Acrylic vs. Ceramic all on four implants?

Question

Does anybody have experience of the all on four implants?  Today I had a consultation with a dentist.  She told me there are two choices for the all on four implants.  The choices are acrylic and ceramic. She told me people who go for the acrylic all on four implants normally get them replaced about every 3 years.  Is that true? I thought the all on four was fitted for life? I have seen dentists who offer a lifetime guarantee for the all on four.   Which is better acrylic all on four or ceramic all on four?

Ara Nazarian, DDS, DICOI · Answer

There are several choices when looking at All On Four Implant Restorations. The most common restorations include Acrylic on a Metal Frame, Porcelain to Metal and Zirconia. Acrylic/Metal Frame restorations are very lifelike, however, over time the teeth can wear or break. If this happens, your dentist may be able to use the same frame with replacement teeth. Porcelain to Metal restorations require less maintenance, do not wear over time and keep their luster over time. Issues that can present with Porcelain to Metal include chipping of the porcelain in those individuals who are heavy grinders. Zirconia restorations are less likely to chip or break and require very little maintenance compared to Acrylic/Metal frame restorations. Prices of All on Four Implant Restorations using these materials definitely differ in price ranging from the low side (Acrylic/Metal) $14,000 an arch to the medium (Porcelain to Metal) $23,000 an arch to (Zirconia) $26,000 an arch. Depending on the number of extractions, grafting necessary, complexity of the surgery, prices may vary from state, provider and number of extra implants placed.

Sara Amini, DDS · Answer

Hi,Usually after surgery we fit temporary teeth which are acrylic and after a few month replace with porcelain final restorations.
Dr Sara Amini, London,UK

Kerem Turgut Atasoy, DDS, PhD · Answer

Hello.There are different prosthesis materials used in All-on-4 system. Acrylic is mostly used for temporaries. It can also be used as permanent material but due to its nature, it can undergo discoloration and wear.Ceramics are more resistant against discoloration and it's more durable material than acrylic.But all prosthesis materials may need to be changed after a certain time period like 8-10 years. Implants are the lifetime pieces of this treeatment.

Dushyanth Paul, MDS · Answer

All on 4 Dental Implants are fabricated from Titanium Grade IV and when done using world renowned brands like Nobel Biocare, they last for a lifetime. Successful dental implant placement is possible when the technique is being performed by an expert Implantology team that comprises of experienced and highly qualified Implantologists, Oral Maxillofacial Surgeons, Periodontontists and Prosthodontists. 
  
From what you have described I understand that you have been told about the post-implant prosthesis, where there are 2 options. One is the acrylic hybrid screwable prosthesis and the second one is high-end screwable prosthesis with individual Zirconia ceramic crowns. Both the prosthesis have Titanium substructure from Nobel Procera, Sweden, that reinforces the prosthesis. The latter is fabricated through CAD-CAM technology, is more expensive and is aesthetically more superior to acrylic prosthesis. It is the acrylic prosthesis that may need replacement after probably a period of 5 years.

Jyoti Singh, MDS · Answer

I feel you are confusing with the implant material or and the prosthesis/ teeth material. I would like to throw some light on this.
1. Implants which are commonly used are made up of titanium alloys with different types of coatings like plasma, acid etched, hydroxy apatite etc. on them which can improve implant bonding to the bone. Nobel Biocare, Straumann, Bio Horizons, are some top brands of implants
2. Type of prosthesis on top of these implants, have  framework inside the prosthesis + types of teeth
Framework can be made up of metal alloys or zirconia or PEEK polymer
And teeth on top of framework can be made up of Acrylic, metal ceramic, metal free ceramic, zirconia or composite resin
The type of prosthesis or material best for you depends on many factors like quality and quantity of bone around implants, relation of upper / lower jaw with each other, space available for placing the teeth, smile line, lip length, opposing dentition etc etc 
Wear of Acrylic is more in comparison to ceramic or zirconia teeth. That may require changing of the Acrylic Teeth ONLY after 4-6 years depending on the quality of Acrylic. Implants and framework need not to be replaced.

Implant brands will give you lifetime warranty that will not require replacement. 
Ceramic or zirconia teeth are more natural looking , more strong and  durable.

Tarsys Loayza, DDS, MSc · Answer

Hello
It all depends on the state of your teeth, not all dentures are the same, not all procedures require the same attention, however when you decide your best option you must make all the possible proposals with your dentist.
Regards.

Lance Timmerman, DMD, MAGD - Account Suspended · Answer

There are 3 parts to implant treatment: the fixture, the restoration, and the connector.  The fixture looks like a screw and is made from titanium (can also be made from zirconia but those are for individual teeth and not the All on Four treatment), the restoration is a crown or bridge (an arch for All on Four is a bridge), and the connector is called the abutment.

What YOU were told is the variation in material selection for the RESTORATION.  There are MANY options: acrylic, acrylic with a metal frame, zirconia, zirconia with a metal frame, composite material, etc.

When offices give a lifetime warranty, there are usually conditions and fine print, and I doubt would give that to an acrylic restoration due to them wearing out.  I think they last longer than 3 years, but mileage varies.

In ALL of this, the titanium implants remain the same (normally).  It is only the restoration that is getting replaced.

German Arzate, DDS - Account Suspended · Answer

The MAIN CONCERN,on cases like this is the amount of bone you have , and this will determine which material its best for you,because maybe you ask for zyrconia but this will make a side effect over the implants,and you could not distribute the masticatory forces.and sometimes acrylic can be used,but this will depend on the patient case.

Acrylic vs. Ceramic all on four implants?

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