FULL MOUTH REHABILITATIONS WTIH IMPLANTS: ALL-ON-FOUR / ALL-ON-SIX

In which cases is a FULL REHABILITATION WITH IMPLANTS indicated?

• Cases where the patient has lost teeth in a whole arch (upper or lower jaw).
• Cases where all the teeth have been lost in the mouth (upper and lower).
• Cases in which the remaining teeth are not conservable and due to the poor condition in which they are in, and their poor prognosis, they must be extracted.

To rehabilitate an entire arch (upper or lower) with implants, it is NOT necessary to place as many implants, as teeth which need replacing. Usually placing either 4 and 6 implants per arch is enough. This is what is known as the All-on-Four and All-on-Six technique respectively.

Regardless of the number of implants to be placed to restore an entire arch, it is also important to distinguish between 2 types of prostheses:

1. FIXED Complete Restorations over Implants: The teeth that are placed on the implants are fixed and therefore are not removeable. It is the closest thing to natural teeth.
2. REMOVABLE Complete Restorations over Implants: The teeth are dentures which are retained on abutments which are attached to the implants. This way, when the prosthesis is placed, it does not move and it behaves like a fixed prosthesis, even though the patient can remove it at any time, since it is removable.

Below we will describe the 2 techniques with can be applied for Complete Rehabilitations with Dental Implants:

“ALL-ON-FOUR” technique:

It is a type of rehabilitation of an entire arch (upper maxila or lower jaw) supported by only 4 implants. It is a cheaper alternative, due to the small number of implants needed to support the entire arch.

To put a simile to facilitate the understanding of this technique: it would be like “a table supported by 4 legs”. It is the minimum that “the table” should have in order to stay upright.

Due to this, it is a very interesting alternative for many patients, but it is not always the ideal alternative for ALL cases.

There are times when, due to the patient’s available bone and other factors, it may be necessary to place more than 4 implants. These type of cases in which more implants are needed, usually can be solved with 6 implants, which is known as the All-on-Six technique.

“ALL-ON-SIX” technique:

This technique restores an entire arch on 6 implants. In this case, the type of prosthesis is usually, in most cases, a fixed, non-removable prosthesis, which is like natural dentition.

HOW DO I KNOW IF I NEED AN ALL-ON-FOUR OR ALL-ON-SIX TECHNIQUE?

There are 3 steps:

The first thing is to know is the patient’s medical situation: illnesses, medication and allergies.

Once the Medical History is detailed, the specialist in Implantology and Implant Prosthesis, Dr. Rico, will perform an oral examination to know the specific details of the mouth (the bite, the aesthetics, the dimension of the lower third of the face, and a series of tests to find out what the patient really needs in each specific case). This assessment by our specialist and the Medical History, has no cost for the patient.

Finally, it will be necessary to do a 3D Dental CT Scan. This is a digital 3D radiograph with minimal radiation (which we do at our Dental Clinic), which allows us to see the available bone in 3 dimensions and therefore allows us to assess the quantity and quality of bone that the patient has to place the implants. With this tool we can also decide the ideal size, type and position of the future implants.

With all this, the patient is explained all the available alternatives to rehabilitate their mouth: 

• If you can have a fixed and / or removable prosthesis.
• If it can be done with the All-on-Four technique or with the All-on-Six technique.
• All the specific details of the case that we have evaluated are explained, so that the patient understands the why of everything we propose.
• A quote of each alternative will be provided, so that the patient can study it and decide, without any type of compromise.

If you are interested in placing implants, do not hesitate to contact us, we can help you and we will provide you with all the information you need. If you want more information about implants in our Clinic, on these links you can get to know us better.

– Dental Implants at A2 Dental

– Implant cases in our patients 

– Dr. Rico, our implantologist

All our professional team, the doctors and oral hygienist, have obtained the certificate of the Spanish Dental Foundation that accredits them for the post-Covid reincorporation, controlling all the security measures against the Covid-19. These accreditations, together with all the security measures and new protocols that we have established at the A2 Dental Clinic, have allowed us to create a very highly safe space for our patients.

We are back as of May 11th.

For more information about our protocols, you can see a video in the previous blog entry.

This is for you, for our patients. We want to explain the new protocols that we are going to carry out so that you are familiar with them when you start coming to your appointments.

1. The first step at the clinic will be to disinfect your hands with hydroalcoholic gel for 30 seconds, following the instructions established by the World Health Organization.

2. We will provide you with shoe covers before passing to the clinical area.

3. Do not walk around the clinic, please wait in the waiting room until you are called.

4. Our team is equipped with all the protection measures recommended by the Spanish Dental Foundation, to avoid any possible doctor-patient contagion. This includes: Protective clothing, Double face-mask, Facial protection, Hat, Double gloves

5. When you sit at the dental chair, remove your face-mask and you will rinse with an effective mouthwash against the coronavirus for a minute, before starting the treatment.

6. Protective glasses will be placed on the patient, as we have always been doing in our usual protocols

7. After each treatment, in addition to the rigorous disinfection and sterilization protocols that we have always carried out, we will also do a comprehensive disinfection of the room and surfaces, with a disinfectant solution. The treatment room will be ventilated and we will space the appointment time between patients in order to carry out this whole process.

8. When you are at the reception, you will see a line in front of the counter indicating the minimum safety distance of 1.5 meters, in addition to the protection screen that will guarantee your safety outside the treatment room.

All these new measures are in addition to those we have always been carrying out. It is important to remember that we are a group of professionals who are used to treating patients with highly contagious diseases, such as Hepatitis C or HIV, and we have always done so safely. Every instrument or material that touches the mouth of our patients has gone through a sterilization process. Therefore, even though we cannot guarantee an environment completely free of possible risk, we have created a highly safe space for our patients.

We continue to attend DENTAL EMERGENCIES as usual and are now rebooking our patients little by little, with the new protocols. Looking forward to being with our patients soon.

In the case of a dental emergency, whether due to pain, infection or dental trauma, it is very common to require an antibiotic treatment, prior to clinical treatment.

In the case of having to take antibiotics, DID YOU KNOW THAT ANTIBIOTICS CAN ALTER YOUR INTESTINAL BACTERIAL FLORA?

Antibiotic treatment can alter the intestinal microbiota, causing a decrease in beneficial bacteria and promoting the growth of harmful bacteria, producing the so-called Antibiotic Associated Diarrhea (AAD). This can occur in 1 in every 3 people.

WHAT ARE THE SYMPTOMS OF AAD?

The main symptoms are: increased number of bowel movements and change in consistency.

Symptoms may appear during antibiotic treatment, but in most cases they appear between 1 and 10 days after finalising the treatment.

WHAT TO DO IN CASE OF AAD?

AAD can be prevented by taking specific probiotics if taken, together with antibiotic treatment.

These probiotics with benefits at the intestinal level can also help improve symptoms, since they reduce the duration of diarrhea, the number of bowel movements and normalise its consistency. In addition, in case you need rehydration due to the loss of fluids, it is convenient to combine the probiotic with rehydration salts.

Therefore, it is very important to combine antibiotic therapy with a PROBIOTIC. This way, we will maintain a correct balance of the microbial flora, which is so relevant for the proper function of the body.

If you have any questions, please do not hesitate to contact us, our team will be happy to solve any questions you may have.

You can call us on +34 971 201 123

Or contact us here.

It has been demonstrated that women’s gums have certain peculiarities that make them more susceptible to changes, compared to those of men.

Women’s gums require special attention and especially at certain stages of development in their life. The reason why they are more affected than men is due to hormonal changes. Hormonal changes make gum diseases more vulnerable because of female hormones (estrogen and progesterone). The increase in hormones in certain periods of their life cause more blood flow to the gums and make them more sensitive and susceptible to any external agent that can irritate them. When hormone levels are high, the gums are more sensitive to plaque and bacteria, making it prone to inflammation and bleeding. If gum inflammation (gingivitis) is not treated, it can progress in periodontitis (inflammation and loss of the tissues which surround the tooth).

The gums of women during PUBERTY:

During puberty, the increase in hormone levels causes higher blood circulation in the gums. As a result, they tend to swell and may have a greater tendency to bleed.

As a young woman grows, the tendency of bleeding decreases. However, if proper prevention is not performed, the gum can be permanently damaged.

The best way to prevent this situation is with daily care of the teeth and a regular visit to your dentist to perform periodontal preventive measures and early diagnosis in case of more serious problems.

The gums of women during PREGNANCY:

The gum also undergoes many changes during pregnancy. Frequently, pregnant women suffer more gingivitis from the second or third month. This disease is characterized by inflammation, bleeding and a red color of the gum caused by the accumulation of plaque. There is a risk that the bone and other tissues surrounding the teeth can be permanently damaged if no treatment is performed.

Patients in periodontal treatment should take care of maintenance during pregnancy because often the condition of the gum worsens during the pregnancy, therefore now more than ever it is very important to visit the dentist. The indicated time to do gum treatments is during the second trimester.

Research studies show that periodontal disease in pregnant women can be a risk factor for the birth of immature children. Maintaining good periodontal health is the mother’s best interest to have a healthy child.

If you are taking oral contraceptives, you may be susceptible to the same symptoms that affect pregnant women.

The gums of women during MENOPAUSE:

The most important effects that women can suffer in this stage of life is the sensation of dryness and irritation.

If you use estrogen supplement patches, they will barely affect your mouth. However, progesterone may increase gum irritability and the tendency to swelling, bleeding and redness.

Sometimes, after menopause, a certain degree of osteoporosis appears. Osteoporosis has recently been linked to a greater tendency to suffer from periodontal disease. In these cases, gum health care should be a priority objective in the affected women.

If you want to know more about gum diseases and how they are treated, click here. 

Invisible orthodontics does not involve braces, like in other conventional orthodontic treatments. It is based on a series of custom made transparent aligners (guards) which are made individually for each patient. They are changed during the course of the treatment until the teeth are correctly aligned.

With this system, before we start the treatment, we can see the final result of what the teeth will look like through a virtual 3D Clincheck, which implies a lot of precise information we can see about the treatment before starting.

WHY HAS INVISALIGN BECOME SO POPULAR? WHAT ARE IT’S ADVANTAGES?

Invisible orthodontics (Invisalign) has become our orthodontic treatment of choice for most of our patients, with Invisalign being 90% of the Orthodontics we do at the A2 Dental Clinic. This is due to its numerous advantages:

• ESTHETICS: it is based on using transparent aligners and they are very esthetic, as you can barely see them. 
• BETTER ORAL HYGIENE: you can take them out them at any time, to brush your teeth and floss, to eat, or in case of an important event.
• COMFORT: as the treatment does not require metal braces or wires, it does not cause discomfort or lacerations in soft tissues (lips or cheeks).
• FUNCTION: Invisible orthodontics has evolved a lot in recent years. Dental movements with this technique are softer but constant, which makes it more effective in certain movements compared to conventional braces, where the forces exerted are more punctual and of greater pressure.

At the beginning of the treatment, each patient receives their own kit, which includes all the care and maintenance instructions, as well as a case to store the aligners.

Frequently asked questions of our patients at A2 Dental:

HOW LONG DOES THE TREATMENT LAST?

The duration of treatment will depend fundamentally on the initial state of each patient’s teeth. This means that it depends on your “malocclusion” (type of bite) and the amount of teeth to be moved or rotated.

If it is a case of mild malocclusion, the treatment can last approximately 6 months.

If it is a complex case, it can last up to 24 months or more.

Each patient has a different bite, so you cannot give generic estimates regarding time. Ideally, if a patient is interested in Invisalign, they can have a first consultation with the Orthodontist, who will indicate the estimated time of treatment and resolve any questions. This first consultation with the Invisalign Specialist has no cost, nor any commitment at A2 Dental.

DO I HAVE TO TAKE SPECIAL CARE WITH WHAT I EAT?

In general, as opposed to with normal braces, you can eat as usual and there are no specific restrictions. This is because the aligners need to be removed when eating and therefore there is no reason to restrict food or drink.

CAN I SMOKE WITH THE ALIGNERS?

In the first place, it is important to highlight the harmful consequences of tobacco both for the oral tissues and in the body in general. In the case of smoking during the treatment, smoking whilst wearing the aligners is not recommended, since they can stain and obtain a bad taste.

DOES INVISALIGN HURT?

It is a painless treatment. Invisalign usually has a much shorter period of adaptation than with conventional brackets. Most people may notice some discomfort during the first days of treatment or when the aligners are switched out. This sensation should gradually disappear with the use of the aligner. The advantage of Invisalign is that, unlike conventional braces, there is no rubbing of the braces against the lip and therefore does not create traumatic ulcers.

WHAT HAPPENS IF I HAVE NOT WORN THE ALIGNERS ALL THE TIME I SHOULD HAVE?

It is very important to wear the aligners the 22 hours indicated, throughout the whole treatment. If for any reason, it has not been possible and you have worn them less time, you would be to speak with the specialist and will probably need to extend the use of some of the aligners to make sure that the correct movements are going to be carried out during the treatment.

HOW DO I CLEAN AND TAKE CARE OF MY INVISALIGN?

Both the Invisalign and teeth must be cleaned after each meal. The aligners are to be cleaned with a brush, water and soap. Additionally, cleaning crystals will be provided in the kit.

If you want to know more about Invisalign, click here.

If you want to know more about our specialist in Orthodontics, Dr. Morá, see his profile here.

If you would like to have an appointment for a free consultation with our orthodontist, contact here.