Upper - get all on 4s or loads of implants and crowns

zzboardzz

Ive a mess of an upper. Mix of old crowns ( replaced twice over 30 years) and some bad teeth

I have to consider getting the lot removed and getting all on 4s.

Or

Getting a mish mash of implants and saving some crowns.

What to do?

Im concerned that I will regret getting all on 4s but they will look consistent at least. Some say its an aggressive approach

or

Versus going to the dentist so so many times over the next 20 years as crowns fail and get replaced with implants.

Dianthus

Whatever you do will have it's own pros& cons& maintenance requirements 're time& expense.
Depends on what your priorities are. It's interesting that you haven't mentioned a removable prosthesis (denture) as an option.
It sounds like a full mouth rehabilitation case, so I'm assuming you've seen a prosthodontist for consultation?

zzboardzz

Dianthus wrote: »

Whatever you do will have it's own pros& cons& maintenance requirements 're time& expense.
Depends on what your priorities are. It's interesting that you haven't mentioned a removable prosthesis (denture) as an option.
It sounds like a full mouth rehabilitation case, so I'm assuming you've seen a prosthodontist for consultation?

Yes they want to do periodontal cleaning as step 1 and Im aprehensive as I dont want to fast track treatment until I weigh up all my options.

I have a few crowns and Im considering a clean slate on the upper.

They are not in great condition (dont have mush anchorage) having been replaced twice since I was 20

So if $ was no issue, does a load of bridged implants beat a removable prosthesis on magnets or something? Or even a fixed one

There are so many options Im a bit over whelmed.

Dianthus

Write down a list of your questions& concerns, & return to the specialist for a review/follow-up appointment in order to clarify the best course of action. They'll also be much happier that then you're both on the same page as regards the long-term plan, rather than you changing your mind/having doubts midway through treatment. Measure twice, cut once.
It's a lot to take in, & every case is different.

zzboardzz

Dianthus wrote: »

Write down a list of your questions& concerns, & return to the specialist for a review/follow-up appointment in order to clarify the best course of action. They'll also be much happier that then you're both on the same page as regards the long-term plan, rather than you changing your mind/having doubts midway through treatment. Measure twice, cut once.
It's a lot to take in, & every case is different.

Good idea, thanks

cf52

Best implant is a human root...up to a point. How old are you now? In good health? Once upon a time we stove to have folks hold on to
their teeth. The new religion of a "balanced appearance" and "greatly improved function" are all well and good for the true believers. I'm not so sure...there is whole lot of downside to loss of the innate sensitivity that our teeth feedbck to us 24/7
If what you have left are loose, rotten, infected, lots missing, and on their last legs, and the bone is good enough, yep, all on 4 is not a bad idea...run it by the person recommending it again and next time, ask just how bad are you going to be if you stay as is now in say, 5 years time...

zzboardzz

Ive still made no decision as its so difficult ...

Expensive / time consuming - Its possible to get a mish mash of Implants and re done crowns and then if that doesnt work then opt for all on 4s

Less expensive / aggressive - But if I go direct to all on 4s Ive arrived at my destination with no recourse to implants ...

My concern ...

All on 4s dentures will look obvious, add 10 + years onto me and I will regret my decision, they will feel alien

Oral Surgeon

zzboardzz wrote: »

Ive still made no decision as its so difficult ...

Expensive / time consuming - Its possible to get a mish mash of Implants and re done crowns and then if that doesnt work then opt for all on 4s

Less expensive / aggressive - But if I go direct to all on 4s Ive arrived at my destination with no recourse to implants ...

My concern ...

All on 4s dentures will look obvious, add 10 + years onto me and I will regret my decision, they will feel alien

The placement of implants in between teeth (to be saved) will be different to the placement of implants with a view to an all on 4 hybrid...

Best to decide if the teeth can be saved or not in the long term and go from there...

If you save teeth and place implants inbetween them and then later have to remove the natural teeth, then those implants will likely be not deep enough to allow the dentist/ technician to make a full arch of teeth on them....

btkm8unsl0w5r4

What you need is a good dentist or specialist that you trust to do the job right, everything else falls into place from there. I am a big fan of all on 4 but it has its issues, I like to maintain a few teeth if I can to give the patient some feeling in the jaws. Having said that sometimes you need to remove the teeth. As Oral Surgeon said, there can be issues with having implants placed for individual teeth converted to a full arch, you need a good dentist to plan that out. All on 4 also requires maintenance, teeth to break and wear out. They can look very good if the effort is put in. You really need to discuss your options with the dentist proposing this, internet randomers can only give internet random advice, and its not based on what your dentist can achieve.

helimachoptor

where are you based OP?

patem2ar

Beau Round Porcupine wrote: »

What you need is a good dentist or specialist that you trust to do the job right, everything else falls into place from there. I am a big fan of all on 4 but it has its issues, I like to maintain a few teeth if I can to give the patient some feeling in the jaws. Having said that sometimes you need to remove the teeth. As Oral Surgeon said, there can be issues with having implants placed for individual teeth converted to a full arch, you need a good dentist to plan that out. All on 4 also requires maintenance, teeth to break and wear out. They can look very good if the effort is put in. You really need to discuss your options with the dentist proposing this, internet randomers can only give internet random advice, and its not based on what your dentist can achieve.

What are your thoughts on overdentures or indeed telescopic bridges/ coping bridges/ Lindhe /Nyman type bridges. I find them a good long term transitional technique which can be modified as/when individual abutment teeth irreparably fail.

btkm8unsl0w5r4

patem2ar wrote: »

What are your thoughts on overdentures or indeed telescopic bridges/ coping bridges/ Lindhe /Nyman type bridges. I find them a good long term transitional technique which can be modified as/when individual abutment teeth irreparably fail.

All depends on the restorative space available, which is often related to the mode of tooth loss. Transitional prosthesis can work well indeed, it depends on the patients own thoughts on re-treatment cycles.