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All-on-4® using guided surgery

by Dr. Kamsiah G Haider BDS, MDSc

Nov 26, 2017

 

All-on-4® using guided surgery 

 

The All-on-4® treatment concept was developed in the 1990s as a way to best restore the full arches of the upper and lower jaws. The procedure uses only four implants to secure all teeth in place, hence the name “All-on-4.”

CBCT guided implant planning and surgery is a facially driven treatment plan. It first involves planning an ideal dental restoration for a patient; this may be a complete denture or, for a partially edentulous patient, a digital diagnostic wax-up of the planned restorations.

This virtual treatment plan is then sent to a laboratory (in this case the DSD lab in Madrid) for fabrication of an appliance that is used at the time of surgery to accurately place the implants in their planned position(s). Most larger implant manufacturers offer guided surgery-specific instrumentation for flapless implant placement. When desired and indicated, techniques and armamentarium are available for extractions, bone reduction, immediate implant placement, and immediate loading, all of which are commonly used in the All-on-4 protocol.

At surgery, the surgical guide was properly positioned and stabilized using stabilization pins. Implant-specific instrumentation was used to place the four planned implants to full depth and accurate direction using guided-surgery techniques with implant mounts .

Guided surgery and dental CAD/CAM are complementary technologies that can make the surgical and restorative phases of implant therapy more efficient and predictable.

 

Conclusion


The use of CT-guided surgery to perform the All-on-4 procedure is a combination of technologies that is still not very in common practice.  We @drkamsiah prefer the combination  of these two techniques, together with the digital smile design concept to improve the aesthetic outcome as well.
—-drkamsiah

 

Dr Kamsiah G Haider Prosthodontist, DSD Master & Instructor, BDS, MDSc

A dentist , a continuous education junkie and inspiring other dentists to be a real dentist !

Who do you want to help you improve your smile if you are looking for a dentist? Dr. Kamsiah also known as Dr. Kam is cosmetic dentist with over 30 years experience . As a Master and Instructor of the Digital Smile Design , together with dental implantology , prosthodontics and orthodontics I have the experience and knowledge to handle the most complex cases in cosmetic dentistry. Oral reconstruction, rehabilitation with or without dental implants and conscious sedation dentistry all in one place.

She earns her membership of the International Association for Orthodontist (iAOi) in 2014.

She has been a Diplomate of the American Board of Prosthodontics and Implantology (ICOI) since 1997. She’s into guided surgery and full mouth rehabilitation on failed dentition also known as teeth in a day with the help with digital dentistry. Something she’s passionate about since embarking into private practice 23 years ago.

Dr. Kamsiah was a full time lecturer at the University of Malaya and an Associate Professor at the International Islamic University and lectures on prosthetics , the All-on-Four concept and recently on the Digital Smile Design.

Specialties: Prosthetic Dentistry, Dental Implants, Cosmetic Dentistry, Orthodontics, Invisalign, Bone-Screw Orthodontics, AO4, Teeth in one day.

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