Details about All on 6 implantation, price and advantages of prosthetics on 6 implants

With a significant or complete absence of natural teeth, patients are faced with the difficult task of going through a painful, lengthy and expensive treatment process that involves the gradual replacement of each lost tooth. Moreover, with a long-term lack of teeth, bone tissue quickly succumbs to loss, which provokes the need for osteoplasty.

All-on-6 implantation, as evidenced by reviews, helps not only to minimize the costs and time required to restore lost teeth, but also eliminates increased tissue trauma during massive surgery.

The Implantmaster clinic employs implant surgeons of the highest category who have solid experience in the use of such unique techniques. In addition, they have in-depth knowledge and skills in working with special software, which eliminates any errors during the implantation procedure and guarantees a prolonged result.

Next, we will provide detailed information regarding the key advantages of this technique and the features of its implementation in practice.

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Content

1 What is All-on-6 dental implantation?

2 Pros of All-on-6 implantation

3 Difference between implantation of the entire upper and lower jaw on 6 implants

4 3D implantation planning All-on-6

5 Using a Surgical Navigation Guide for All-on-6 Implantation

6 Type of prosthetics for the entire jaw on 6 implants

7 What implants should be used when implanting All-on-6

8 Stages of the All-on-6 implantation method

9 Disadvantages of All-on-6 implantation

10 Photos before and after All-on-6 implantation

11 Other methods of full jaw implantation 11.1 Trefoil from Nobel Biocare - denture on three implants

11.2 NobelZygoma zygomatic implants – implantation without bone grafting

11.3 Straumann Pro Arch – all on 4-6 implants

11.4 Differences between All-on-4 and All-on-6 technologies when implanting the entire jaw

12 Price of All-on-6 turnkey implantation at Implantmaster dentistry

What are the advantages of the technique?

So, we already know that the use of All-on-6 or All-on-6 dental implantation technology involves the implantation of 6 implants on one jaw. Other characteristic features include inclined fixation of implants in the distal sections, a screw method of fastening the prosthesis and its fixation within a week from the date of surgery, the possibility of refusing bone grafting, as well as 3D modeling of each individual stage of treatment, up to the development and installation of a prosthetic structure . We will look at all this in more detail. But for now we will talk about the benefits that the patient receives. And, by the way, they can’t help but please!

One-stage protocols are becoming more and more popular in dentistry today, and this trend is quite justified. Such techniques have many advantages compared to classical two-stage technology. Here, for example, regarding prosthetics on six implants:

• the fastest possible results: you actually get new teeth in just a few days. If we ignore the preparation stage (and it takes from 2-3 days to a couple of weeks), then the whole process will take about 2-3 days. And this is for the installation of implants and subsequent prosthetics! It seems incredible, but the fact remains
• impeccable aesthetics: dentures look not just great, but incomparable and truly natural. Look at the photos before and after treatment - this is how patients are transformed. The contrast is especially noticeable among those who did not wear removable dentures, but walked for a long time with damaged teeth,

• the ability to quickly and effectively solve all your problems: you can chew, bite off foods and finally remember their taste (especially if you previously had removable dentures that covered the roof of your mouth). You can finally forget about sore gums and bad breath. New teeth will not only be beautiful, but also work – truly and without restrictions,
• correction of the bite and ensuring the correct load: a competent doctor will definitely make sure that the new dentures are comfortable, evenly distribute chewing pressure and thereby normalize the functioning of the jaw joint. Yes, it may be a little unusual at first. But improvements will become noticeable within a few days,
• the ability to carry out treatment in the presence of periodontitis and loss of jaw bone: this means that you can forget about complex and expensive treatment and all the problems associated with these diseases,
• a chance to avoid complex and expensive bone grafting,
• minor tissue damage and quick recovery: because in most cases, implants are placed through a puncture. The process is also facilitated by templates through which the structures are implanted into the bone,
• minimizing any risks of errors and inaccuracies through the use of advanced 3D modeling technologies (read more about this below),
• wide possibilities of prosthetics.

As an additional bonus, it is worth highlighting the rejuvenation effect. After installing new teeth, wrinkles, which most often result from the absence of a large number of teeth and malocclusion, are noticeably smoothed out. You can also see this in the photo. Many older patients note in their reviews that their wrinkles around the mouth have smoothed out, and the lips themselves have become noticeably fuller. However, this is not a plus specifically for the All-on-6 implantation technology, but a pleasant bonus for any high-quality dental restoration.

What is All-on-6 dental implantation?

The “All on 6 Implants” technique is an improved modern method of restoring missing teeth, which involves the use of six dental implants. Moreover, two of them are fixed in the frontal region, and the remaining four are installed in the area of ​​the chewing teeth. This procedure uses a screw type of fastening and Multi-unit abutments.

The inclined position of the lateral implants helps to select areas with sufficient bone tissue. In this case, the doctor is able to bypass the nerve endings and maxillary cavities located in the immediate vicinity of the implantation site and which are subject to significant risk when implementing the traditional technique.

In the process of the above procedure for prosthetics of the upper jaw, zygomatic implants can be used: two-piece Zygoma. Thanks to their use, it is possible to restore lost units even with a clearly noticeable absence of bone tissue.

This protocol can be used as part of a one-step technique, with simultaneous fixation of dental systems and dentures. That is, a non-removable orthopedic structure can be installed on the third day after surgery. This allows patients to return to their work schedule in the shortest possible time and without long downtime.

Why do sixth teeth need restoration more often than others?

The sixth teeth (or first molars according to dental classification) are classified as molars. They are laid at the 5th month of intrauterine development, mineralization begins from the 9th month of the intrauterine period, and continues for another month after the birth of the child. The enamel of the “tooth germs” located in the jaw bone finally matures by 1-2 years. The correct formation of molars depends on the course of pregnancy and childbirth.

Molars do not appear at an early age; they do not have predecessors (baby teeth). They begin to erupt at 5-6 years of age, the first of the permanent radical units. The structure of the first molars differs from other teeth of the chewing group - the maxillary sixes have three roots and four canals, the mandibular sixes have two roots and three canals. These are the largest molars, characterized by a wide tuberous surface.

The chewing group, in particular the first molars, are most susceptible to the destructive effects of bacteria and excessive mechanical stress. This is the main cause of irreversible damage to the tooth structure and its loss.

Pros of All-on-6 implantation

Currently, All-on-6 implantation is popular in many countries around the world due to the following advantages:

• Aesthetic indicators. A fixed prosthesis on 6 implants has a natural appearance that matches natural teeth. In this case, two design options can be used - permanent and adaptive. The period of operation of the adaptive prosthesis can reach 24-48 weeks, after which it is replaced with a more durable and aesthetic permanent bridge. One of the most important advantages of the All-on-6 procedure is the ability to fix a permanent type structure immediately, without the need for further re-prosthetics;
• Shortened treatment period. The entire process of prosthetics, including all necessary studies and fixation of implants using the All-on-6 method, takes no more than three days;
• The versatility of the technique. In dentistry, implants using the “All on 6” technology can be fixed even in the presence of serious pathologies in the area of ​​periodontal tissue. In this case, an obligatory stage of the procedure is the extraction of teeth and cleaning of the sockets, and the installation of dental systems is carried out in the deeper layers of bone tissue, which is not affected by the inflammatory process;
• Low degree of traumatization. When implementing the above described technique, there is no need for osteoplasty. Since implants are installed in harder areas of bone tissue, the All-on-6 procedure in Moscow can be performed even with significant jawbone deficiency. This eliminates the need for massive trauma to the gingival tissue;
• Affordable price. Installing only 6 implants contributes to significant savings in treatment costs;
• Rapid restoration of functional characteristics. The patient becomes able to chew food within the first few days after the intervention and fixation of the prosthesis, and a return to a normal eating schedule occurs within 30-60 days;
• Ease of use and high reliability. The installed orthopedic design does not require special care rules. Moreover, it is easily removed from the oral cavity in dentistry if cleaning or relining is necessary. It should also be noted that the material from which the prosthesis is made can be easily adjusted in the patient’s oral cavity.

Indications for implantation of All-on-6 –

It is possible to identify a large group of patients in whom installing a fixed prosthesis on only 4 implants is downright recklessness. And although (in fact) the All-on-4 technique is quite reliable and predictable, it still requires careful selection of patients, and ignoring contraindications inevitably leads to overload of the lateral implants and failure of the entire structure. Let's see who exactly we are forced to offer All-on-6 implantation and prosthetics.

1. If you are a man under 50 years old, or regardless of gender and age, you have large jaws and well-developed chewing muscles. In addition, it is worth adding here patients with bruxism (hypertonicity of the masticatory muscles), as well as if you are going to chew something harder than salad, porridge and cutlets made from finely minced minced meat. If in all these cases we do only All-on-4, then we will certainly get overload and rejection of the lateral implants.
2. If you have a critical amount of available bone.
   Lack of bone volume means that we will have to install dental implants of smaller length and diameter, which consequently reduces the amount of safe chewing load that they can withstand (without starting to destroy the bone tissue around the implants). For example, with the All-on-4 technique, the optimal length of lateral implants is 18 mm, satisfactory – 15 mm, critical – 13 mm. For example, we need to perform All-on-4, and we are only able to place lateral implants with a length of 13 mm. We can install them without fear only on a dandelion grandmother with small jaws, knowing in advance that she will not chew anything harder than sausages. But for other patients in the same situation, we will recommend a prosthesis with only 6 implants. By the way, the implant manufacturer also plays a big role here. For example, if Nobel Biocare and Straumann have implants with lengths of 15 and 18 mm in their line, then Osstem has a maximum length of only 13 mm (draw your own conclusions).
3. If we are talking about a toothless upper jaw, and you have too soft porous bone there. This prevents the implants from achieving good primary and secondary stability and creates a risk of implant failure. After all, do not forget that implant healing will occur under the influence of chewing load. And in this case, the “all on 6 implants” technique will in fact also be more reliable and preferable.
4. Bite and length of the prosthesis.
   With All-on-4, we install implants in the tooth position 5-2|2-5, and thus it turns out that the 6th teeth in the prosthesis will be made in the form of overhanging consoles. Accordingly, the latter already increases the load on the lateral implants. But there are a number of patients in whom (due to the relationship of the jaws) we are simply obliged to add 7 teeth to the prosthesis. If we make 6-7 overhanging consoles on each side at once, then we are guaranteed to overload the lateral implants. And for these patients we will also recommend All-on-6, and in this case the implants will be installed in the tooth position 6-4-2|2-4-6, and thus only the 7th teeth will be in the form of overhanging consoles in the fixed prosthesis .

Conclusions: in general, if the financial side of the issue is not the main thing for you (and you can afford to install a fixed prosthesis on 6 implants), then in any case it is better to install it on 6 implants, and not on four. In fact, this significantly reduces the risks of overloading the lateral implants and their loss along with the prosthesis, and increases the service life of the entire structure. I hope that our argument was clear to you.

How All-on-6 implantation is performed (animation):

Our team of doctors

Maxillofacial surgeon, Implantologist

Bocharov Maxim Viktorovich

Experience: 11 years

Dental surgeon, Implantologist

Chernov Dmitry Anatolievich

Experience: 29 years

Orthopedist, Neuromuscular dentist

Stepanov Andrey Vasilievich

Experience: 22 years

Endodontist, Therapist

Skalet Yana Alexandrovna

Experience: 22 years

Orthopedic dentist

Tsoi Sergey Konstantinovich

Experience: 19 years

Dentist-orthodontist

Enikeeva Anna Stanislavovna

Experience: 3 years

Which implant to choose if there is no molar

The artificial root for the 6th tooth must be reliable, and the crown part must be functional. The dentist will help you choose the most effective type of construction, based on the diagnostic results. Depending on the shape, implants are classified into:

• root-shaped - cone-shaped rods, indicated when there is sufficient volume of the jaw bone;
• lamellar - firmly fixed in the jaw due to its large area, therefore suitable for prosthetics with a lack of bone mass;
• combined - a combination of root-like and plastic in one.

When selecting an implant, the following are taken into account:

1. Length (from 6 to 16 mm). Determined by the structural features of the jaw.
2. Surface . Rods with a rough or porous surface coated with a special coating take root faster.
3. Type of thread . Products that combine different types of threads are characterized by a high degree of osseointegration.
4. Material . The most popular implants are made of titanium. For the production of more expensive structures, zirconium dioxide is used.
5. Method of connecting an implant to a crown . It is important that the connection is tight, which will prevent the formation of micro cracks and the penetration of microbes inside.
6. Survival rate, service life, certification.

In some situations, 2 implants can be used to restore the 6th molar. Thanks to this, the chewing load on each of them will be reduced, and it will be distributed more evenly across the crown and jaw.

Difference between implantation of the entire upper and lower jaw with 6 implants

This protocol can be implemented in practice using the following two methods:

• In the lower jaw: the bone in this area is of higher quality and is less susceptible to loss. Moreover, there are no maxillary cavities, which greatly simplifies the procedure for fixing dental implants. This means that a traditional technique can be used in the lower jaw area - two-piece models are installed, which uses a screw fixation method and special Multi-unit abutments. If there is a significant absence of bone tissue in the lateral area, implants can be implanted at a certain angle;
• In the area of ​​the upper jaw: in this case, there is a more massive loss of bone tissue. Consequently, the requirements for the number and size of dental units are increasing. That is, as part of the “All on 6 Implants” program, zygomatic models of 2, 4 and 6 pieces can be used. This allows the technology to be used even in the absence of significant bone tissue.

What implants can be used

For moderate jawbone atrophy, two-piece models from Nobel and Straumann are usually used. These are products from leaders in the production of modern systems, designed specifically for the use of immediate load protocols (of course, some models). The implants are attached in a completely classical way - in spongy bone. But in a number of situations - at an angle, so there is no need to increase it.

A special type of thread and a unique coating promote rapid fusion of the structure with bone tissue. That is, they have excellent primary fixation - it is much higher than many other similar brands. Due to this, it is possible to install a prosthetic structure, if not on the day of the procedure, then certainly within a couple of days. In addition, as mentioned above, this concept provides for the possibility of fixing zygomatic implants. More often, experts prefer the NobelZygoma model, but in some situations they also resort to the one-part Oneway Biomed, which in turn has a smooth neck and antibacterial coating, providing excellent prevention of peri-implantitis[ii].

That is, depending on the clinical picture and financial wealth, you may be offered the concept of two-part implants, one-part Biomed (all six pieces), as well as a combination of them. If the atrophy is severe, then the complex can be supplemented with long zygomatic implants. What exactly to choose? This question should be asked directly to your doctor - only after diagnosis he will be able to tell you what exactly is suitable in your situation.

As for one-piece implants, this is only the Oneway Biomed brand. Most often, the models are used for basal implantation, but if the situation allows, they can be supplemented with the all-on-6 complex. Their peculiarity is a special type of coating (there is no roughness, it is smooth), so that such implants can come into contact even with inflamed gums - plaque and bacteria will not accumulate (accordingly, they are safe for periodontitis and periodontal disease). In addition, they are longer than usual, so they can be placed deep into the bone - using sections that are not subject to resorption. This is the basal base, the outer alveolar plate. Let us repeat that they can also be attached to the zygomatic bone (as well as the pterygoid and chin). They are securely attached precisely due to these properties.

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Currently, market leading manufacturing companies are targeting their production facilities towards immediate load protocols. Today, these companies supply world markets with high-quality implants designed specifically for one-stage treatment. Because they understand that there is demand from patients.

In order to save money, the patient may also be offered the installation of a prosthetic structure on two-piece OSSTEM implants (South Korea). Each of the presented brands has been on the market for quite a long time, during its existence it has managed to prove the unconditional quality and safety of its products. It is very important not to choose other implants because their effectiveness with immediate loading has not been proven! Although the price may seem very, very attractive.

3D implantation planning All-on-6

A one-stage technique involves performing manipulations on a limited area - in the absence of sufficient bone tissue. In this case, the correct selection of the site for the implant is of particular importance, which will allow for maximum initial stability and avoid damage to the nearby maxillary sinuses and nerve endings.

As part of planning the treatment process, 3D computer modeling technology is used. A mandatory stage of the preparatory procedures is, which allows you to study the quality and size of bone tissue in three-dimensional format. In the case of zygomatic implant models, patients are also recommended to undergo multislice tomography. With its help, it is possible to obtain a more detailed image and more carefully consider the procedure for fixing dental systems.

The results obtained during computed tomography are entered into a special computer application. This allows you to select structures that are optimal in shape and height, as well as select more suitable areas for their installation.

In our activities, we use several modern programs that help to best implement three-dimensional visualization technology and eliminate any errors when fixing dentures on 6 implants.

How is preparation for treatment carried out and what is 3D modeling

Prosthetics on six implants, however, like other Immediate load implantation methods, is often carried out in difficult conditions, when there is bone atrophy (and very uneven), when there is tissue inflammation. Therefore, it is extremely important to avoid mistakes here. So the use of one-stage treatment techniques involves three-dimensional modeling of each individual stage. This is called planning. If a doctor does not use such technology, then there is a very high risk of making mistakes, because The initial situation is (we repeat) complex.

Even at the preparatory stage, the patient must undergo a computed tomography scan of the jaw, the results of which will provide the specialist with a complete picture of the condition of the bone tissue in three dimensions. Moreover, not traditional cone-beam tomography, but even multislice tomography may be required, the need for which usually arises when using zygomatic implants .

Patient history:

“I have had constant problems with my teeth since childhood. Already in adulthood they began to literally crumble. At first I walked for a long time with a conventional prosthesis, which had to be constantly adjusted. Then I finally decided to undergo all-on-6 implantation based on reviews, friends recommended your clinic. And I didn’t regret the choice I made at all. Not only did I get straight, beautiful teeth a few days after the operation, but I also didn’t need any bone grafting, and it was this procedure that really worried and scared me. I had 6 implants placed on my upper jaw. At the same time, the process itself took very little time, it was not painful at all. Before this, of course, I had to run around to different doctors, collect all the permits, get x-rays done and undergo tests, but this fuss is simply nothing compared to my new smile. Low bow to my doctors!”

Dmitry Vladimirovich R., 53 years old, Moscow

After passing all the necessary diagnostic procedures, the obtained data is loaded into a special computer program. With its help, the doctor can select the optimal models of implants, as well as select the most suitable points for their introduction into the thickness of the bone tissue.

Read on the topic: the benefits of 3D implantation and how it is carried out.

Some clinics go even further - they use a three-dimensional printer to create real plastic models of the patient’s jaw system. They actually train on them to place implants. On the one hand, it may seem that this is stupid - as if the doctor does not know how to work with instruments. But on the other hand, this is a real opportunity to see how the implants will behave, to go through the entire process again from start to finish, so as not to make any mistakes at the stage of actual installation. After all, the nerves are nearby, and the sinuses are nearby - due to the fact that there is little bone. These are truly difficult conditions.

This whole process remains behind the scenes - it is invisible to the patient and it seems that preparation for implantation is very simple and quick. But while you are at home, while you are getting ready for treatment, the doctor is not sitting idle - he carefully measures his every step so that you get the result you deserve. Only in the positive sense of this phrase.

Using a Surgical Navigation Guide for All-on-6 Implantation

As is known, when using two-piece implant models, the traditional flap technique is used, in which part of the gingival tissue is detached with the further creation of a bed for the dental structure.

In this situation, Implantmaster dentistry uses special surgical templates, which are manufactured on an innovative 3D printer in the laboratory. After their installation, high precision fixation of dental implants is ensured, and the need for exfoliation of part of the gum tissue is eliminated. We are talking about implementing a minimally invasive method, which eliminates extensive tissue trauma.

Single-component models are fixed in a similar way - they are installed based on the application of the above protocols, without massive intervention.

However, in both cases, the dental structure is twisted into the bone, which prevents it from falling out of the socket and promotes increased initial stabilization.

Learn more about the surgical navigation template »

How are implants installed?

When using two-component models, the implantation process is carried out using the traditional patchwork method and is minimally invasive. With a flap procedure, the implant surgeon peels off a small fragment of gum tissue from the bone, after which he forms an implantation bed. On the other hand, the use of special surgical templates for the most accurate placement of implants allows one to avoid such extensive surgical intervention - the structures are implanted by puncture (minimally invasive), without the need for preparation of the gums and its subsequent suturing.

One-piece one-piece models are implanted in a similar way. In both cases, the structure is literally screwed into the thickness of the bone tissue, which makes it possible to achieve high levels of primary stability and eliminate the risk of implant loss. Since the installation is gentle, the rehabilitation will be quick. This, by the way, is a big plus for elderly patients and people with chronic pathologies and weak immunity - there are no restrictions on treatment.

Type of full jaw prosthetics on 6 implants

By contacting the Implantmaster clinic, you can count on the installation of orthopedic structures two days after the fixation of dental implants. The development of an individual prosthesis is carried out directly during 3D modeling, and its installation on implants is carried out after fitting and adjusting the base of the structure.

Several days before the bridge is fixed are necessary to restore the gums, study the indicators of the initial stabilization of the implants and control the quality of the treatment procedures performed. If the patient urgently needs to have teeth installed using the All-on-6 technology, that is, on the day of the visit to the specialist, it is possible to install a temporary acrylic structure that does not have a metal base, or to adapt a removable bridge that was previously fixed.

But do not forget that when using both types of prostheses, you will need to observe certain prohibitions in eating, since there will be an increased load and, as a result, a high probability of their shifting. In turn, if there is a metal base in orthopedic structures, it will be possible to obtain the necessary stabilization of the implants and achieve their reliable fixation.

Therefore, in this case, the more preferable option is to use a permanent type structure with a metal base. Due to it, it is possible to obtain a more effective and accelerated process of osseointegration, which is facilitated by increased stabilization.

There are two types of such prostheses: made of ceramic-composite material or with the use of plastic crowns. The first option is more budget-friendly, however, despite this, it is considered to be of quite high quality, which is due to the use in modern laboratories of advanced plastic materials with the addition of diamond chips. This has a positive effect on the strength of the structure and allows you to obtain the required shade and natural shine. The service life of such prostheses can reach 3 years, after which they require immediate replacement.

As for durability, the most advantageous here are prostheses made of ceramic composite. Despite their inflated cost, in this case the operational period will be over 5 years, and it will be possible to eliminate the need for re-prosthetics.

In both cases, acrylic gum is provided, thanks to which it is possible to mask the imperfections of the natural mucous membrane, as well as prevent the negative impact of the external environment on the gum tissue.

Prosthetics on six implants

A key feature of All-on-6 implantation, performed in Moscow clinics, is the possibility of immediate fixation of a non-removable prosthetic device. That is, within 48-72 hours after surgery, you will have a non-removable orthopedic structure installed, allowing you to immediately begin the process of chewing food.

But you should remember that initially you will be fitted with a permanent, temporary prosthetic device. Such an adaptive design is included in the All-on-Six price set by the dentist at the initial stage of treatment.

In turn, permanent fixation is included in the additional payment.

Thus, All-on-6 turnkey implantation and the price of this procedure will be determined not only depending on the rating of the manufacturer of dental structures, but also on the material from which the prosthesis intended for temporary use is made. Its design may or may not have a metal base:

• An adaptive prosthetic device without the use of a metal base. Fixation of such an orthopedic structure is performed no later than three hours after surgery. This prosthesis is famous for its ease of production, but you can start using it only after 20-24 weeks, after which the structure is replaced by a non-removable device. If the patient prefers Nobel Biocare dental systems and a temporary prosthetic device without the use of a metal base, the price for dental implantation will be close to 400,000 rubles.

However, it is not recommended to use the above technique for people with a massive jaw system and well-defined chewing muscles, with involuntary muscle contractions, as well as for those who like frequent and long trips. This is due to the increased likelihood of fracture of a prosthetic device without a base.

• Adaptive prosthetic device using a metal base. Such a prosthetic structure is fixed to dental implants only 48-72 hours after surgical manipulation, which is due to the labor-intensive process of its production. However, the metal frame makes the prosthetic device reliable and highly durable, and increases its service life to 3 years. Provided that the Nobel Biocare systems and an adaptive type prosthetic device with a metal base are used - All-on-6, turnkey implantation will be performed at a cost of about 500 thousand rubles.

If a man is planning to restore missing teeth, it is better to give preference to a prosthetic design with a metal base.

If the proposed method of fixing a temporary prosthesis does not suit you, you can prefer the basal implantation technology, within which it is possible to fix a non-removable orthopedic device with an absolute lack of teeth already 72 years after the intervention.

Our clinic’s specialists are focused on the use of modern technologies and have the skills to successfully implement them, which allows the patient to choose the most appropriate method of dental restoration.

What implants should be used when implanting All-on-6

When the “All on 6 implants” procedure is performed, subject to the presence of optimal bone tissue sizes , two-piece models from well-known manufacturers Straumann and Nobel are used. An important feature of such implants is the use of special threads and an improved surface, which makes it possible to activate the process of bone formation. This indicates the possibility of installing permanent orthopedic structures within a short period of time after the intervention - approximately 14-21 days. This also uses NobelZygoma zygomatic implant models.

If you are interested in the option of restoring lost teeth at a more affordable price, then the best option would be a bridge with 6 two-piece Dentium implants.

Implant models

To carry out implantation using the All-on-6 method, two-piece implant models are used. The presence of a special antimicrobial coating helps prevent the proliferation of harmful bacteria, which makes it possible to avoid the development of peri-implantitis1 and inflammation of soft tissues. However, this all depends on the brand of implants. For example, Nobel models have a unique porous TiUnite coating, Straumann are distinguished by the presence of a bioactive hydrophilic surface SLActive - it is largely thanks to such innovative developments that implants take root faster. These are the brands that are best suited for this protocol.

We mentioned earlier that zygomatic implants are also used for this method. They are in the line of the manufacturer Nobel and are called Zygoma (Zygoma). Among all similar models, they were the first to appear on the market, so the recommendations of experts boil down to the fact that it is best to choose zygomatic implants from the Nobel brand, because they are the best and have undergone numerous clinical studies.

Zygoma implants

In addition to the implants themselves, abutments are a mandatory element. They are mounted on top of titanium pins and are designed to fix the prosthesis. This approach uses innovative models: multi-unit. Firstly, they can be inclined. Secondly, multi-unit primarily means that such abutments are designed for screw fixation. What it looks like: they go inside the implant. But inside the abutments themselves there is also a cavity - for a screw that is screwed through the crown or prosthesis.

This is a very important aspect, because it is this approach that makes it possible to reline the prosthesis, and this will definitely be required at first, because the bone regenerates, is restored, and the structure is adapted to the patient’s bite. In addition, the prosthesis may be a little uncomfortable - so it can also be adjusted.

Stages of the All-on-6 implantation method

1. Preparation. Before installing dentures on 6 implants, the necessary laboratory tests are carried out. A CT image is also taken, which allows you to accurately determine the area in the jaw for fixation of the dental structure and create a treatment plan in digital format.
2. Surgical intervention. The most successful result can be obtained if a special navigation template is used. This ensures maximum accuracy of fixation of dental structures and a clear angle of their inclination. To make this template, an impression taken from the patient’s jaw is used (performed using a 3 shape digital scanner). In addition, special recesses for metal guides are formed on the specified template. They exactly correspond to the inclination, position and size of future dental structures. Regardless of the use of the above surgical device, during surgery in dentistry, 6 implants are fixed to you. After the procedure, the patient rests for some time, and the dental technician at this time is engaged in the manufacture of a permanent bridge structure using 10-12 crowns, intended for temporary use.
3. Fixation of the temporary structure. Some time after the surgery, the patient will have a non-removable non-removable structure fixed in place. Over the next 14 days, you will need to re-visit the dentist for suture removal and secondary control by a specialist. In this case, it is allowed to take products of medium hardness, which will speed up the process of osseointegration of dental implants.
4. Installation of permanent structures. At this step, the permanent dentures are fixed. However, at least 12-24 weeks must pass before it is replaced. Some patients, for financial reasons, wear such structures for a longer period, which is considered quite acceptable. As for the length of the permanent structure, it can already reach 12-14 crowns and will be made of zirconium or metal-ceramic material. In this case, the most aesthetic option is metal-free ceramics.

How is prosthetics performed?

A prosthetic device, which is fixed immediately after implantation (surgery), is developed at the computer planning stage. At least its basis is approximate parameters. In most cases, it is necessary to wait at least a few days after surgery - this time is necessary for minimal restoration of soft tissues and to check how firmly the implants are fixed in the bone.

In certain situations, when it is extremely important for the patient to obtain results as quickly as possible and the clinical situation allows, a temporary prosthetic structure can be secured on the day of the operation. However, in this case, an apparatus without a metal frame is used, because there is no time left for its manufacture. It is also possible to adapt a removable denture that the patient previously used. But many practicing doctors do not recommend this approach, since the prosthesis will not fasten the implants, which means you will have to seriously limit yourself in food - otherwise there is a risk of displacement of the implanted structures.

Regardless of whether the denture structure has a metal base, it will be equipped with acrylic gum, designed to hide the uneven gum margin and provide an aesthetically pleasing smile. In addition, it serves as reliable protection against external damage, which is especially important for patients with signs of periodontal inflammation.

Disadvantages of All-on-6 implantation

Considering the All-on-6 technology, as well as its pros, cons and patient reviews, we can conclude that this protocol can only be used for average bone loss. If there is no significant amount of bone tissue, the procedure may be ineffective, since the specified number of implants will not be enough to hold the bridge on the jaw. The only solution may be to fix the cheekbones of NobelZygoma models, but this manipulation can hardly be called budgetary.

Moreover, a prosthesis on 6 implants, which is also confirmed by reviews, must be installed by specialists of the highest category who have the skills to work with one-step methods and can competently draw up a treatment plan using special computer programs. In other situations, the “All on 6 implants” procedure can be carried out in Moscow with significant errors and errors, which will cause the likelihood of severe consequences in the future.

A few words about prices

The full cost of an operation using the All-on-6 protocol depends on a number of factors, including the selected type of implants and prosthesis, the condition and volume of bone tissue, as well as the pricing policy followed by the dental clinic. The price also varies depending on the brand of structures used. Restoring the integrity of one row of teeth can cost from 450 thousand rubles.

When preparing the material, information was used from the websites of dental clinics that specialize in implantation with immediate loading: www.smile-at-once.ru, www.starsdent.ru, as well as from dental portals www.startsmile.ru and www.24stoma .ru.

1. Based on research conducted by the International Implant Foundation.

Other full jaw implantation techniques

If you consider All-on-6 turnkey implantation an expensive procedure, installing removable structures may be a more economical option. But it is not recommended to use such orthopedic products for constant wear. This is due, first of all, to low aesthetic characteristics. Secondly, due to improper load distribution during use of such prostheses, there is a possibility of bone tissue loss. As a result, adjustments to the structure may be required to eliminate the resulting discomfort.

Next, we will talk in detail about similar implantation methods, which are more advantageous compared to the use of removable structures. These include the immediate Trefoil procedure, the Straumann Pro Arch technique and the NobelZygoma zygomatic technology.

Trefoil from Nobel Biocare - prosthesis on three implants

Among the innovative developments of the Nobel Biocare company is the Trefoil technique, thanks to which it is possible to fix a permanent permanent structure not after 16-20 weeks, but on the second day after surgery. This allows you to save money on installing a temporary prosthesis.

Moreover, the effectiveness of the final result is affected by the use of a beam structure, which helps eliminate errors in the deviation of dental systems from their optimal location, determined by the doctor. In this case, the load-bearing beam can be made in advance, and the installation of an orthopedic structure intended for permanent wear can be performed within 1 day after surgery

NobelZygoma zygomatic implants – implantation without bone grafting

This implantation is prescribed for patients who have partial or complete lack of teeth. Also, the above situation may be associated with loss of bone tissue due to the wearing of removable dentures or the prolonged absence of natural teeth.

A distinctive feature of the technique is the use of elongated transzygomatic implants. They have the ability to overcome several layers of the jaw and fix directly into the zygomatic bone. Due to this, it is possible to eliminate the need for a sinus lift and, in the absence of restrictions, install a prosthesis a few days after surgery.

The conditions for performing the above procedure are:

• Absence of teeth in the chewing zone of the maxillary region;
• Partial or complete absence of teeth in the upper jaw;
• The presence of inflammatory phenomena in the area of ​​periodontal tissues;
• Damage to the jaw bone after cancer, injuries and accidents;
• Significant loss of bone tissue in the lateral area;
• Inability to perform sinus lift;
• Patients of the older age category;
• The need for urgent restoration of the aesthetic and functional characteristics of teeth.

Straumann Pro Arch – all on 4-6 implants

Currently, the manufacturer Straumann offers patients an innovative treatment method, thanks to which it is possible to fix the implants at an angle, and on the same day install a fixed-type orthopedic structure.

Another unique development of the company is the Pro Arch TL technique. It is used in cases of complete absence of natural teeth. In this case, All-on-6 implantation is carried out on a turn-key basis, and the dental units are fixed in a strictly parallel and vertical position in relation to each other. As for the area with insufficient bone tissue, special implant models that have a shorter length are used here.

Indications for performing this technique are:

• The patient has absolutely no teeth;
• The presence of decayed teeth subject to extraction;
• The presence of inflammatory processes in the area of ​​periodontal tissues;
• Slight loss of bone tissue in the lateral sections;
• Slight loss of bone tissue in the area of ​​the front teeth.

What is the essence of the method

The considered method of replacing missing teeth involves the installation of six two-piece implants with a special type of abutment. Two implants are implanted in the front area of ​​the jaw, while the remaining four are fixed in the lateral areas, in the area of ​​the chewing teeth. Preliminary bone grafting is not required, because the implants are installed on the sides at an angle, which makes it possible to minimize the risk of injury to the nerves and sinuses.

Implantation using the all-on-6 protocol

It is interesting that sometimes (if the doctor knows this technique and if the patient has pronounced bone atrophy), zygomatic implants can be additionally used on the upper jaw. They reach a length of 5-6 cm and are attached to the cheek bone, which is located in the cheek area and in front of the ears. It is incredibly strong and does not undergo changes in volume and structure, so with this approach it is often used for attaching implants.

For information: 2, 4 or even all six zygomatic implants can be used as part of this protocol. Their introduction, of course, significantly increases the cost of implantation. But at the same time, it allows us to solve the problem of extremely pronounced atrophy, which is a very, very significant plus.

“I have been struggling with my teeth since childhood. For as long as I can remember, I constantly wandered around dental clinics. But time passes, I’m not getting any younger, so at some point the question arose about a radical solution to the problem. After a long study of all possible options and communication with specialists, I chose implantation using the all-on-six method. It was, of course, scary, because all my friends who have implants said that the treatment was very long, but then they promised that in a week I would be walking with new teeth. Honestly, I was incredibly happy and impressed that after 5 days I was fitted with a prosthesis, which, by the way, is very cool and doesn’t stand out at all. While I’m still going with him, about a year has passed. In general, everything is great, I’m just happy! And I sincerely don’t understand those people who are forced to wear removable dentures after they received implants, because there are such excellent methods!!!”

Marina, Moscow, fragment of a review on the website irecommend.ru

The treatment protocol under consideration refers to one-stage implantation methods. A non-removable orthopedic structure is usually fixed within a few days after implantation. Such an impressive rate of treatment allows the patient to return to a normal lifestyle in the shortest possible time.

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Differences between All-on-4 and All-on-6 technologies when implanting the entire jaw

All-on-6 implantation, performed in Moscow, is considered an improved version of the All-on-4 technique. However, in the first case, there is a more optimal distribution of chewing pressure, which is facilitated by an increased number of dental implants. As a result, the fixation strength of the orthopedic structure is significantly increased.

Read more about All-on-4 implantation »

The sixth tooth from the top - features

The upper jaw consists of a body and 4 processes. The bone here is less dense than on the bottom. The teeth of the lateral sections are located close to the maxillary sinus, so a sinus lift (a procedure to raise the bottom of the sinus) is often performed before implantation.

The teeth on the side of the jaw are called molars. They are most susceptible to caries due to increased stress and accumulation of food debris, which are difficult to clean out. The structure of chewing teeth differs from those located in the smile zone. Chewing ones have a wide horizontal plane, 2 tubercles, strong thick enamel, 2 or more roots. The artificial tooth must exactly replicate these features.

Turnkey price for All-on-6 implantation at Implantmaster dentistry

The turnkey All-on-6 implant price listed below includes a CT scan, diagnostics, 3D planning and laboratory testing performed prior to surgery. Moreover, the price for fixed dentures on 6 implants includes a lifetime warranty from the manufacturer, and we also have a 10-year warranty on the dentist’s work. In addition, you can expect to receive an annual dental checkup for 10 years.

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How is the All-on-6 surgical stage performed?

We have already said above that the surgical stage of All-on-6 implantation implies that the implants are installed in the teeth position 6-4-2|2-4-6. The installation of implants can be carried out using 2 different types of surgical techniques, which will greatly affect the duration and traumatic nature of the operation. We have the following 2 surgical techniques with which All-on-6 implantation can be performed...

• using a surgical template,
• classical technique (without using a template), which implies the need to make incisions in the gums and detach the mucoperiosteal flaps from the bone - followed by suturing at the end of the operation.

a) Implantation with an individual surgical template –

For the patient, this is the most non-traumatic and comfortable version of the operation, and in this case, for the installation of 6 implants, about 45 minutes will be enough for us. An individual surgical template is something like a transparent mouthguard, which at the beginning of the operation is fixed to the toothless jaw using pins. In such a template, special guides will be made for the pilot drill or cutters, with the help of which the implantologist will form a bed for each of the implants.

This template is individual for each patient, and the position of the guides for the pilot drill and cutters is calculated and modeled in a special program on the computer where your CT scan is loaded. Thus, taking into account the topography of the bone tissue in the image, we can model the ideal position of the implants in the jaw, and then the position of the guides in an individual surgical template (this can be a “Nobel Guide” or similar).

All this will allow us to install 6 dental implants in the ideal position - without making incisions and peeling mucoperiosteal flaps from the bone. We will install implants only by making small holes in the mucous membrane. But, if we didn’t have a template, then the implant surgeon would have to see the surface of the jaw bone tissue with his eyes to install implants, and for this he would need to peel off the flaps (gum) widely.

Operation progress (with Nobel Guide template) –

Advantages of surgery with the NobelGuide surgical template:

• The operation lasts only about 45 minutes,
• no need to peel off mucoperiosteal flaps - makes the operation not only quick, but also easily tolerated even in elderly patients, and in addition - in the postoperative period there will be no severe pain, hematomas, swelling of the soft tissues of the face,
• the risk of complications (injury to nerves, maxillary sinuses) is reduced due to the fact that the template allows you to bypass dangerous anatomical formations,
• very often, the presence of a template allows you to do without bone grafting (even in patients with severe bone volume deficiency) - due to super-precise positioning of implants in the jaw bone tissue,
• This implantation technique can be performed even in patients with osteoporosis and diabetes mellitus, and is also optimal for patients with a complicated medical history (for example, in the presence of cardiovascular and other diseases).

b) Classic All-on-6 technique with flap detachment –

If we do not make a custom surgical guide, then to install the implants we will need to see the surface of the bone, which means we will simply have to make incisions and widely peel the gum from the bone. Below we will show you the progress of the All-on-6 operation on the upper jaw, where at the time the operation began, the patient had 6 front teeth with a high degree of mobility in the jaw (these teeth were removed at the very beginning of the surgical operation).

Classic technique of All-on-6 implantation –

* Please note that in addition to removing mobile teeth, the surgeon made incisions along the alveolar ridge of the jaw, after which mucoperiosteal flaps were detached from the bone. After this, the patient had 6 Straumann BLT implants installed, and the gums were sutured. It is worth noting that in this patient the flaps were folded back quite sparingly, because The patient had no noticeable loss of bone volume. Usually the flaps are folded back much wider, and this is what causes quite severe pain, swelling and bruises after surgery.

In addition, the need for flap detachment also leads to a longer healing period. Stitches applied are usually removed on the 10th day. And at the very end of the operation, the implant surgeon will screw the so-called “Multi-unit” abutments into the implants, which are the gold standard for permanent prosthetics of toothless jaws. Immediately after fixing the multi-unit abutments, the patient is sent to an orthopedic dentist for the manufacture of a temporary fixed adaptive prosthesis.

Minimal tissue trauma is the key to quick rehabilitation

If two-piece implants are used, their installation is usually carried out using the classic flap method, i.e. with peeling of the gums from the bone tissue, followed by the formation of a bed for a titanium structure. However, at this stage, in most situations, we use special surgical templates - they are printed on a latest generation 3D printer directly in our dental laboratory. They are fixed on the entire dentition and allow not only to install implants as accurately as possible, but also to prevent gum peeling, i.e. carry out minimally invasive implantation, without incisions and sutures2.

The installation of one-piece implants is carried out according to a similar scheme - they are implanted into the bone using a tissue protocol, again without massive incisions.

But in both situations, the implant is screwed into the bone, as a result it is not lost or removed from the socket, but is compacted around the structure - a compression effect is triggered. This is one explanation why implants have high primary stability.

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Patient history

“They brought me back to life! Despite the complicated picture of bone tissue atrophy and all the difficulties that I had to endure, I don’t regret at all that I didn’t give up and found doctors and a clinic that helped me. Thanks to my doctors. I’m younger, my whole life has changed!”

watch a video with the patient

Implantation of 6 teeth

The implant on the sixth tooth is installed more often than others, since it is a “running” tooth, that is, it actively participates in chewing, and therefore deteriorates faster than others. As a rule, the restoration of the sixth tooth is performed using the classical (two-stage) method: first, an implant is installed, and after 4-6 months, when the implant has completely taken root, a crown is installed.

A long-term absence of sixes can lead to displacement of neighboring units and, accordingly, to a change in the bite. The teeth located on the opposite jaw will move forward, which threatens to expose the roots. Therefore, to maintain healthy teeth and bite, it is recommended to install an implant.

What to do after installing an implant in place of the 6th tooth of the upper jaw

After surgery, it is necessary to use anti-inflammatory and antiseptic medications prescribed by the dentist. For the first 2 weeks after implantation, the patient should exclude solid and starchy foods from the diet. It is better to chew on the opposite side. After eating, you can use waxed dental floss. When brushing your teeth, use a brush with soft bristles, but avoid the operated area.

To avoid rejection of the design, exclude:

• visiting a sauna or bath;
• increased physical activity;
• alcohol and smoking;
• air travel.

During the rehabilitation period, you should regularly visit the dentist for preventive examinations.

Alternative Treatments

A budget alternative can be removable prosthetics. However, it is still not recommended to be considered as a permanent option for restoring lost teeth. Firstly, due to its not entirely aesthetic appearance. Secondly, due to subsidence of bone tissue, which occurs due to uneven load. As a result, the denture will have to be repositioned frequently, because its comfort directly depends on the evenness of the alveolar ridge.

All-on-4 prosthetics

To restore the entire dentition, 4 pieces are used. implants. In its original version, the use of this protocol is justified when there is a sufficient volume of bone tissue or its slight atrophy. Otherwise, due to the small number of supports for the prosthesis, the entire system will quickly become loose and fail.

Learn more about the all-on-4 protocol >>>

Zygomatic implantation

This involves the use of zygomatic implants, which are attached outside the jawbone. They have incredibly stable primary fixation, allowing them to be loaded immediately without risk of displacement. The protocol is applied only to the upper jaw.

Read more about zygomatic dental implantation >>>

Basal implantation – Basal Complex

Indications for the use of this treatment protocol are acute bone tissue atrophy, periodontitis and periodontal disease, inflammation of the jaw bone. The number of implants per row is from 8 to 12 pcs. Their difference is that they are single-component, fixed in the deep parts of the jawbone and even capture the zygomatic bone, which are less subject to resorption and atrophy. Therefore, their fixation is much better.

Read more about basal implantation technology >>>

Protocol implementation options

• features of prosthetics of the lower jaw: here, as a rule, atrophy is less pronounced and there is good quality of bone tissue. In addition, there are no maxillary sinuses, which greatly facilitates the process of implantation. Therefore, a classic approach is used in the lower jaw - two-piece implants with multi-unit abutments and screw fixation of the prosthesis are installed. In case of atrophy of the lateral sections, a certain tilt of the implants is allowed,
• Features of prosthetics on the upper jaw: here bone tissue atrophy is always more pronounced. Therefore, the requirements for the number and length of implants are increasing. Thus, within the framework of the all-on-6 protocol, zygomatic implants can be used in the amount of 2, 4 or even 6 pieces. With this approach, the technique can be used even with pronounced atrophy of the jaw bone. Read more about zygomatic implantation in the corresponding article >>>

Models and brands of implants

For this method, in the presence of medium-volume bone, two-piece implants ]Nobel[/anchor] and Straumann are mainly used. These are premium brands, their main difference is in special types of threads, as well as unique coatings that activate the growth of jaw bone cells. As a result, permanent dentures can be installed almost instantly – in 2-3 weeks. In addition, this protocol also uses zygomatic implants - usually Nobel Zygoma, and in some situations - one-piece Oneway Biomed. The use of the latter, which have a smooth neck and antimicrobial coating, is an excellent prevention of peri-implantitis3 or inflammation of the tissue around installed implants.

As a budget option for dental restoration, prosthetics using six two-piece implants from the South Korean brand OSSTEM can be offered.

Each of the listed companies has been producing solutions for dental implantation, including immediate loading protocols, for about 40 years, owns dozens of patents and today has numerous results of practical research that prove the high quality of the products.

Expert opinion
Nikolay Vladimirovich Namdakov Maxillofacial surgeon, implantologist, orthopedist Work experience 18+

“Today, more and more manufacturers are moving towards developing models for immediate load protocols. In our practice, we use products from companies that have many years of experience in the production of models specifically for one-stage installation and instant prosthetics. We also value practical clinical studies that confirm the high quality of products in the long term.”