Georgia Reconstructive Dentistry

Nobel Biocare CAD/CAM Based Technologies

The All On Four and Teeth In An Hour trademarks, owned by Nobel Biocare, incorporate various treatment protocols that include the use of a proprietary implant placement and planning guide (NobelGuide) that is used by Dr. McFarland to configure implant locations, depths and angulations that provide rock solid stability and anchoring.

Special Advantages

Because of the use of cone beam ctscans and specialized CAD/CAM treatment planning software, implant placements are created with utmost precision and specificity that can, for many patients, eliminate the need for bone grafting procedures ... once considered a requirement for any type of traditional implant.

Edentulated Maxilla
Edentulated Upper Jaw with Implants

All On 4 Treatment Choice

In our office the All on 4 tooth replacement protocol has become a popular treatment choice for long term denture wearers who are seeking a better tooth replacement alternative or want to enjoy the benefits of dental implants with minimal need for additional bone grafting.

CAD/CAM engineering principles are used to develop implant surgery guides that create the best advantage of nearly any type of jawbone health condition.

Bone Leveling and Guided Implants

Nobelguide Implant Surgery Template
Representative Implant Surgery Guide
As can be seen in the adjacent photos, the patient's maxillary bony ridge has uniform height and width. Bone leveling was performed to create the best advantage for bone width while eliminating the need for additional treatment costs for bone graft surgery.

A computer generated Surgical Guide similar to the Nobelguide pictured here was used, for assuring uniformity in placement and depth of all four implants.

The use of ctscan-based treatment planning all but eliminates the guesswork of what implant configuration will provide the healthiest cosmetic and functional outcome.

With bone height now uniform across the entire arch, the task of fabricating a new titanium based framework of new prosthetic teeth can be completed with more precision.

Titanium Try In
Computer Generated Bridgework Try-In

Understanding Vertical Dimension

Loss of vertical dimension or smile and/or bite height is a natural phenomenon that occurs with normal wear and tear issues... even with the healthiest of teeth. Patients whose dental treatment histories that haven't been "perfect" will tend to show more loss of bite height as they either lose teeth or the teeth shift.

Extreme cases of lost vertical dimension where the jaws give the appearance of "over closing" (granny mouth) can almost routinely appear in cases where too many teeth have deteriorated.

Denture use, in particular an extended use of dentures, also routinely causes loss of bite height, but more usually attributable to the loss of bone height.

Final Prosthesis
Final Prosthesis

Vertical Dimension Compensation

For this patient the loss of bite height was due mainly to losing back teeth and wear on the remaining front teeth. This left an eneven ridge which was leveled prior to placing the implants making for a better fit at the gumline and a more even biting plane or surface.

Custom titanium millwork developed from prosthodontic stone modeling (see above right picture) was developed to provide a rock solid framework width and bite height characteristics that would replace what was once provided naturally by Mother Nature.

Screw Retained Dental Implants

Screw Retained Permanence

The cosmetically and functionally balanced prosthetic teeth, as pictured here, have been fabricated upon a near fail-safe framework that reconstructs what was lost over decades of normal wear and tear dynamics that affect tooth height and bone characteristics.

Non removeable attachment (screw retained) was recommended to provide the best predictable function with the convenience feature desired by the patient.

Screw Retained Dental Implants
Mirrored View - Upper Arch
Routine maintenance and tissue health hygiene procedures are performed on a regularly scheduled basis, to assure long term endurance.

Final Composite Resin Cosmetics

Upon successful installation of the fixed bridge with the use of recessed titanium screws, composite resin compounds are used to create a uniform cosmetic appearance for the entire new arch of prosthodontic quality teeth.

The adjacent mirrored view of the upper arch reflects the absence of any tell-tale attachment screws.

Final After Photo
New All On Four Good Looks and Function
The composite resin product is easily and routinely removed by Dr McFarland for the purpose of removing the bridge to facilitate scheduled hygiene procedures that promote tissue health and long term servicability.

Treatment Summary

Tooth loss and tissue loss attributable to life long wear and tear issues in conjunction with extended use of denture products were successfully overcome for this patient with the use of a custom All On Four fixed screw retained acrylic - quartz bridgework.

The specialized quartz fillers used for individual denture teeth possess similar properties of high end composite resin products used in cosmetic dentistry that provide the appearance of natural tooth structures, including translucency along the biting edges.

Denture teeth that don't look like denture teeth.

CAD/CAM designed implant surgery guides derived from cone beam ctscans enabled the best implant placements that took the best advantage of the patient's bone health characteristics.

Bone leveling was provided throughout the arch that created a level plane for a best-fit non removeable prosthetic that compensated for minor variations of any lost bone height, thereby assuring a complete restoration of the patient's bite and smile height dynamics as it would appear at a much earlier age.

Nobel Biocare Questions?

Call our office at (770) 623-0930 to schedule a consult with Dr. McFarland to learn more about the expanded treatment options available through guided implant dentistry.

Efficient, computer generated fixed bridge design can offer treatment savings (time, invasiveness, cost) that weren't possible just a few years ago. Patients with specific questions about any of the material on this page are invited to contact us directly with our on-line Ask The Dentist form. Dr. Marie or Dr. Chris will respond directly with the answers and information you are seeking.