All-On-Four Or One-On-One Dental Implants: Which Is Right For You?

14 January 2015
 Categories: Dentist, Articles


Dental implant surgery--and indeed, dental implants themselves--have come a long way since their invention. What began as a last-ditch effort to provide an adult with the ability to chew has grown into an entire cosmetic industry, providing solutions for an incredibly diverse range of people. Today, two of the most common implant techniques are one-on-one and all-on-four. Each of these has distinct benefits, so it is important to understand what these processes entail. If you've been told that implants are an option for you, this handy breakdown will help you to make a decision on which procedure is best for your needs.

What's the Difference?

The difference between both of these items lies in the way they are anchored into the mouth. One-on-one dental implants anchor in tooth-by-tooth with their own individual anchors. All-on-four implants come in one piece for either the bottom or top of your mouth; they anchor in at only four points.

Both use heavy gauge surgical screw-and-nut systems to ensure that they remain in the mouth, even during chewing.

Additionally, some one-on-one dental implants may not have a gumline base. They can be implanted deep within the natural gum if enough skin still exists. All-on-four implants do have a gumline base that sits against your own gums.

Why Would a Patient Choose One-On-One Implants?

The biggest reason that most patients choose one-on-one implants is that they simply don't need a full mouth reconstruction. They may have existing teeth that can be saved, even if it's just one or two. It's almost always better to save existing teeth than to replace them, as your chewing and speaking will be far more natural.

Some patients also find it easier to afford full mouth reconstruction over time; they'll pay for a single implant at a time until their smile is restored. This is something that can't be done with all-on-four implants.

According to this article, one-on-one implants can also help to correct bite problems in those who are only missing back molars. This can prevent the other teeth from shifting, and may circumvent the need for a full mouth reconstruction later on.

Why Would a Patient Choose All-On-Four Implants?

The main reason most patients decide to go with all-on-four implants relates to the time needed to install them and the ease with which the process can be completed.

Because this type of implant functions by providing patients with a fixed, full-arch prosthesis, once the original teeth have been removed and/or the gums have been prepped, it can be installed all in a single session. This means that the recovery process isn't protracted.

The shorter overall recovery time, paired with the shorter required overall treatment time, can be very convincing for those who live busy lives.

Finally, all-on-four implants are less likely to shift. The way they are anchored into the gum is unique when compared to other prostheses; each of the four anchor screws is angled in a slightly different direction. This alternating pressure works with the device and your natural bite to keep it perfectly aligned over time.

That can mean fewer adjustments or replacements down the road.

Are Both Techniques Right For Every Patient?

As with any other surgical procedure or prosthetic device, neither of these implant installation styles will be right for every patient.

Firstly--and perhaps most importantly--you need to retain nearly all of the bone underneath your gums in order to create a strong anchor. 

If you have extremely advanced bone loss due to infection, cancer, or other illnesses, implants may not anchor well within the mouth.

Quick tip: If you are struggling with advanced oral care issues of any kind, even if you haven't decided on treatment, you should consider starting a vitamin D and calcium regimen. Both have been shown to prevent bone loss over time.

For other patients, the issue is with the natural shape of the gum line or jaw. Severe overbites, underbites, or crossbites can make all-on-four implants difficult to anchor, too. However, other procedures can often be completed first to bring the mouth to a more even shape prior to the procedure. In patients who don't wish to correct these issues, one-on-one implants can be easier to align to your natural mouth.

Very young children, the infirm, the elderly, and anyone else who may require assistance with day-to-day hygiene may also be a poor choice for this type of procedure. Recovery does require excellent cleaning and hygiene. 

What Makes a Good Candidate?

While it's impossible to judge whether you are a good candidate without diagnostics, most dentists look for:

  • Patients who have lost all or most teeth due to illness or injury
  • Patients who are, overall, fairly healthy
  • Patients who still retain fairly healthy gums, or whose gums can be restored and corrected easily

Overall, the vast majority of patients are considered suitable for either of these techniques. Ultimately, your dentist will advise you on which seems more appropriate for your needs. Full mouth reconstruction sounds far more complex than it often is, thanks to new and quickly advancing technologies. If you have questions about which procedure is right for you, schedule an appointment with your dentist today, or go to sites of local dental clinics to learn more.