Being Well Informed About Teeth-in-a-Day®, All-on-4®, and Other Types of Implant-Immediate Load Treatment Procedures Offering Same Day Dental Implants

Dr. Marlin is One of the Few Prosthodontists in the DC Area Who Works with His Own In-House Technician to Convert a Removable Appliance to a Fixed One, Immediately After implant Insertion

There are multiple versions of this technique that are being marketed under the following trade names: All-on-Four®, Clear Choice®, “Teeth In A Day®Teeth In One Visit”,“Bar Attachment Denture”, “Dental Implants in 3 Minutes”, “Immediate Load Hybrid Prosthesis”, and many other one-day implant treatment offerings of a full arch of replacement teeth. To avoid confusion, we group all of these variations of the same therapy together via our own term, “Same-day Implants & Prosthesis” with the qualifier that we believe in bone preservation, whereas the above techniques are uniformly based upon bone reduction (see our web page, All-on-4® Type of Procedure, for the details).

“Dear Dr. Marlin,

I wanted you to know how extremely happy I am with the excellent care you’ve given me over the past decades. I appreciate your attention to detail, your insistence that every outcome is cutting edge of dentistry, and what I would call your intelligent artistry. All of that makes it worth the 150 miles drive for the last 20 years.”

Are you a candidate for implants and replacement teeth in one day? When you schedule an evaluation, we will provide a detailed analysis for you.



    1. How do I know if I am a Candidate for Implants and Teeth in One Day?

Mouth X-Rays, Jaw X-rays, Mouth CT ScanTo see if you are a candidate for receiving implants and teeth in one day, a complete diagnostic work up is necessary. This includes taking models of your mouth, X-rays, and a CT Scan of the jaw(s).

Once the information has been collected during your formal conultation, your dentist (rather than a patient consultant) should personally discuss your existing condition, available treatment options, the ramifications of non-treatment, and the risks when pursuing treatment. Usually, he or she will be able to show you where your implants would be placed on the CT Scan in a “virtual reality” presentation.

    1. What is the Same Day Implant Prosthesis (All-on-Four® type of procedure, the Immediate Load Hybrid Prosthesis)
Immediate load prosthetis
Fixed prothesis

Converting a “floating” denture to a fixed prosthesis seated on the implants immediately after they have been inserted is very rewarding. You will instantly chew with a solid bite. Most patients on the verge of losing all of their hopeless teeth in a jaw, are candidates for avoiding a denture. Each case needs to be carefully evaluated as to the nature of the problem and the alternative treatment options.

There are multiple versions of this technique that are being offered under the following trade names: “All-on-Four®”, Clear Choice®,Teeth In A Day“, “Teeth in an Hour“, “Dental Implants in One Day“, “Teeth In One Day“, “Teeth In One Visit“,“Bar Attachment Denture“, “Dental Implants in 3 Minutes“,”Immediate Load Hybrid Prosthesis” and many other one-day implant treatment offerings of a full arch of replacement teeth. We group all of these therapies together via our term, Same-day Implants Prosthesis. We will discuss the pros and cons of the treatment, along with any alternative treatment plans at your consultation.

Before Treatment:
Full Upper Denture
with hopeless lower teeth
Before same day dental implants

After Treatment:
Full Upper Denture with Full Arch Lower Fixed Prosthesis Inserted Over Implants
After same day dental implants

    1. Should I save my teeth, rather than having them extracted?

If most of your teeth are not salvageable, an immediate load, implant-supported fixed prosthesis is an excellent treatment option. However, if many of your teeth can be saved with a good prognosis, that treatment should be presented to you as a treatment option to make an informed decision as to which treatment is preferable, and why.

We will explain to you, in our opinion, why certain teeth are not salvageable, why you are being considered for the Same-day Implant Prosthesis (Immediate Load Hybrid Prosthesis, All-on-4® type of prosthesis, etc), along with other treatment options are available to you (see Alternative Treatment Plans). In short, if your teeth cannot be saved, why not?

    1. How many implants do I need?

Each implant maintains the integrity of the bone, since it is a replacement titanium root (see Dental Implants). A greater number of inserted implants translates to enhanced support for the prosthesis along with additional preservation of the bone.

With the Same-day Implant Prosthesis, a minimum of four implants is necessary to support the fixed prosthesis, but additional implants can provide additional bone preservation and a greater number of future treatment options. We will discuss this with you at your consultation visit so that you can choose the treatment that works for you taking into account your budget and your desires.

    1. Will I be able to have additional implants in the future?

The angulation of your new implants (such as in the All-on-4® technique) can affect your ability to have additional implants placed near them in the future.

In some instances, angling these implants is necessary because of a lack of bone, in the posterior part of your jaw, but, in other instances, the implants do not need to be angled. There are differences of opinion amongst practitioners as to when that technique should be used, and as to what implant locations and angulations are ideal for different types of cases. At your consultation, we will show you how we plan to place your implants as we demonstrate it on your CT Scan (3D image).

Secondly, if too much bone is removed in order to insert implants without bone grafting, the ridge, where the bone has been reduced, may not be high enough or adequately wide enough to receive implants in the future. If significant bone reduction has been recommended, you need to ask how that will impact your option to have future implants inserted in other sites, if any existing implants were to fail or if a different type of restoration were to be desired.

    1. Do I need Bone Grafting?

Bone grafting preserves the jaw’s ridge when teeth are extracted (see Bone Grafting). Once teeth are extracted, the surrounding bone will shrink as it is no longer needed to support the teeth, except where implants are placed.

According to an implant clinic, ClearChoice® Centers, “the Bar Attachment Denture Procedure can replace a full arch of teeth in one day, using only four implants and without bone grafts often saving time and money.” This statement implies that all teeth can routinely be extracted and replaced without any bone grafting. We disagree with this therapeutic approach. There are cases where a great deal of bone would have to be removed in order to insert the implants in one day. Without preserving the ridge by placing bone in the extraction sockets, patients will, most likely, lose more bone over the years in areas where implants have not been placed. While, in most cases, the procedure can be performed at the insertion of the implants and the fixed prosthesis, preserving the bone may require an additional procedure. You need to be made aware of the advantages of preserving your ridges, along with the additional costs, in order to make an informed decision as to whether or not you want to have an additional procedure that would enhance your long-term prognosis.

    1. Will I be able to maintain good hygiene with my new Hybrid Prosthesis?

Maintain good hygiene with my new Hybrid Prosthesis

With the appropriate design, you will be able to have very good hygiene with your new Full Arch Hybrid or Screw-Retained Porcelain Prosthesis.

If the appliance is fabricated too close to the gum tissue, it will be very difficult to clean under it. In order to maintain your new teeth, the restorative dentist needs to make sure that there is adequate room for hygiene brushes and other oral care products.

    1. What Are My Treatment Options?

In many cases, we have found that patients have not been presented with alternative treatment options, besides one of the “Same Day” immediate load implant procedures. At times, these patients have preferred one of the alternative treatment plans that maintains their healthy teeth.

In many cases, we have found that patients have not been presented with alternative treatment options, besides one of the “Same Day” immediate load implant procedures. At times, these patients have preferred one of the alternative treatment plans that maintains their healthy teeth.

    1. Can my full arch appliance have porcelain crowns as an option?

Yes, some patients choose to have individual porcelain crowns placed instead of traditional denture teeth for an additional cost. In this case, each tooth is separately created from porcelain for an enhanced, life-like effect. This premium choice gives some patients the more natural effect that they desire.

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