The All-on-4 implant protocol and single implant protocol differ significantly in terms of timing, particularly in how quickly the restoration can be completed and the healing process involved. Here’s a breakdown of the key differences:

1. Implant Placement and Procedure Timeline:

All-on-4 Protocol:
– Immediate Placement and Loading: In many cases, the All-on-4 protocol allows for immediate placement of the implants and the attachment of a temporary fixed denture. This means that after the surgery, the patient may leave with a functional set of teeth on the same day or within a few days. This is often referred to as “teeth in a day.”
– Fewer Implants: The All-on-4 procedure uses four strategically placed implants to support a full arch of teeth (upper or lower), which streamlines the surgical process.
– Final Restoration: After 3-6 months of healing, during which the implants integrate with the jawbone (osseointegration), the temporary denture is replaced with a final, more durable prosthesis (typically zirconia or porcelain). However, the patient enjoys a fixed, functional set of teeth throughout the healing phase.

– Single Implant Protocol:
– Delayed Placement and Loading: In most cases, after a single implant is placed, the site requires 3-6 months for healing and osseointegration before the permanent crown is attached. During this period, the patient may need to wear a temporary denture or bridge if they are missing visible teeth.
– Sequential Procedure: Each implant is placed individually, and the crown is placed only after complete osseointegration of each implant.
– Final Restoration: The permanent crown is placed after the healing period, but there is usually no immediate restoration for aesthetics and function on the day of surgery.

2. Healing and Osseointegration:

– All-on-4:
– Since the implants are placed at an angle and engage more bone, they offer high initial stability, allowing for immediate loading with a temporary denture.
– Healing and osseointegration happen while the patient already has a functional, fixed denture in place.

– Single Implant:
– The healing phase generally involves a waiting period where the implant integrates with the jawbone before loading. This could involve wearing a removable denture or temporary restoration for esthetics but no immediate permanent solution.

3. Treatment Time:

– All-on-4:
– Shorter overall treatment time because patients often receive a fixed prosthesis (temporary) the same day or soon after the surgery, with the final prosthesis placed after 3-6 months.
– Total time from surgery to final prosthesis: 3-6 months, with functional temporary teeth available during healing.

– Single Implant:
– Longer process as each implant needs to heal individually before the crown is placed.
– Total time from surgery to final crown: **3-6 months**, but without immediate functional teeth (or with temporary removable solutions).

4. Surgical Complexity and Invasiveness:

– All-on-4:
– Involves fewer implants and is often suitable for patients with lower bone density, reducing the need for bone grafting.
– The surgery can be performed in one session, often followed by immediate loading with temporary prosthetics.

– Single Implant:
– Bone grafting or sinus lift may be required if bone density or volume is insufficient.
– Each implant is placed individually, requiring more sessions if multiple implants are needed.

Summary of Key Differences in Timing:

– All-on-4: Immediate function with temporary teeth (same day or within days), final restoration in 3-6 months.
– Single Implants: Requires a healing period of 3-6 months before the final restoration, with no immediate fixed teeth in most cases.

The All-on-4 protocol is generally quicker when it comes to providing functional teeth, making it an attractive option for full arch replacements.

Related article:
What does quality mean in full-arch restoration?

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