ALL ON 4 TREATMENT

Dentares Smile Clinic is well known in Antalya, Turkey to consistently provide high-
quality all-on-4 treatments at affordable prices compared to Eastern Europe, UK and
USA. Implants with advanced microtechnologies are used to give patients with
decayed dental conditions a renewed, confident smile. 
What is the all-on-4 technique
The all-on-4 treatment is a surgical technique that supports a fixed prosthesis with
evenly distributed bite closure on only 4 implants per jaw. The all-on-4 technique was
developed by a Portuguese dentist called Dr. Paulo Malo in 1998. Dr. Malo
concluded that 4 implants placed in certain angles were able to avoid sinus cavities
and nerve canals of the jaw bone in order to provide and support a full arch
prosthesis. Since then, the All-on-4 method has been adopted globally as a standard
treatment for patients with severe bone loss. 
When severe bone loss is present, it can be observed that the space between the
bone structure of the sinus cavity on the upper jaw and the bone structure and nerve
canal on the lower jaw is inadequate to support implants. Therefore 4 implants are
able to be placed in the anterior (front) jaw avoiding these important areas. Two
implants are placed vertically at front positions of the jaw bone and one implant is
placed either side of these at 45 degrees facing towards the back of the jaw. The
angle allows for even distribution of bite force across a full arch denture, opposed to if
all 4 implants were to be placed vertically. 
Who is a candidate for the all on 4
The all-on-4 technique is a great permanent prosthesis treatment option for patients
with removable dentures seeking to make life easier and to have the ability to have
harder foods like steak or nuts.
Patients with severe bone loss on both jaws, many missing teeth, decayed, broken,
or wobbly teeth may be suitable for the all on 4 treatment. 
In most upper jaw cases, if the sinus has invaded the bone structure to the point of
only a few millimetres available. Then sinus lifting and bone graft would make this a
riskier surgery and so the all on 4 can be recommended. In lower jaw cases, there is
a nerve canal that runs along the bottom of the jaw and stops just outside the chin. If
the bone structure between teeth and the jaw's nerve canal is just a few millimetres,
then the all on 4 treatment would be recommended. Complications such as a burst
sinus, excessive bleeding and nerve damage are risks not worth taking in order to
include posterior implants.

How long is the process?

The whole process requires two visits to Turkey, 3 months apart. The first visit will be
4 days long with about 2-3 appointments. The second visit will be 7 days long and
require 4-5 appointments.
What implants are suitable for the all on 4 treatment
Dentares Smile Clinic only works with high quality, internationally known brands. All
the brands we use can be applied for the all on 4 treatment. The implants we use are
NTA®, Camlog iSy®, Global D® and Straumann®. Please contact us for more
information and to find out why we prefer this brand of implants.
What can disturb the process
There are a few things that can extend treatment time and affect the osseointegration
(healing between bone and implant). Those are abscesses and after-care habits.
Patients will discover from the x-ray & 3D tomography results in the consultation
stage, if they have bone abscesses. These are little pockets (or cysts) of pus and bad
bacteria. If the abscess (1 or more) is within the surgical area implants are to be
applied. Then first, we must surgically extract the infection and place bone grafts.
This can delay the treatment process a further 3 to 6 months depending on the size
of the abscess and bone graft applied.
It’s not possible to speed up bone healing unfortunately, but we can provide good oral
hygiene, quit smoking and eat a healthy, diverse diet to ensure the healing is not
delayed or affected. Smoking cigarettes and vapes restricts vascular circulation to the
gums and bone resulting in vital nutrients and antibodies not being able to reach the
healing site. This can lead to an infection and a failed implant. Extending the
treatment process by up to 3 to 6 months.
Alcohol causes oral dehydration, dilates the capillaries, and interrupts a process
called osseointegration. Dehydration and dilation increases swelling and can lead to
blood clots, leading to necrosis of the capillary. Affecting the transport of nutrients
and healing factors to the implant area. Osseointegration is the process of bone to
implant integration. The bone tissue grows into the microscopic pores and enhanced
surface areas of the implant.
The temporary denture is created only for aesthetic reasons. The denture is made of
a brittle acrylic and is prone to breaking with improper usage. Dentures should not be
used functionally. This means that the denture is not made to withstand bite forces
while chewing and is only meant for aesthetic reasons. For example you can talk to
your work colleagues, friends and family with a confident smile. This is because
dentures place force on the implants and can disturb healing. It will always be the
priority of the doctor to ensure the maximum benefits of healing. This is to protect the
patient. We need to preserve the bone structure we have.

For these reasons: smoking, drinking and inappropriate denture wear can disrupt the
healing process and lead to complications; extending the process healing time to 3 or
even 6 months.

What are the benefits of the all on 4 treatment in Turkey?

Implants have been shown to significantly reduce bone loss in most patients. When it
comes to the preservation of your bone structure, implants are a really good option to
consider. Not only that, the implants allow the patient to have a functional and
aesthetic set of dentures. Patients can experience an instant bloom of confidence
when their prosthetics are first fitted. 
The bite force is evenly distributed so patients are able to eat whole foods again.
They are able to enjoy steak, nuts, apples, candies and other wholesome foods once
again.
The best part about the aesthetic design is that the patient gets to choose a designer
style and a shade of white they feel happy with. 
In the UK, the all on 4 treatment requires 9 to 12 months to complete. At Dentares in
Antalya, Turkey, you can complete the all on 4 treatment within 3 months.
The all on 4 treatment is also much more affordable compared to prices in the UK,
USA and Eastern Europe. Due to the economic conditions of Turkey in recent years,
dentistry in Turkey has created a significant price point advantage for tourists.
Turkey has a great hosting culture and it shows at Dentares. Patients always feel
safe and cared for during their stay. Patients are given a VIP transfer service
between the hotel, clinic and airport, a hotel for their stay, and the service from clinic
staff and doctors are second to none. 
Turkish doctors have been able to hone their dental skills with daily implant and
prosthesis treatments. At Dentares Smile Clinic, specialist doctors are assigned for
each stage of treatment, ensuring patients are tended to by experts for each
treatment, every step of the way.

What are the disadvantages?

Unfortunately, scientists haven’t been able to hack the body healing factors. Our
bone tissues still take months to heal and so for the all on 4 treatment we need to
allow 3 months to complete.
Patients are required to travel from their home countries to Turkey for treatment. So
patients need to manage work and life responsibilities to have the time to come to
Turkey twice. In reality, the all on 4 treatment can be finished in Turkey in 3 months
opposed to the UK where it can take 9 to 12 months to complete. So patients really
save time at the end of the day and have their dream smile fast.

The all on 4 treatment requires surgical risk and fully licensed and experienced
surgeons to complete the treatment and so it can get pretty expensive.
Comparatively, the all on 4 treatment can be a third of the price of western countries. 
Long-term smokers and frequent drinkers may have a hard time for a few weeks or
months looking after the implants post-treatment. It is recommended not to smoke or
drink alcohol while the body recovers. Patients can use nicotine patches but it does
not replace the habit of having the physical feeling of a cigarette in the mouth.
Some patients can struggle having no temporary dentures or non-fixed dentures
because they need to take them out and clean them each day. They are only given
as an aesthetic measure.
Having implants means that patients will need to wait 3 to 6 months. Patients will
follow the hygiene advice of the doctor to ensure their implants heals and integrates
with the bone in the best possible way. This means actively caring and attending to
small changes, cleaning and so on.
Although rare, local complications that may occur during dental implant surgery are:
nerve injury that may result in numbness; but is usually temporary and bleeding.
Complications that may arise after surgery are: infection and failure of the implant to
integrate with the bone.

How much does the all-on-4 cost in Turkey
In Turkey, the all on 4 treatment can be up to 60% cheaper than UK, USA and
Western European prices. Of course it also comes down to the specific patient's
need. Some patients may have abscesses in their planned implant area so the
infection(s) are required to be surgically removed and treated. They will need to wait
3-6 months for these areas to heal before implants can be placed.
Patients have the option to choose the brand and quality of their implants. Dentares
Smile Clinic offers NTA®, Camlog iSy®, Global D® and Straumann®. for the all on 4
treatment. This can dramatically affect the price. 
The prosthesis material, clinic reputation and prosthodontist will also vary the price. 
What's the difference between all on 4 and all on 6
The all on 4 treatment uses angled implants to provide stability in the back of the jaw
due to the loss of bone. The all on 6 treatment is different because candidates for the
all on 6, have sufficient bone structure to support 6 vertical implants evenly placed in
the jaw.