Ali John Jazayeri, DDS

Great question. First off, both of these options are excellent restorative treatments which give you fixed, durable teeth. Here are the major differences between the two treatments:

1. Costs: Full mouth dental implants (FMDI) typically requires 8 implants whereas all-on-4 (AO4) requires only 4 implants. As a result, FMDI are more costly and technique sensitive. Generally, FMDI cost at least $10K more than AO4.

2. Time: AO4 can be done relatively quickly, anywhere from one day up to 3-4 months. FMDI typically require extensive bone augmentation surgeries. As a result, FMDI treatment can take upwards of 6 months, even more than a year sometimes.

3. Aesthetics: Both of these options look great and realistic. However, all-on-4 teeth are all connected as one piece. Plus, AO4 teeth have a large pink segment which replaces the gums. FMDI has more natural looking teeth and less pink gum showing.

Now these options are both wonderful. They are permanent, preserve your jaw bone, look beautiful and you really can't go wrong either way. Good luck!

AJ Jazayeri DDS 

Very good question. Actually, both options you have suggested are acceptable. So one option is to convert your two implants into a 4-unit implant supported bridge. The second option is to place one implant in place of two teeth and restore with two crowns on top. I will be totally honest with you, your dentist should have recommended pulling these two additional teeth when you received your first two implants. I almost always address the lower front 4 teeth together (via 2 implants and a 4-unit bridge). As far as which is the better option, that's up to you. They both work well if done carefully.

Your tooth can be restored with either a post and crown or a dental implant. For you specific case, I would definetely recommend an implant over crown for several reasons. First off, you’re only 35 years old, so the chances of your crown failing in the future is very high. Second, the tooth broke below the gum-line, leaving very little tooth structure to support a crown. Finally, the tooth you broke is a well known tooth to fail and require dental implant. Lateral incisors are very weak teeth with little tooth structure to support a crown once the tooth breaks below the gum-line. Of course, if you absolutely prefer a crown and post, you can go that route too. However, it will most likely cost you more time and money in the long run in my opinion.

Waiting 2 years may be a bit too long, but so long as the implants have healed and the cover screw has stayed on, it’s not an issue. Your implants are buried so they need to be exposed, known as second stage surgery, so restoring them will take much longer than a week (most likely about one to two months). Now don’t wait too long either, as eventually the opposing tooth moves down into the space and creates a significant restorative issue. Best of luck! 

Unfortunately, placing a dental Implant is your only long term solution. It looks like you had a root canal and crown where the crown, along with 90% of your tooth structure above the gum line, broke off. You can put a new post and crown, but given your young age and bite problems, it won’t last you too long and you just wasted $1,000+. 

The solution is to take the broken tooth out and place a dental Implant instead. In 3 to 6 months when your implant will heal and you can receive your crown and have your tooth back! 

As you know, dental implants are expensive. Depending on where you live in the US, a tooth extraction, dental implant and bone graft (which you will likely require) will cost between $2,500 to $5,000+. Typically, general dentists who perform implants charge less than periodontists or oral surgeons. However, be sure to find an experienced one. Most dentists offer financing, so if you have good credit you can pay monthly payments.

If you can’t afford an implant at the moment, I recommend you wear a denture for the time being. A denture costs only a few hundred bucks. Wear it until you can afford the implant. Don’t waste your money on a new crown as it won’t last. Same with a bridge, as you will break that too in time and end up with even more missing teeth. I hope this helped.

Sorry to hear that your crowns fell off. Lots of dentist cement their implant crowns with temporary cement and this was most likely the cause. Dentists do this so that they can retrieve the crown should it even break, get loose, etc. Now to answer your question, it's always better to contact your original doctor first and ask for their opinion. Make sure to get all the information pertaining to your dental implants from your original implant dentist. Find out exactly what size and brand each implant is, for example "implant #18 is Implant Direct Legacy 3 with a 5.5 mm width and a 10 mm height". Next, go and do some thorough research and find an experienced implant dentist near you. Don't just go to any dentist as addressing implant complications is very tricky and technique sensitive and is not for every dentist. Finally, be prepared to spend a good chunk of money, possibly a few thousand, on your treatment. There is the possibility that you may require a new abutment, screw, crown, etc. and implant dentistry is much more expensive than general dentistry. Hope this helped answer your question and best of luck!  

Hi there. It's always better to travel in the States, to have a dentist who is accountable in case something goes wrong. For instance, sometimes a tooth falls off and you must go back to your original dentist in these cases to have the repair done. If you're willing to travel to So. Cal, my office happens to be running an all-on-four special during September, which happens to be dental implant month. We're offering the treatment at $14,999 per arch. The initial surgical phase will take about 1 to 2 weeks and 3 to 4 months later the restorative phase takes about 1 month. I happen to have a good colleague in Arizona, but unfortunately he doesn't do AO4, otherwise I would've referred you to him! Regardless of where you get your treatment, All-on-Four is a much, much better treatment as compared to dentures or implant-retained dentures (which are still dentures). You get much better chewing, much better looks and most importantly, better bone preservation and they feel almost like your original teeth.

When you hit a tooth in a bad accident, it can cause internal bleeding. This will turn the tooth yellow over time. You asked if you should take the tooth out or not? The only reason to take this tooth out is if you’ve had a root canal already and the root canal is failing. Just looking at your picture, this doesn’t seem to be the case for you, although an X-ray and full exam is required. The second part of your question was if you should put a Porcelain Veneer on the tooth. If the tooth if salvageable, then yes, a Porcelain Veneer it your best solution. Bonding stains and turns yellow and is ineffective for larger, more visible fractures. The only other viable solution is internal bleaching. Internal bleaching is when your dentist applies bleach inside the tooth nerve, assuming the tooth has already had a root canal, until the tooth turns white. Keep in mind that Porcelain Veneers are so effective that they have pretty much replaced internal bleaching as a solution, but I just thought it would be interesting for you to know about it. Good luck with your Porcelain Veneer!

Hey there. Placing veneers or crowns will cover your gum recession, but you’ll end up with long teeth that don’t fit in. Plus, you don’t look like you have damage or restorations on your front teeth. It seems like gum graft is a much better option for you. First off, you won’t damage your teeth with a gum graft as opposed to crowns and veneers. Secondly, your front teeth would look nice and even with a gum graft and there won’t be any mismatch. By the way, I would consider Invisalign before doing the gum graft. This will straighten your teeth and reduce the possibility of relapse. Also, pay attention not to brush as hard to prevent future damage to your gums. Hope this helped!