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When Does 4=6? With All-on-4 ® Implant Dentures

When it comes to implant dentures, 4=6. At least, that’s the conclusion of a 5-year randomized clinical trial looking at the use of All-on-4 ® or All-on-6 ® immediate placement dentures. Although All-on-4 implant dentures experienced more minor complications, All-on-6 implant dentures experienced more implant failures. But there were no statistically significant differences between the treatment approaches.

Great Results with More or Fewer Implants

One of the things you will read if you are researching All-on-4 implant dentures is that some dentists don’t think that four dental implants are enough to support a full arch of dentures. Nevermind that the first dental implant patient ever had only four implants on his full denture that lasted him more than 40 years until his death. Nevermind the outstanding engineering that went into developing the very solid and very stable All-on-4 implant denture. Some dentists still insist that four implants are just not enough to provide a stable implant denture.

Implant dentures are reliable

To help determine this question, researchers took 40 patients and randomly assigned half of them to receive All-on-4 implant dentures and half to receive All-on-6 implant dentures. All dental implants were immediately loaded using the typical protocol for these implant dentures.

They followed all 40 patients for five years — no patients dropped out of the study — and measure the survival rates of dental implants and prostheses, complications, bone loss around implants, and the health of gum tissue around implants.

By the five-year follow-up, seven dental implants had failed: six in the All-on-6 group (comprising 5% of the total) and one in the All-on-4 group (1.25% of the total). The difference in implant failures was not statistically significant. None of the dentures failed. Both type of implant dentures experienced biologic and technical complications. Although All-on-4 implant dentures experienced more complications, the difference was not statistically significant. Marginal bone loss was higher around All-on-4 implant dentures, but it wasn’t statistically significant. There was no appreciable difference in periodontal parameters between the dentures.

Four Is Enough

With all due deference to Dick Van Patten, four is enough. At least, when it comes to implant dentures, four implants are sufficient to secure the denture for full function and long life. The treatment concept is thoroughly engineered, well tested, and has an excellent record of performance.

So why do some dentists bad-mouth the concept? There are many possible reasons. One is that it could be what they were taught in school, based on lessons learned trying to make four implant dentures in the early days of dental implants, before the innovation of the All-on-4 concept. Or maybe it’s just their uncertainty — they think more is better and don’t want to take a risk.

But what is true is that these dentists typically don’t offer All-on-4. They don’t have the experience with the procedure and haven’t seen how well it works. All-on-4 implant dentures aren’t always the right choice, but for many people, they are the best option.

To learn whether you’re a good candidate for All-on-4 implant dentures in Westchester County, please call (914) 332-4402 today for an appointment with an implant dentist at Advanced Dentistry of Tarrytown.