Watch the video recording from live webinar held by DentalimplantsFriends and presented by a dental expert, dr Andrea Burazin Kurti, DDS, from B. Dent dental clinic in Croatia. Dr Kurti has talked about “All-on-4 dental implants – everything you need to know before you go abroad”. If you have serious problems with loose teeth, gums or you are fed up with traditional dentures, we recommend you consider having All-on-4 dental implants procedure.
In this webinar you will find the answers to the most common questions asked by dental patients:
- What are all-on-4 dental implants?
- Will insurance cover all on 4 dental implants?
- What do all on 4 dental implants look like?
- How much does all on 4 dental implants cost in Croatia?
- How painful is all on 4 dental implants?
- How to prepare before the first dental appointment?
- How to clean all on 4 dental implants?
- How to care for all on 4 dental implants?
Dental implants are like real teeth: you can eat all types of foods and you leave the dental clinic with a great smile right after the implant pricedure. Forget about uncomfortable dentures and upgrade your smile with a permanent solution. If you want to know more about all-on-4 method, this webinar is exactly for you. Read the transcript from Q&A from the webinar. Dr Kurti’s answers are below.
I’m thinking about All-on-4 on the upper jaw. I smoke a lot. Is it possible for smokers to do All-on-4?
We have done a lot of All-on-4 for people who are smokers. What we tell them is that it would be great not smoke for 24 hours after the surgery. However, if you are a smoker your dentist may be less happy to recommend implants to hold your whole teeth. It is obvious that you then have to go every six months to a dental hygienist to clean everything around the implants and the bridge so that everything is fine. We haven’t had any issues with smokers. Implants act the same as natural teeth.
Could you also let me know what are the other obstacles to having dental implants?
Diseases like osteoporosis or diabetes. These need to be under control so if you’re taking medications, we need to see what medications, how often and for how long. Also, if you are taking hormones, for periods or the menopause, and if this is under control then implants fine is fine. If these illnesses are under control and if you are taking medicines every day then you can do All-on-4 or any kind of implement. If it is not under control then better not.
Regarding patients with gum disease. I was wondering if dental implants can be placed on gums which are problematic or if first, a patient needs some kind of gum treatment. How does this work?
When a person has gum disease or periodontal disease, the surgeon does a thorough cleaning and oral care for those patients. It needs to be perfect afterwards because gum disease is the main reason you lose your natural teeth. When you are taught how to clean around the implants there shouldn’t be any problems, because when we remove your infected teeth, the gums recover.
Can the teeth be extracted on the same day?
It is always on the same day because when we extract the teeth we clean the bone of infection to put the implants in a healthy bone. That’s why we remove all traces of gum disease. After that, you just need a checkup every year at the dentist and the gum disease shouldn’t come back, you need just to clean implants perfectly. It is most important that you clean implant perfectly. It’s not difficult but some patients think that when they get something artificial they don’t need to take care of them, but gum disease can always come again because implants are made like your natural teeth. We call them third teeth. You have your first set, your second set and the third is the implants.
I’m wondering is it possible to do the treatment during one journey?
During the first visit, you can only do the temporary bridge so you should come twice. In the first visit, we do the implants and put in a temporary acrylic bridge and after three to six months, when the gums are not swollen anymore, there is a gap between the gums and the bridge in All-on-4. t Idoesn’t look really great. Also, acrylic is not of the same quality as zirconium or titanium and that’s why it is necessary to come again after three to six months to do a new bridge that will fit perfectly on your gums and implants because in the two months after the extraction of the teeth, the gums and bone reduce.
When I come for the second visit to get my permanent bridge you take the impressions of the gums. How long do I wait for the permanent bridge?
We need five to seven working days for the permanent bridge and you should be here all that time. We take impressions and then after that we have three more visits and then on the fourth, we put in the final work and screw it in. So, in total, we need seven days, but it can be done in five days if you call us three weeks in advance, as it is a lot of work for our technician.
What are the advantages of All-on-4 and All-on-6? I have heard about both methods.
All-on-4 is a very good method for implants as the implants on the left and the right side can be angled and in that way, we can use the bone you have. So, if you don’t have bone, and most people don’t have bone at teeth number five, six and seven, we can use the bone you have. It is mostly in the front area where you need to put six implants. We put in six straight implants but you need to have great bone at tooth number six. Mostly, there is not enough bone here and we need to do a sinus lifting and put in a lot of artificial bone. That is an expensive procedure. The main problem with All-on-6 is that we cannot do permanent work quickly on those implants; we need to let them let them integrate and this takes three to six months, and if you do sinus lifting even eight months. In that period, you need to wear dentures and that is a major difference. Then there is the price of course – All-on-Six is more expensive. With All-on-Six you do not get a temporary bridge but have to use your own dentures or we can make you new dentures. But these are still dentures which you need to take out and brush. With All-on-4, you get six fixed teeth in 24 hours: with All-on-6 you need wait eight months to one year until you get your fixed teeth.
How can you help me to survive and look good during the time till the crown stage?
Patients get temporary bridges so they can they look good from day one. They look really great. We give them antibiotics and some painkillers and very often corticosteroids which they need to take for three days. From taking the teeth out, taking impressions and putting in four implants, you get a new set of teeth in 24 hours. Unbelievably, we haven’t had anyone who has had any pain. It is very important after the surgery that you put ice on your face for two to three hours so you won’t be swollen. If you go out in the sun in 35-degree temperatures and walk around the city then you will swell up, for sure.
You mentioned that you use a local anaesthetic during the implantation some patients are afraid of injections. How many injections do I need?
It depends how many teeth we need to pull out. If we need to take out three teeth then around four to five injections and the aesthetic is done. If you need more teeth out, there are more injections. We don’t go over seven or eight injections, but it depends on the weight of the person we are implanting on.
What about if the patient is toothless?
If the patient is toothless, implantation is done in half an hour to 45 minutes. After that, we take impressions and that takes an hour. With two or three injections everything is done. If we have the CT scan, we have a great plan and know perfectly, to the millimetre, where we are going and what size of implants we’re talking about.
I was wondering if after the procedure of implantation the patient can drive.
Yes, but we usually give a ride. Some want to go by themselves and that’s OK, but we always provide transportation between the clinic and hotel.
What does the cost include?
In the first phase when you come, you pay for the implants and temporary teeth. After three to six months, when you come to do your permanent teeth, your pay for the permanent teeth then. The price depends on the brand of the implant you are using; here we use Nobel Biocare and Neodent.
Which implant is better, Nobel Biocare or Neodent?
I would always recommend Noble Biocare. This is a top implant and is very tough. Noble is the Ferrari or Bentley of implants. Neodent is a middle range implant, the Volkswagen or Opal, if I can make the comparison. It doesn’t mean that the Noble implants will last longer, but Noble is a manufacturer that has been producing implants for 80 years and they have a name. Neodent has existed for 30 years so we don’t have so much feedback on their implants placed 30 years ago. With Noble, we have that. Both Noble and Neodent give a lifetime guarantee so that is really important. It’s important to mention that Noble actually invented All-on-4.
What is an FDI questionnaire?
It is a worldwide dental questionnaire that we use before our patients come and before we start to do implantation. It asks if you’re suffering from any disease, if you have been treated over the last two years and if you are taking medical drugs so we know about your health. Google FBI questionnaire, print it, fill it in and send it to us so we can be prepared in advance. It’s very convenient for patients.
While I’m waiting for my permanent bridge, is it possible to see my new smile in some kind of a simulation?
When you are waiting for permanent teeth, you can see a simulation and our technician can do that, but not for the temporary bridge. We don’t have time for that because when you do All-on4, it is very important that the top 24 hours we put the bridge on the implants. After that, we cannot do anything with them because after we put those four implants, within 48 hours they have primary stabilization, very strong stability in the bone. After that, after 48 hours, this does down so we don’t want to do anything with them.
You mentioned that the second visit, getting permanent the bridge is about five to seven days. What about the first visit, the extractions, implants and the temporary bridge? How long does a patient need to stay at your clinic during the first stage?
During the first stage, for or two or three days tops, so for 24 hours or the day after, just so that we can check everything is okay, to rest a little the day after. For example on a Tuesday at 6 o’clock we put in the implants and the next day, on Wednesday at 6 if everything is okay you can go back home. We like those three days so that we can monitor everything and to check the bite. Sometimes, after 24 hours of getting a new set of teeth, you cannot, as a patient, feel if your bite is even on the left or right side so the day after, when you eat something, you have a better feeling of it. We just like to see if everything is fine.
Speaking of eating, after you get the temporary bridge, do you have to follow a special diet?
No. You can eat whatever you want right away, just like with your natural teeth. Alcohol is allowed straight after the procedure, not when you’re under antibiotics.
What happens if the implantation fails? I know it’s unlikely to happen, however, I often have bad luck.
You have a lifetime guarantee on implants. If implantation fails, we have the lot number for each implant and send this to the manufacturer. They send us a new implant. We put the new implant into the bone and the second time it won’t fail. One time it may fail, the second time it’s just not possible.
I’ve heard about ceramic implants. Do you do ceramic implants at all?
No, we don’t use ceramic implants, as we don’t have enough research yet. Ceramic implants are like glass and they can break and actually I don’t think they are common anywhere in the world. It would take about 10 years to see how other doctors do this and to have more research about side effects.
Do I have to pay for a replacement implant?
No. Implants are under a lifetime guarantee, so you don’t pay for them.
Do patients need to prepare anything else or what kind of services do you have for patients who come from other countries?
It is important that you to send us an FDI questionnaire and the CT scan so we can make up the plan. We pick up the patient at the airport and we pay for the hotel or apartment. We prefer you to be in an apartment because you have a fridge there and you can cool down. It is easier for the patient, as we have noticed. We also have transport from the apartment to our clinic and back, and we give them a ride back to the airport after everything is done. So actually, you don’t need to take anything; we provide you with antibiotics and painkillers, we do x-rays here, before and after implantation, so we actually have everything you need: you don’t need to take anything with you. We just need just to know if you are allergic to any antibiotics like penicillin so that we know to give you another type of antibiotics.
You mentioned x-rays and medication. Are those included in the total price or do you have to pay extra?
X-rays and medications are included in the price. We have these in our clinic so you don’t need to go anywhere else; everything is included.
Is it possible to be allergic to titanium?
No. That’s why we use titanium because you cannot be allergic to titanium, which is a biocompatible material. We haven’t had any patient who was allergic. In all branches of medicine this is the material that doctors use: for hip replacements for knee replacements, all of these are made of titanium.
More about the presenter and the clinic
B. Dent is a dental clinic located in the western part of Zagreb. It has over 12 years of experience and its dental surgeons place over 200 implants a year. The clinic offers free online consultation via Skype, free pickup from the airport and, what is important for patients undergoing surgery, 24-hour free emergency contact. The place is extremely popular with international patients and most of them travel to Croatia from the United Kingdom, Ireland or Germany.
Who is the webinar’s presenter? Dr Andrea Burazin Kurti graduated from the Faculty of Dental Medicine in Zagreb in 2004 and she also received a postgraduate specialist degree. In 2008 dr Kurti opened her own dental practice – B. Dent. She is a member of the Croatian Dental Chamber and authored many articles on aesthetic dental medicine. Dr Andrea is constantly upgrading her knowledge and skills during Croatian and international workshops and conferences in the field of dentistry. Her patients appreciate her warm and friendly approach to patients.
Watch the webinar on All-on-4 dental implants and make the first step to a new healthy smile – contact the clinic for a quote for your dental implants.