The idea of providing an All-on-X prosthesis to a patient seems overwhelming and complicated. This actually happens very often. When I hear in an oral surgery exam room “they wanted me to get four implants”, there are no exceptions, just like when I hear a surgeon say “they want us to take three more impressions”.

First, the patient must have a functional and aesthetic denture that allows him to eat, speak and smile correctly. Second, a full arch conventional denture can be used as an interim restoration until implant therapy is complete.

After healing, the implants can be restored with a full arch prosthesis. There are many ways to achieve this. Locators or friction fit abutments may be utilized to retain a denture that is essentially “fixed” but can be removed by the patient for hygiene purposes. A bar may be utilized, or the prosthesis may be screwed directly to abutments already torqued to the fixtures. Inter-occlusal space is an important consideration here, as different prosthetic designs require different amounts of space to accommodate necessary components; 15mm from the implant platform to the opposing occlusal surface is a good benchmark number to consider here.