January 21, 2021

The All-on-4® Treatment Concept: Eliminating the Need for Bone Grafting

Bone grafting is a surgical procedure used to prepare and rebuild damaged bone structures. In restorative dentistry, bone grafting is used to repair jaw bones in preparation for traditional dental implant placements. The All-on-4® treatment concept, however, eliminates the need for invasive surgery and bone repair completely, making it a great alternative to expensive and time-consuming bone grating. 

What is Bone Grafting?

Bone grafting is a surgical procedure that replaces damaged, deteriorated, or missing bone in areas affected by trauma, disease or congenital malformations. The replacement bone can be taken from your body or, in an increasing number of cases, can be entirely synthetic. 

Depending on the type of injury and location of the to be replaced bone, surgeons usually choose between two types of bone grafts based on material groups:

  • Autograft, or bone grafting that utilises bone from inside your body, often from hips, ribs the pelvis, or wrists. This requires additional surgery to acquire the bone and can increase your risk of infection. 
  • Synthetic variants, meaning artificial fillers made from ceramic or polymer based materials, for example, bioglass and calcium sulphate.

How Does Bone Grafting Work?

Bone grafting has been an essential part of medicine for many centuries. Shortly after the invention of the microscope in the 1600’s, the Dutch doctor Jacob van Meekeren performed the first bone grafting procedure on a soldier with a damaged skull, using a piece of dog bone as implant material. We’ve come a long way since, and in 1991 the first synthetic ceramic product was cleared for use.

We now know that bone grafting is based on three biological mechanisms called osteoconduction, osteoinduction, and osteogenesis.

  • Osteoconduction: Bone graft material serves as a type of scaffold or framework for new bone growth, which is perpetuated by the native bone. It uses the bone graft material to spread and generate new bone.
  • Osteoinduction: Involves the stimulation of cells with the aim to form new bone. A bone graft material that is osteoconductive and osteoinductive will serve as a scaffold but also trigger formation of new bone. 
  • Osteogenesis: Occurs when cells that form new bone originate from the bone graft material and contribute to the growth and formation of new bone in the recipient.

Reasons Why Your Surgeons May Suggest Bone Grafts

Bone grafting is done for numerous reasons, but the most common use is in the application of dental implants. The procedure aims to restore and stabilise the anchoring area of a missing or decayed tooth. A dental implant needs to be supported by healthy, natural bone to survive. Many patients, however, present with bone deficiencies that makes it very difficult to fit an implant. 

jaw bone

Deficiencies in the jaw bone can be caused by a number of factors:

  • Trauma to the face
  • Infections and diseases 
  • Congenital malformations 
  • Failed surgical procedures
  • Deterioration of the bone caused by missing teeth 

And what about cases that aren’t related to dental issues? Bone grafting may also be performed when fractures do not heal well after the initial treatment or to help bone heal around surgically implanted devices, such as artificial joints. Sometimes it’s even used to fuse joints to prevent movement. 

Why can tooth loss cause bone loss? Your jawbone has a very important job: Supporting and holding your teeth. If you lose one or multiple teeth, the bone thinks it’s time to retire, resulting in a loss of bone material that can make it very difficult to successfully place an implant if you wait too long!

How is Bone Grafting Used in Dental Implant Procedures?

Before inserting a standard dental implant, bone grafting may be required to ensure that the anchoring titanium screw sits stable and strong in the bone, and offers enough support for a successful implant procedure. 

Bone grafts are usually outpatient procedures and performed by most dentists. Patients are sedated to prevent discomfort, before the surgeon undertakes the necessary repairs. 

Bone grafting is done in three stages - provided there are no complications:

  1. Bone grafting. Healthy bone or synthetic material is placed between the sections of bone that need to fuse.  
  2. Implant incision. To place the dental implant, a hole is drilled into the bone. A titanium screw will serve as the root of the new tooth. 
  3. Crown attachment. Once the gums are healed, a new artificial tooth can be fitted.

Bone grafts are a lengthy procedure. The dentist may need to harvest bone from another part of the body in a separate surgery. You will also need to factor in additional healing time between receiving the bone graft and getting your titanium screw implanted. All in all, bone grafts typically take up to six months to heal. 

Bone Grafting: Risks and Complications 

Bone grafting can be beneficial for repairing bone almost anywhere in your body. And whilst they’ve become a routine surgical procedure over the last years, they do involve risks and complications that should be carefully considered before opting for such a procedure. Bone grafting, as with so many surgeries and complex procedures, is associated with a prolonged recovery time and a significant infection risk. 

Common bone graft risks and complications:

  • Pain and swelling of gums and face
  • Bruising of skin and gums
  • Inflammation and infection 
  • Minor bleeding
  • Nerve injury
  • Blood clots
  • Rejection of the bone graft
  • Reabsorption of the graft

As with most implant surgeries, there is a risk of your body rejecting the material that has been inserted, even if it stems from another part of your body. The risk of rejection is, however, minimal, since no living material is transferred.  There is also no need to match the blood types of the recipient and donor. 

world renowned


Why is All-on-4® the Better Option?

The world-renowned All-on-4® treatment offers a permanent, fixed solution to missing or decayed teeth. It’s the perfect option for those seeking full-arch replacement, including anyone who has previously been told they were not eligible for dental implants. All-on-4® replaces a full arch of teeth on only four dental implants, where there is the most bone and dense bone. This significantly reduces the number of implants required and it also increases the success rate of the procedure as the angulated implants offer the flexibility to maximise good bone. 

As a result, All-on-4® costs a lot less than alternatives: You won’t be paying excessive amounts for bone grafting and individual tooth implants. The price for a full bridge replacement works out to be of much better value for your money.  All-on-4® doesn’t unnecessarily draw out your recovery time either. After all, we promise new teeth in a day. You can take our word for it.

Did we mention that the Next Smile™ All-on-4® does not require bone grafting? 

The advanced All-on-4® procedure greatly reduces risks and complications, whilst ensuring the aesthetics and function of your new teeth are to the highest standards. Next Smile™ All-on-4® provides quality full-arch prosthetic dental bridges that are as close to your natural teeth as possible without needing bone grafting. 

In a Nutshell

All-on-4® with dental implants have a 98 percent chance of implant survival and eliminate the need for bone grafting - which is invasive, costly and in many cases, very uncomfortable. The All-on-4® procedure, on the other hand, is well tolerated and often completed in a single day. Patients undergo surgery and receive their new teeth within 24 hours. Bone grafting often involves multiple surgeries and recovery can take over a year. All-on-4® with dental implants is hygienic, easy to maintain and clean. It also costs only about half the price of alternative techniques that require bone grafting and the placement of more than four implants. 

When conducted by Malo trained and endorsed Next Smile™ All-on-4® dentists, you will enjoy better outcomes in terms of functionality, look and feel compared to more invasive methods.

This is the Next Smile™ difference

More than 150,000 patients have already been treated with the  All-on-4® method. Will you be next? Get in touch with our friendly team at your local Next Smile™ All-on-4® Centre to find out if you’re a suitable candidate. Give us a call today!