ALL ON FOUR. PROSTHETIC CONSTRUCTION IN MANDIBULA

In the clinical dental practice, often, we are faced with patients that have very few teeth, or they haven’t got any at all – total tooth loss. The prosthetic is the future of these problems. With its many possibilities, it has a scientific basis to solve all these cases with mobile or fixed prosthodontics. In these cases we’re doing reconstruction and rehabilitation of the mouth with prosthodontic appliance in order to make up for the lost teeth and to set up functional and aesthetic harmony of the patient’s mouth. Nowadays, the prosthetic treatment of the total tooth loss combined with oral – surgical procedure called ALL ON FOUR is ideal, practical and safe reality to solve such a problem. Metal – ceramic fixed construction is placed over the 4 integrated implants. The crucial question is the biomechanical loading of the fixed construction, which asks extensive analysis and planning of the case. At the very beginning, based on the panoramix X-ray images and studio models, we are marking the most suitable static positions for the implants on our model. In advance, we have to keep in mind the action of horizontal and vertical strength. They act like flipping mastication strength and we have to calm and balance them. The augmentation of the ridge, correct designing and forming of the suprastructures, as well as the stable and polygonal orientation of the occlusion, are inevitable. Later, with oral – surgical treatment the implants are placed, together with ridge augmentation and its voluminous enlargement. After a 3-6 month period we’re starting with producing of the future fixed metal ceramic construction that at the end is going to be screwed like suprastructure over the implants.