Tilted vs. Straight Dental Implants

One question that has been repeatedly asked by the patients at FMS Dental Hospital is "how many implants do you want to place in my edentulous jaw to replace the missing teeth; isn’t just 4 enough?".

To answer this, they need a clinical examination and a CBCT scan to assess the available bone. Sometimes virtual digital planning will give the correct dimension (size) and number of implants required for the patients.

Over a decade, the FMS Dental Implantology team that consists of Implantologists, Maxillofacial surgeons & Prosthodontists, with the support of in-house CAD-CAM dental lab, have treated hundreds of patients with different implant protocols depending on the available jaw bone.

Tilted (All-on-4 ) vs. Straight (All-on-8) Dental Implants

They  like to place 7-8 dental implants parallel to each other (straight) whenever sufficient bone is available in the jaw. Zirconia or composite teeth can be fixed over these implants with either a cementable or screwable option. For more than 20 years, this protocol has been followed where parallelism is given importance when placing implants.

But most of the time, patients delay in opting for full mouth rehabilitation with implants. As a result, the jaw bone keep resorbing and there will be hardly any bone left on the backside of the jaws because of maxillary sinus pneumatisation in the upper jaw and the position of the mandibular nerve in the lower jaws. Patients also delay the removal of infected teeth until they lose all the bone and become totally mobile.

In the past, an additional surgery was required to graft the bone in these situations with sinus lift in the upper jaw and a block graft in the lower jaw by taking bone graft from the iliac crest or another part of the body. After a waiting period of 6-8 months, implant surgery was then  be performed in the grafted area.

Now, with the revolutionary changes in implant and abutment (connector) designs, a new concept called All-on-4 has been developed. In this method, support from the front and middle parts of the jaw bone are taken and two straight implants and two long tilted implants that emerge posteriorly are placed. These 4 Implants will be supporting 12-14 teeth based on their positioning and length.

Advantages of All-on-4 dental implants:

  1. Highly predictable & success rate above 99%
  2. No second surgery, no grafting and no waiting time
  3. Immediate fixed provisional teeth in 2-4 days followed by permanent teeth after 5-6 months
  4. Strong screwable prosthesis with zirconia or composite resin teeth on titanium, zirconium or peek frameworks. This way of replacing crowns on a screwable framework gives excellent results with signature smiles and aesthetics
  5. In the hands of expert implantologists, whether it is all-on-4 tilted or all-on-8 straight implant protocol based on the available bone, patients will regain their chewing comfort, phonetics (speech) and lost self-esteem

About the author

FMS Dental Hospitals, established in 1993, with over a million patients treated, has been widely recognized as one of the India’s leading Dental Care Service Provider. The Hospital is run by a team of multi-disciplinary clinicians and dentists, including highly experienced Implantologists, Cosmetic Dentists, Maxillofacial Surgeons, Prosthodontists, who are able to perform over 10 specialties of dentistry all under one roof.

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