MANDIBLE FULL ARCH
The bone above the nerve canal at the molar sites, the bone width at the front tooth sites, and the options when conditions are not met. In the lower jaw, these three decide where to place.
Mandible
A full-mouth implant (also called a total implant) is a treatment that restores the teeth and the bite of an entire jaw. In the lower jaw, basal bone exists at the front tooth sites, so placement is possible in most cases when a bone graft is added, and the bone height remaining above the nerve canal at the molar sites decides the design. Yeonhap Dental Clinic's basic design is a three-segment fixed prosthesis in which at least 6 implants (2 at each molar site and 2 at the canine sites) support 12 artificial teeth, and if the molar bone is insufficient, we consider All-on-4 at the four front sites.
CT Planning
At the first consultation, we measure the remaining bone and the nerve canal position at each lower-jaw site on 3D CT and decide the design.
Three Things
The molar sites, the front tooth sites, and the options when bone is lacking.
If the bone above the nerve canal is 5 mm or more, we consider placement while also looking at the width and the position of the nerve. If it is under 5 mm, Yeonhap Dental Clinic does not plan even a short implant at that site and considers All-on-4 at the four front sites.
In the lower front tooth sites, basal bone exists, so in most cases an implant can be placed if a bone graft is added. The bone is often narrow and a graft follows; we look for a position that leaves 2 mm on the cheek side and 1.5 mm on the tongue side around the implant, and if that cannot be secured, we graft on the same day.
If the bone allows, we first consider a three-segment fixed prosthesis with at least 6 implants. If the molar bone is insufficient, we consider All-on-4, and if even the four front sites are difficult, we check the conditions at two sites and consider an implant-supported denture. Besides the number of sites, we also take cost, maintenance, and the patient's wishes into account.
Four Months
The timeline is counted from the day of placement. The upper jaw has different criteria and timelines and is explained separately.
If four implants with a diameter of 4 mm or more, a length of 8.5 mm or more, and an initial stability of 30 Ncm or more are secured and the connection design is suitable, a fixed provisional prosthesis is attached within the same day to 1 week. Even if six are placed, we select the four that meet the conditions and connect them, and about 90% of lower-jaw full-mouth cases qualified.
We expect about 4 months from placement to the final prosthesis, and the wait after extraction is separate. If conditions allow, we place on the day of extraction; if not, we wait and then place. The lower jaw can be treated first on its own, and because the upper jaw has different criteria and timelines, see the upper-jaw guide.
Before Visit
Bring them if you have them. If not, we will calculate from CT on the first day.
Basic design: A three-segment fixed prosthesis uses at least 6 implants (2 at each molar site and 2 at the canine sites) to support 12 artificial teeth. All-on-4 supports 12 artificial teeth as a single piece on 4 implants at the four front sites, and No. 7 is not made. Judging the sites: If the bone above the nerve canal at a molar site is under 5 mm, we do not plan even a short implant there and consider All-on-4 at the four front sites. At the front tooth sites, basal bone exists, so placement is possible in most cases when a bone graft is added, and if 2 mm on the cheek side and 1.5 mm on the tongue side cannot be achieved, we graft on the same day. Choice: Even if the bone allows it, you can choose All-on-4 if you prefer, and even if the four front sites are available, an implant-supported denture can be chosen depending on NHI coverage conditions. A comparison of the two methods is in the Full-Arch Implant (All-on-X) Guide. Provisional prosthesis and timeline: If there are four implants meeting the conditions, within the same day to 1 week; if not, you use a temporary denture. It takes about 4 months from placement to the final prosthesis, and the estimates by starting point are in the timeline guide. Whether to place on the day of extraction is judged separately.
The number and positions of implants, the 5 mm reference, and the provisional prosthesis specifications are Yeonhap Dental Clinic's own standards. The margin above the nerve canal is 2 mm by default, and our clinic has an exception only for short implants, placing a 4 mm implant at 5 mm of remaining height to leave 1 mm of margin, so a site with less than 5 mm is not planned. This exception is our clinical judgment, not a value verified in the literature; we referred to Soto-Peñaloza 2017 for the All-on-4 treatment concept and Gallucci 2014 for immediate loading conditions. The figure of about 90% is an experience figure from Yeonhap Dental Clinic's lower-jaw full-mouth cases. For this reason, in a lower-jaw full-mouth consultation, Yeonhap Dental Clinic measures the bone height above the nerve canal at the molar sites in millimeters on the first-visit CT, and if six implants are feasible, we recommend the three-segment fixed prosthesis first. References: Soto-Peñaloza 2017, systematic review of the All-on-4 treatment concept · Gallucci 2014, consensus statement on implant loading protocols The upper-jaw implant sites and the plan for treating both jaws together are explained in the related links below. Treatment results may vary depending on each person's oral condition. Which methods are applicable and how healing proceeds vary from person to person depending on the remaining bone and general health.
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