CERAMIC FACETS
CERAMIC FACETS
All on 4 & All On 6
A smile in one day
- a new life
with stable and natural teeth
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WRITTEN BY: Dr. Aleksandar Despotović
We used to have no real solution for those patients who came to us with a complaint that, although they have all their teeth in their jaw, or at least most of them, they are all dislocated to the extent that they can no longer function nicely with such teeth.
Imagine the stress it would be for us dentists if you had to inform the patient that their degree of periodontitis is so advanced that all the teeth are for extraction, that after the extraction one must wait a few months for the bone to form and stabilize in the new position, and that after they receive a plastic total prosthesis, which is designed to work on the vacuum principle.
Those with a lot more money could ask for the installation of classic implants and a bridge on them, but in order to make a bridge, you must first replace the bone that does not exist in the original scope in periodontopathy. So, more laborious and often less certain surgeries and a lot of waiting for a prosthetic solution.
Danas, zahvaljujući inovativnom i revolucionarnom pristupu poznatom pod nazivima ALL ON 4 i ALL ON 6 (Sve na 4 i Sve na 6), takve pacijente, koji nam često dolaze u svojim najboljim godinama, možemo da obradujemo činjenicom da nove zube mogu imati isti dan na dan vađenja svojih zuba, da je sve implantima podžan rad i da zato stoji fiksno u ustima i prevenira dalji gubitak kosti. Sve to po znatno manjim cenama nego što bi bile cene ugradnje klasičnih implantata uz ugradnju veštačke kosti.
Zar vest nije sjajna, brže, sigurnije, manje hirurgije, jeftinije, za sve uzraste, i za starije ljude?!
Više o tome u ovom tekstu, a ako se odlučite da vam u tom smislu pomogne naš implantno protetski tim, zakažite besplatan pregled na dnu stranice.
Am I for an "ALL ON X" solution?
Take a mirror and see if you have any of the conditions in these pictures:
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Do you have very loose teeth and receding gums?
You no longer have your teeth and want to stop wearing removable braces
If you are one of the patients in the pictures, you are a patient for ALL on 4 or ALL on 6...
Šta su ALL ON 4 i ALL ON 6?
A ll on 4 (All on 4) is a popular name for an implantological - prosthetic system that consists of 4 implants per jaw and a prosthetic part that is screwed to these implants and that replaces the teeth and part of the gums and bones that are missing after tooth loss. In this type of fixed prosthetic work, the first molars are the last teeth on both sides of the jaw, which is the necessary minimum number of teeth for good appearance and function.
For those who want to know more, here is a summary:
The two front implants are vertical, and the 2 end ones are angled, which allows them to be long enough to provide stability in conditions of lack of bone in height. In this way, the bone does not have to be implanted or the mandibular nerve moved to obtain bone height before implantation.
The prosthetic part itself is called a hybrid bridge . The standard bridge prosthetically replaces only the teeth, and the hybrid contains both a part that replaces the teeth and a part made of pink material that replaces the missing pink bone ridge. Therefore, with a hybrid bridge, it is not necessary to bring the bony ridge to its original height and width by inserting a replacement bone before placing the implant, but the implants can be placed immediately in different heights of the ridges, because the ridge is compensated prosthetically with pink material.
All on 6 is an identical system that is screwed onto 6 implants, 3 on each side of the jaw, which is more common in the upper jaw, which is larger and where the bone is less dense....
To make sure there is no confusion, a simpler solution is also possible in the lower jaw, it is a covering prosthesis on 2 or 3 implants, but it is on the Driker, it rests on the gums as well, not only on the implants, and it has plastic elements of each total prosthesis and such a prosthesis is taken off every night for hygienic maintenance, so that's why there is an all on 4 option, there is much less interest in these basic versions. In the upper jaw, this type of prosthesis also covers part of the palate, so the taste of food is felt less, even though that palate plate is reduced compared to a classic total prosthesis that does not have implants.
A fourth is also possible. a more complex variant , first upgrade the bone to the level of the young days, install 6 to 8 implants that are not at an angle, then make a standard bridge on them, and then it leads to a longer wait, two or more surgical procedures, more expensive total price and the impossibility of accurate determination prices, which is not the case with the all on x version. This variant is OK if the ridge is preserved and of uniform height and width after tooth loss, so no addition is needed to level the height of the bone, which is rarely the case.
For most patients, All on 4 or ALL on 6 is the ideal solution: excellent aesthetics and function for a more acceptable amount of money and with less major surgery and uncertainty, "new teeth on the same day".
New teeth the same day?
Postoji više načina da se dođe do istih rezultata.
U jednoj od opcija, za koju su najviše zainteresovani pacijenti koji kratko ostaju u Beogradu, novi privremeni zubi se dobijaju u istom danu ili dan kasnije od trenutka kada se u jednom i jedinom hirurškom zahvatu izvade preostali zubi, ugrade implanti.
Taj fiksni potpuno estetski i funkcionalni privremeni rad koristite dok implanti ne budu prihvaćeni u celosti od strane kosti nakon 3 ili 4 meseci i nakon toga uzimaju se novi otisci za izradu finalniog trajnog rada, tzv. hibridnog mosta. Privremeni most je sve vreme u ustima dok traje izrada trajnog mosta.
Da li će se raditi opcija sa novim zubima istog dana zavisi od više stvari: od toga koliko vam se žuri, od toga kolika vam je cena prihvatljiva, od toga koliko je zuba preostalo u vilici pre vađenja, od toga koliko vam je kost čvrsta da bi dozvolila da se implant odmah čvrsto ušrafi...
Zato pre dana za hirurgiju predhodi dan za konsultacije. Tada donosite 3D snimak vilica, koji oralnom hirurgu - implantologu služi da vidi visinu, širinu i gustinu prepstale kosti, kao i odnose sa viličnim sinusima. Na osnovu anamneze (medicinske istorije), kliničkog pregleda i analize snimaka, dobićete prezentaciju plana lečenja u vašem konkretnom slulaju. To podrazumeva informaciju koje je za vas najbolje rešenje, all on 4 , all on 6 ili nešto drugo ili eventualno ima mogućnosti za više opcija. Takođe razgovaramo i o cenovnim opcijama, vremenu dobijanja novih zuba, potrebi za analgosedacijom, opcijama za stalno protetsko rešenje i slično.. Ukoliko se ovom prilikom odlučete za uradnju implanta na način da se hirurgija odradi uz pomoć hirurškog vodiča za ugradnju implantata, onda se već u ovoj prilici uzimaju preliminarni otisci... Takođe ako već nemate ni jedan svoj zub, i rešimo da je najbolje da prvo napravmo klasične totalne proteze koje će posle ugradnje implantata biti preoblikovane u redukovane privremene proteze fiksirane šrafovima za implante, onda u ovoj seansi već možemo da uzmemo otisak za izradu istih. Ohrabrujemo i online video konsultacije , iako prednost dajemo poseti ordinaciji radi konultacija.
Sama operacije radi ugradnje implantata traje oko sat ipo vremena, u lokalnoj anesteziji. Ukoliko se radi sa hirurškim vodičima gde je položaj imlantata precizno definisan uz pomoć 3d snimka vilica i softvera za planiranje i izradu hirurških vodiča za preciznu ugradnju implantata, tu je i privremeni most na implatima gotov još pre dana kada se radi ugradnja implantata, a ako se ugradnja implantata radi slobodnom rukom, onda se nakon vađenja preostalih zuba (ako je potrebno) i ugradnje implantata uzima otisak za izradu privremenog mosta koji će se fiksno ušrafiti na te implantate kada bude izrađen, par sati ili par dana nakon uzimanja otiska. Za pacijente koji ne žive u Srbiji, bitno je istaćei da se postavljaju resorptivni konci nakon hirurgije koji će se i sami raspasti pod uticajem pljuvačke posle određenog vremena, pa ih nije potrebno skidati.
Nakon tri ili četiri meseca, uzima se otisak i izrađuje stalni hibridni all on 4 ili all on 6 most, za šta vam je potrebno da budete dostupni za ordinacijske posete oko 7 dana.
Am I a good candidate?
for ALL on 4 / All on 6?
Most likely it is. Only a small number of patients are relatively or absolutely contraindicated,
This therapy is not performed in patients who are undergoing acute chemotherapy or radiation therapy , it is necessary to pass a few years after the last therapy of this type in order to access the installation of implants for ALL on 4- ALL on 6. These patients often have the need to compensate teeth in which the disease is in an acute phase and has had a bad effect on the teeth.
This therapy is also not recommended for patients with severe autoimmune diseases that require organ replantation .
For smokers, therapy is possible and is done routinely, although it is recommended that they stop smoking for a period before the start of the therapy, as well as after the therapy, so that the duration of the implant will be better and the microcirculation in the bone will improve.
In a patient with controlled diabetes , it is possible to install an implant and it is done routinely, and if the microcirculation is more impaired, therapy in hyperbaric chambers is recommended to improve the microcirculation beforehand.
If you don't have any teeth , and you want to switch from a total prosthesis to a hybrid bridge that won't move when you speak, won't interfere with your tongue or the feeling of food, you are the ideal patient.
If you have severe periodontitis , all your teeth are loose and move, and you are in your prime, this is the ideal solution for you, because you will get work that will be functionally and aesthetically almost identical to your teeth from your youth.
What is the success rate of implantation?
Are there any guarantees?
Once placed, implants are intended to remain in place forever.
The prosthetic part can be removed in the doctor's office and repaired if ever needed.
The success rate of such works is high, around 98% , so you have no reason to worry.
The manufacturer of the implant itself guarantees that you will receive a new implant free of charge if for any reason the implant is rejected from the jaw. Those cases are rare and are usually resolved successfully in the next attempt.
The free service guarantee cannot apply to our time and other resources that are not free to us. What we can guarantee is that we will do things according to the protocols recommended by the implant manufacturer.
There may be a change in the treatment plan due to some unforeseen circumstances beyond our control, but it is important for you to get the desired result in the end.
We work with several well-known global brands, such as Bredent, AlfaBio and Zimmer...
We are always with our patients.
What are the available prosthetic variants of hybrid bridges after 3-4 months of implant placement?
You don't have to decide right away. After installing the implants for ALL ON 4 or ALL ON 6, you have 3-4 months to better inform yourself and make the decision that seems best to you, in relation to the fact that each of the materials has its advantages and disadvantages, which we will honestly share with you.
These are the most common prosthetic options for a final fixed hybrid bridge on ALL on 4/ALL on 6 implants
Acrylate hybrid prosthesis with titanium substructure
This kind of hybrid bridge consists of a titanium (metal) bar , over which is pink acrylate and acrylate teeth, as are found in total dentures. This type of bridge is fixed to 4 or 6 placed implants with the help of 4 screws, and this allows it to be easily unscrewed in case a repair is needed.
Relatively lower price and easy, fast and affordable repair in case of need are the biggest advantages of this hybrid bridge. Cartilage teeth can be easily and quickly repaired if a tooth breaks or wears out in case of some trauma. Because the titanium bar is also quite flexible, the hanging parts of the bridge can bend laterally in case of premature contact in the lateral part, so it protects and the screws with which the bridge is screwed to the implants so that they do not loosen and to some extent protects the prosthesis itself from breaking due to some trauma. The teeth in the acrylate hybrid bridge are more abrasive than natural teeth, they wear down over time, primarily the side teeth, which sometimes, in some 3 to 5 years, reduces the space in the front as well, and this leads to the eruption of the teeth from the lower teeth due to less free space when speaking and chewing, which is easily and quickly repaired and is not expensive.. In order to avoid possible excessive wear of the teeth, we recommend that you wear a protective splint at night . opposite jaw you have your teeth, they will be uneaten over time. After several years of wear, alrilat begins to slightly absorb moisture from saliva, so small brown discolorations may appear next to the teeth. That is why it is possible to polish this bridge from time to time, but we repeat that it is not complicated, takes a short time and is not expensive. Their weight is less than the weight of pure titanium hybrid bridges.
Kompozitna hibridna proteza sa podstrukturom od kobalt hroma
Ovakav hibridni most se sastoji od isfrezovane kobalt hrom prečke, preko koga je roze kompozit i isfrezovani kompozitni zubi. Ovakav most se uz pomoć 4 šrafa fisksira za 4 ili 6 postavljenih implantata, i to omogućuje da se lako odšrafi u slučaju da je potrebna reparatura.
Ovaj hibridni most je sličan akrilatnom hibridnom mostu, po svim karakteristikama. Nešto malo manja verovatnoća je da će se lomiti od akrilatnih hibridnih proteza ili proteza od punog cirkonijuma, jer se sam kompozit donekle ugiba pod pritiskom. Manje nego predhodni most upija vlagu iz usta i ne prebojava se iako može biti potrebe da se dopolira zbog visokog sjaja posle nekog vremena. Dobro se pokazala kombinacija gornjeg hibridnog mosta od punog cirkonijuma i donjeg hibridnog mosta od kompozita. Reparacija kompozita moguća i u ustima, u ordinaciji.
One-piece full zirconium hybrid prosthesis
A one-piece prosthesis made of solid zirconium consists of only one material - zirconia (if we exclude metal prosthetic matrices), a white material which, after thermal treatment of zirconium, becomes a material as hard as stone. Such material is then painted with gum and tooth colors, and it is possible to make them so that the final facet layer is made of pure ceramic, for even greater aesthetics.
These prostheses are slightly heavier than the previous ones, but patients get used to them quickly. They are superior in aesthetics , the shape of the teeth can be highly individualized because digital libraries of teeth are used to cut the entire bridge in one piece. They are very smooth and shiny , like glass, so they absolutely do not lose their shine over time, nor do they absorb moisture and pigments from food. They are very strong materials, and the most resistant of all materials to cracking, but if in rare cases a fracture occurs, then a whole new bridge must be made. The combination of an upper hybrid bridge made of solid zirconia and a lower hybrid bridge made of composite has proven itself well.
Hybrid prostheses made of individually milled metal substructure
on which metal-free crowns are individually cemented
These consist of a metal substructure that has been milled so that one part of that metal is in the form of individually ground teeth , ready for individual acceptance and cementation of metal-free crowns . Since the crowns are made and cemented individually to the metal frame, the costs of possible repairs are significantly lower than with a hybrid full zirconia bridge, because the broken crown can be individually removed and a new crown made, and its design is saved on the computer. Slightly more likely to break a metal-free crown than with a full zirconia hybrid bridge, but a much cheaper repair. The construction of such a bridge is of superior aesthetics, but also the most expensive, in terms of initial costs. However, it should be measured whether over the years this is still a more profitable and faster option, due to relatively easy and affordable reparation.
ALL on 4
- BEFORE AND AFTER PHOTOS
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Don't worry if you can't pay everything right away.
If you are employed for an indefinite period or are a pensioner,
we offer you the option of paying in installments through an administrative ban .
All you need is to get our form, get it certified by your company or pension fund - and that's it!
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Satisfied clients
For every recommendation! If you haven't found your dentist, I highly recommend it! Professionalism, kindness, availability, skill, knowledge. No mistake.
Knowledgable, considerate and gentle, dr. Despotovic keeps providing top quality services to my family and me. From braces to crowns, all of his interventions resulted in durable and comfortable fixes. My 4-year old son went out smiling after his first experience with the "drill", dr. Despotovic worked him over like a charm. Price-performance ratio: unbeatable!
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All on 4
All on 6
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Premijum fiksna zamena za totalne proteze
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Nema velike hirurgije, sinus liftova i velikih nadogradnji kosti
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Vrlo kratak period do novih zuba
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Funkcija slična funkciji prirodnih zuba
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Jeftinije od klasičnog mosta na više implantata
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Bezbolna ugradnja
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