our implant bars. Through Nobel Biocare's NobleProcera division, we design, and have milled, the titanium bar which will support the acrylic and premium resin teeth. Preat has additive manufacturing (AM) technology which allows for unlimited geometric freedom combined with the accuracy of CNC machining. The bar can be made as direct to implant, or to multi-unit abutments. The multi-unit abutments have two screw holes; one to secure the abutments to the implant, as is with a typical implant abutment, and one to secure the fixed detachable to the abutment.

 

 

 

 

 

The two photos below, courtesy of NobelProcera, illustrate various stages and options for the wrap around All-on-4 bar.

 

 

 

 

 

The verified master soft-tissue model and acrylic framework are shipped to the production facility. The acrylic/resin framework is replicated through a scanning and measuring technique and a one-piece titanium framework is milled and produced. The texture of the "Wrap-around" titanium framework is produced without any polishing service and the framework is left in a roughened or textured design. The rough surface provides additional mechanical retention for the processed acrylic. Please note that we, at Global Dental Solutions, design our bars with retention nodules for additional acrylic retention.

Denture teeth are set-up and attached to the framework following standard laboratory procedures. Final denture wax-up is completed as per case design. Take notice that although the photo above shows metal, our completed restoration would take the acrylic to the gum line, if the implant allows for it.


All on 4 Bar wraparoundThe denture set-up and framework is clinically checked for accurate fit, form, and function. The prosthesis is then processed. Only the metal of the titanium bar cylinders, which fit into the implants, are left exposed.


The photo to the left illustrates a wrap around bar with metal lingual and ridge (click for a larger view). The acrylic covers only the occlusal and buccal surface, while metal exists on the ridge and lingual surfaces.

 


 

An illustration of the direct to implant, wrap around bar, fixed detachable All-on-5 restoration.


An illustration of the wrap around bar, fixed detachable, All-on-4 to multi-unit abutment restoration. Take notice that the multi-unit abutments have two screw holes; one to secure the abutments into the implants and one to secure the fixed detachable restoration to the abutments. The screws used to secure the fixed detachable to the abutments are smaller than the screws used to secure the abutment to the implant.