All-On-4

An important component of treatment planning for an all-on-4 case (or “all-on-x” to indicate an unspecified number of implants) is knowing what the lab fee will be. The fee for an all-on-x bridge is affected by several important choices that you and your patient must make. Whether the lab is asked to be involved at the case-planning stage, or at surgery, or for post-surgery records, or simply “cloning” an existing prosthesis, the cost can vary a great deal. You are able to tailor the cost of your prosthesis by your choices of the level of lab participation in the process, the design of the prosthesis you desire, the type of materials you prefer, and the level of artistry your patient requires.

If you are providing the lab with an existing patient-approved prosthesis or setup, we will clone your existing denture or patient-approved setup into a hybrid bridge.  Select from the following choices:

Ceramic on Trinia

Lithium disilicate or Prettau zirconia crowns bonded to a milled framework.  Choose Pekkton, Trinia or Tecno Med framework. Aesthetic pink composite is applied to the facial. Lighter in weight; impact resistant.

Monolithic Prettau

All-monolithic Prettau zirconia. Aesthetic enamels applied only in the pink zone. Strongest design. All functioning surfaces are zirconia.

monolithic zirconia

PMMA with Metal Substructure

Monolithic PMMA teeth set on a milled metal bar with milled interfaces. Composite applied in facial pink zone. Monolithic for stronger teeth that won’t debond.

PMMA with metal substructure

Prettau with Metal Substructure

Metal framework with bonded zirconia teeth and pink composite. A good choice for a case that offers limited vertical restorative space.

Prettau on Prettau

Prettau zirconia micro-enameled crowns are fused ( not cemented ) to a Prettau zirconia supporting structure. Ceramic is applied to the pink zone. Implant interfaces are cemented titanium inserts.

Prettau with Enamel

Monolithic Prettau zirconia with enamel applied to anterior aesthetic zone and pink gingivae. Implant interfaces are cemented titanium inserts. Excellent synergy of esthetics and strength.

Zirconia with enamel

 

Fees are based on our receipt from your office of a patient-approved existing prototype prosthesis which we will transform (clone) into the hybrid bridge you choose. In this case we will not be making any design changes to what you send us. The fees are based on four implants; additional implants are $500 each.

The treatment protocol for a hybrid bridge is in three phases:

  1. Diagnostic and planning phase is where records are taken to determine if the patient is a candidate for the all-on-x procedure. A “whole team” approach is of paramount importance in planning the surgery and treatment sequencing. Our office is glad to assist in this without charge.
  2. Prosthetic prototype phase is where principles of smile design and occlusion are applied to construct a prototype bridge for the patient to “test drive” for a period of time. This is only possible if immediate loading is employed or after integration. In this phase additional records will be taken. If our assistance is requested for this phase, our fee ranges from $900 to $1800.
  3. Realization phase is where the definitive zirconia prosthesis is realized from the tested prototype bridge. Before the work for this phase begins both the restoring doctor and the patient will be asked to give signed permission for the lab to produce the zirconia prosthesis based on the design of the prototype bridge. This is necessary so that all parties understand that once final production begins any changes to the design will incur additional cost to the patient.