All-on-4® treatment is a major investment in your health and we want you to be thoroughly educated on it so you can feel confident in your decision making process. Not all dentists or dental labs provide the same quality as Wiand Dental Laboratory. Here are questions to ask about this treatment option along with an explanation of why it is important to ask.
Do you offer IV Sedation?
If the surgery runs longer than it should, local sedation can begin to wear off or become non-effective at a certain point. This may compromise the procedure thereby increasing the risk of non-completion the same day resulting in a removable denture instead of your fixed prosthesis. You would then have to return for a second procedure to complete. Additional training is required for executing IV Sedation. This requires monitoring vitals and the knowledge to handle any potential emergency situation. It is critical that you are in capable hands because there is always a chance of unforeseen circumstances.
What type of implants and components will be used for my treatment?
The All-on-4® Treatment Concept was developed by Dr. Palo Malo using the Nobel Biocare system of implants, components, and CAD/CAM framework. All the research supporting the success of the All-on-4® is based on the Nobel system, not generic components. If you pay less for this treatment, most likely generic components are being used. While there is a cost-savings associated with generic components, there is no research to back up what the outcome or longevity will be for your restoration. Doing this twice would cost much more than doing it right the first time. Additionally, you will want to make sure that the implant components chosen come from a reputable company that will be in the market for years to come should you have any challenges in the future.
What type of training does the dentist have to perform this procedure?
This is a surgical procedure not to be taken lightly as this is full arch rehabilitation. The dentist performing this procedure must have taken advanced training because navigating the anatomy of the maxilla and mandible requires great confidence, skill, and experience.
Is the surgeon seasoned in this procedure?
A good way to find out is to ask how many of these surgeries they have performed to date. This single most important thing the surgeon must do is make enough room for the final set of teeth. When they don’t, it compromises the strength of the teeth which leads to fractures and more time and money.
Which laboratory do you use and why?
The lab is responsible for designing, crafting and fitting both your provisional set of teeth and your final set of teeth. There is a vast range of options out there so we highly recommend that you research the lab that will be making the prosthesis. Just like the dentist, the lab needs to have expertise as well. The materials and processing the lab chooses for your restoration in addition to their level of knowledge will set the course for your treatment and long-term outcome. Like generic components, if you pay less for this procedure savings are likely to come from the use of sub-standard lab materials which will most likely compromise the long-term durability of your prosthesis.
How will my final set of teeth be designed?
There are two options for design including an acrylic wrap and a primary mill with exposed titanium. An acrylic wrapped bar has acrylic wrapped around an implant bar with teeth processed into it. This type of design can be bulkier in the mouth sitting closer to the tissue making it harder for the patient to keep the prosthesis clean. A primary milled bar with exposed highly polished titanium close to the tissue prevents tartar build-up and allows easy access for proper hygiene.
Do you offer additional options for the final set of teeth?
While the process is the same, your final set of teeth can be upgraded to stronger materials such as Zirconia if you tend to be hard on your teeth or have a tighter bite. Be sure you go through the options of what and why with your dentist.