Replacing Several Teeth or a Full Arch

The Options, Plainly

A systematic review by Heydecke and colleagues in Clinical Oral Implants Research found full-arch fixed reconstructions on four to six implants surviving at 97.5 percent over five years and 95.0 percent over ten in the upper jaw, and 97.9 percent and 95.9 percent in the lower.

	Implant bridge	Snap-in implant denture	Fixed full-arch teeth
Replaces	Two to four teeth in a row	A whole arch	A whole arch
Implants	Two to three	Two to four	Four to six
Removable?	No	Yes, by you, for cleaning	No, only by the dentist
Feels like	Natural teeth	A much more stable denture	Natural teeth
Best for	A section of missing teeth	Patients who want stability at lower cost, or who need an easily cleaned option	Patients who want fixed teeth and have or can build the bone

What We Will Tell You Honestly

If teeth can be saved with periodontal treatment at a reasonable cost and prognosis, we will say so before recommending that they come out. If your bone or health makes fixed full-arch teeth a poor bet, we will recommend the option that will actually last. That is the difference between a specialist practice and a center that sells one product, and if you have already been quoted a plan elsewhere, a second opinion is a reasonable thing to want.

Dr. Verrett is the only doctor in this practice. The person you meet at the consult plans your case, does your surgery, and sees you at every visit afterward. Nobody is handed off.

The Names You May Have Heard

All-on-4 is a trademarked name for fixed full-arch teeth on four implants, two of them tilted to use the bone that remains. All-on-X means the same idea with whatever number of implants the case needs, usually four to six. Teeth in a day describes attaching a temporary fixed set on the day the implants go in, which works when the bone allows and is a mistake when it does not. Implant dentures, snap-in dentures and overdentures are the removable option in the table above. Hybrid is the dental term for a fixed full-arch set of teeth. All of them are offered here where they fit. The consult is about which one fits you, not about a brand.

We will also say where the evidence runs out. A systematic review by Kwon and colleagues in the Journal of Dentistry found good survival for full-arch fixed hybrid prostheses over five to ten years, but too little long-term data beyond ten years to draw firm conclusions. Anyone who promises you a thirty-year number is guessing.

How to decide between full-arch options works through the same decision in detail, including the questions worth asking whoever you see.

What Happens

1. Consult and cone-beam CT. We evaluate every remaining tooth, the bone in each arch, the sinus and nerve positions, and your medical history. You get a written plan with the options that fit and the sequence for each.
2. Planning with your dentist. The final teeth are designed first, then the implants are positioned digitally to support that design. A surgical guide is made from the plan.
3. Extractions and placement. Often the same visit, under IV sedation. Where bone allows, a temporary fixed set is attached the same day. Where it doesn’t, healing comes first.
4. Healing. Three to six months. Soft diet on a temporary.
5. Final teeth. Made and billed by your dentist. If your dentist prefers, they may bring in a prosthodontist; that is their call. We coordinate their estimate with ours before you commit to anything.
6. Maintenance. Fixed full-arch teeth need professional cleaning around the implants two to four times a year, alternating between our office and your dentist. This is not optional; it is what makes the investment last. A five-year follow-up by Costa and colleagues of patients who already had inflammation around an implant found peri-implantitis in 18 percent of those who kept preventive maintenance and 43.9 percent of those who did not.

Recovery

Full-arch surgery is the largest procedure we do. Expect a week of swelling and soft food, with sedation keeping the day itself comfortable. Most patients are back to normal routines within a week to ten days.

A Case from This Office

Cost, Insurance, and Payment

Full-arch treatment varies in price more than anything else in the practice, because the number of implants, the grafting, the type of final teeth, and the sedation all move it. Nobody can quote you a real number before seeing a 3D scan, and a number quoted over the phone is a number that will change.

What you will get here is a written, itemized estimate at the consult, before anything is scheduled. It covers the surgical side: extractions, grafting, implants, temporaries, and sedation. The final teeth are made and billed by your dentist, and we coordinate their estimate with ours so the number you decide on is the whole number. An implant center that quotes one all-in price is quoting the same two parts added together; compare totals, not halves. The practice is an out-of-network provider, but it files your dental insurance claims on your behalf so you can receive reimbursement directly from your insurance company, and monthly payment plans are available. What treatment costs and what drives the number explains how the estimate is built, and insurance and financing covers the payment side.

The consult itself is a conversation and a scan. Nothing is treated that day. Request a consult in North Austin, or call the office at (512) 346-6097. If the day is the part that worries you, sedation and comfort covers the options, including IV sedation.