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Dental implants have changed the face of dentistry over the last 20 years. They have been nothing less than a miracle in the replacement of teeth whether it be a single tooth, multiple teeth, or as an anchor for a denture. As the technology matures, new advancements and techniques come into play. One of those newer techniques is called All On 4 Dental Implants. This technique allows for the placement of four dental implants (hence the name all on 4 dental implants), and the restoration to be placed on the same day. Patients leave the office with teeth. For this reason all on 4 dental implants are also called “new teeth in a day“.

Who Wants All On 4 Dental Implants?

The patients who choose all on four, do so for many reasons including, poor fitting existing dentures, terrible trauma causing tooth loss, decay or periodontal disease causing progressive tooth loss. The most common patients to choose all on four, are not denture wearers. They are patients who have been fighting an uphill battle for a while and know that they are losing their teeth. These individuals have been trying to hold on as long as possible because they do not want to have any time in their life without teeth, and the thought of a removable denture is not an option.

What are All On 4 Dental Implants

The All on 4 Dental Implants procedure was developed in the mid 1990′s. The all on 4 dental implants system has allowed for a variety of patients who, for various reasons, were not considered good candidates for traditional dental implants to now become candidates.

The All on 4 Dental Implants procedure uses four dental implants per arch (upper or lower).  The dental implants in the back are placed on an angle to take maximum advantage of the existing bone structure. Special dental implants were developed that could support the immediate fitting of replacement teeth. This treatment is attractive to those with loose dentures or those in need of full upper and/or lower restorations. With the All-on-4 dental implants procedure, qualified patients receive just four dental implants and a full set of new upper or lower replacement teeth in just one appointment. This usually able to be done without dental bone grafts.  The real attraction to the all on 4 dental implants procedure is how quickly permanent dental implants can be placed. This allows patients the ability to leave the same day with a denture that is fixed in place and stabilized by the dental implants.

Traditionally, the  approach to restoring a full arch of teeth (either upper or lower) usually involved dental bone grafts, six or more dental implants, and as much as 18 months of treatment. In that time, the patient would be wearing an interim denture while the dental bone grafts and dental implants heal and integrate into the bone. This can be very expensive, time consuming, and uncomfortable for a patient to continuously go back for treatment.

What Appointments are Needed for All On 4 Dental Implants?

The All on 4 Dental Implants procedure consists of the following visits:

Initial Visit(s) – The initial visit(s) for the all on 4 dental implants procedure is necessary for the dentist to do a proper treatment plan for you. These visits will include gathering pertinent medical history, needed X-rays, dental impressions, photos, and a CAT Scan. The dentist will then be able to review all the information with the patient and develop the proper course of treatment.

Actual All On 4 Dental Implants Procedure Visit – At this visit the patient will undergo the procedure for placement of the 4 dental implants. Following placement of the dental implants, the dentist will place the denture in and the patient will leave in the afternoon with a beautiful set of fixed, functional teeth.

Follow-up Appointments - The patient will need to return to the dentist for occasional dental examinations over the next several days, weeks, and months to ensure comfort and fit. In about 6 months, the patient will return for a final set of dentures. The reason for the 6 month wait is to give the tissues in the mouth time to heal properly, correct anything the patient wishes to change, and to allow the implants to properly integrate into the bone.

Conclusion on All on 4 Dental Implants

More than 100 million people in the United States alone are missing between 11 and 15 of their permanent adult teeth. By the age of 60, almost 70% of these people are completely without teeth and in desperate need of complete oral rehabilitation. This is where the all on 4 dental implants procedure comes in and is able to restore people’s teeth and change their outlook on life.

 

Root Canal Therapy (also called root canal treatment or endodontic treatment)  is a dental procedure in which the diseased or damaged nerve (pulp) of a tooth is removed and the inside areas (the nerve or pulp chamber and root canals) are cleaned, filled and sealed permanently to avoid infection. Without treatment, the surrounding tissues of the tooth (including the gums and bone) will become infected and a dental abscess can form.

A tooth’s nerve and blood vessel provide nutrients and hydration to a tooth as well as sense of temperature. It provides the sensation of hot or cold. The presence or absence of a nerve will affect the routine functioning of a tooth. Over time the tooth with the root canal dehydrates which makes the tooth brittle and more susceptible to fracture. Most often, a crown is placed after root canal treatment is completed to protect the tooth and restore full function.

Root canal therapy is considered by many to be the most feared dental procedure. Does that surprise you?  Surveys completed by the American Association of Endodontists reveals that most people with a fear of the dentist are based on others’ experience and not their own.

The inaccurate information they receive about root canal therapy prevents patients from making a properly informed decision regarding their teeth.  Many patients will ask that a tooth be extracted rather than experience a root canal procedure.

Painless DentistryRoot canal treatment is needed when the nerve or pulp tissue becomes inflamed or infected. The inflammation or infection can occur from a number of ways: Decay that extends into the pulp chamber, repeated dental procedures on the tooth, or a fracture or chip in the tooth that allows bacteria to spread into the pulp chamber. Also, a traumatic injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to a dental abscess.

Root canal therapy is almost always recommended because a tooth is causing pain from a condition that is irreversible. Pulpitis (inflammation of the pulp), an infected pulp, broken teeth, or a slowly dying nerve are all common reasons for root canal therapy.

Root canal therapy is used to alleviate pain. Most people who have root canal therapy admit they did not experience any pain during the appointment and felt better afterward.

Signs that a root canal may be necessary include pain, prolonged sensitivity to temperature (hot or cold), tenPainless Dentistryderness to touch and chewing, darkening or discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, bone and surrounding gingival tissues. Sometimes, no symptoms are exhibited.

Root Canal Therapy generally requires one or more visits to the dentist and can be performed by either a dentist or a specialist called an endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice is generally up to the dentist on who will perform the root canal. The reasons the dentist may send you to the endodontist include: degree of difficulty of the tooth involved and need for a microscope, re treatment of a Painless Dentistryprevious root canal, and the patients preference. You and your dentist will discuss who is best suited to complete this treatment for you.

The first step is to take an X-ray (if one has not been already taken during the diagnosis) to see the shape of the root canals and determine if there are any indications of infection in the surrounding bone tissues. Your dentist or endodontist will then use a local anesthetic to numb the area surrounding the tooth. Anesthesia is not always necessary but generally preferred by patient.

Once numb, the pulpal tissue along with bacteria, the decayed nerve tissue and related debris are cleaned out from the inside of the tooth and roots. Tiny instruments called dental files are used to measure the length of the root canal and to shape and clean the inside of each root. Sterile water, peroxide, or sodium hypochlorite are used periodically to flush away the debris and kill bacteria..

Once the tooth is thoroughly cleaned, each root canal is filled to the end with a rubbery compound called gutta percha and sealed . The process essentially is like a cork to prevent bacteria and fluid from re-entering the tooth, and keep it sterile. Some dentists like to wait a week before sealing the tooth. This will give the Painless Dentistryinflammation a chance to settle down. Some prefer to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed to keep out contaminants like saliva and food until the next appointment.

The final step may involve a more extensive restoration of the tooth. Generally a tooth that needs a root canal often is one that has a large filling or extensive decay. Even when decay was not a factor, the root canaled tooth is weaker than a ”live” tooth. Therefore, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it back to full function again. After restoration, you will not notice any difference in its function or form. You and your dentist will discuss this need further and decide together the best course of action for you.

Root canal therapy is highly successful and has more than a 95% success rate. Many teeth repaired with a root canal can last a lifetime.

Most root canals are performed to relieve the pain of toothaches caused by pulpal inflammation or infection. With modern techniques and anesthetics, most patients report that they do not feel any pain once the procedure is underway. Root canal procedures have the reputation of being painful. Usually most patients report that the procedure itself is no more painful than having a routine filling placed.

For a few days following treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over the counter or prescription medications or an antibiotic if an infection was present. Follow directions given to you very carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your dentist.

As noted above, the pain from root canals in modern dentistry is from the infection that presents to the dentist and the actual procedure should be pain and worry free. Best defense against developing a toothache is to see your dentist regularly, maintain proper oral hygiene, and call your dentist if you have any pains or discomfort.

Radiograph of RCT

Xray of completed root canal