How Many Dental Implants Do I Need?


Dental implants for many years have represented the state of the art in permanent tooth replacement. A dental implant is essentially an artificial tooth root that is placed into the bone of the jaw by a surgeon. Because the implant is made from titanium, a unique metal that is compatible with the natural tissues of bone and soft tissue, the bone of the jaw will attach directly to the implant surface and it becomes like part of the body. The implant can then be used for a variety of applications, ranging from replacing a tooth, to retaining a prosthetic nose used to reconstruct a defect left from cancer surgery.

Choosing the Correct Number of Implants

The number of implants needed for a specific purpose is of major importance to the patient. Your implant plan will be discussed extensively during your initial meetings with your oral surgeon. This plan will take a number of factors into consideration.

  • Too few implants can lead the implants to be overstressed and fail.
  •  Too many implants can make them more difficult to use.
  • More implants than necessary increase the cost of treatment.

The number of implants required for the replacement of a single tooth or a few teeth is usually straightforward:

  • A single tooth requires a single implant.
  • Two teeth require two implants.
  • No more than three teeth should be placed on every two implants.

Please note that there are many exceptions to the last generalization, but your doctor should be able to clearly explain any reasonable exceptions. For example, the lower front six teeth are very small and carry relatively little force, thus it is common to replace these six teeth with just two implants. One implant per tooth makes it easier for the patient to maintain hygiene.

Full Arch Replacements: “All-on-4” Implants

Replacing a full arch of teeth (example: all upper teeth) has historically been controversial, but the concept of All-on-4 implants has challenged much of this traditional thinking. Simply put, “All-on-4” refers to the idea of replacing a full arch of teeth on four implants.

Here’s what you need to know about All-on-4 arch replacement implants:

  • Proven by extensive research to be highly successful.
  • This is not a new concept, but protocol has been refined greatly in recent years.
  • Relies on phenomenon know as “cross arch stabilization” to brace implants against one another.
  • Typically performed as “immediate load,” which means the patient gets implants and new teeth in same day.
  • Uses fewer implants than historical protocols, saving patients money.
  • Usually eliminates any need for bone grafting reducing surgery and cost.

Do some “All-On-4” patients need more than four implants?

Dental implant research indicates very high success rates using four implants. In fact, studies show a 97 percent success rate in the upper jaw and a 99 percent success rate in the lower jaw. This higher success rate in the lower jaw is thought to stem from the denser, stronger bone in the lower jaw bone.

Studies have also identified that certain patients should be considered for more implants in the upper jaw in order to increase the likelihood of success. These patients include:

  • Male patients
  • Smokers
  • Patients with low bone density
  • Implants where opposing arch still has natural teeth
  • Patients with bruxism (abnormal tooth grinding habit)
  • Patients with other complicating illness, such as diabetes

Is  All-On-4 all I need?

There is not a cookbook plan that works for everyone. Patients are all different. They have different goals, anatomy, medical conditions, and financial resources. All of these must be taken into account when formulating a patient specific plan. For this reason, it is equally important to be an informed patient and to choose a surgeon with extensive training and experience.

For More Information About Dental Implants & All-on-4 Implants

The surgeons of the Surgical Arts Centre have a combined experience of over 50 years in the planning and placement of dental implants for permanent tooth replacement. For more information, or to schedule a consultation call (406) 549-6600.

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