By Lori Lovely
When Bea Rose sat in the waiting room at Associated Oral & Maxillofacial Surgeons of Peoria for her six-week checkup after undergoing the All-on-4 procedure, a new patient sitting next to her couldn’t tell she’d already had it done. “It feels natural and looks great,” says the 62-year-old Groveland resident.
The All-on-4 procedure is designed for patients with a failing arch of teeth who are considering dentures. Four implants help restore one arch of teeth at a time for a result that more closely mimics natural teeth.
“It’s for a specific niche of patients who have lost a handful of teeth or have issues functioning with a conventional denture,” adds Nathan Schroeder, DMD, MS. Patients must meet specific criteria to qualify as candidates for the procedure.
Rose qualified. Having worn dentures for years due to a road accident at a young age, she said they “never fit well, never worked properly.” But it wasn’t until her dentist, Dr. Chris Loudermilk in Tremont, sent her to Dr. Schroeder for an opinion about repairing damage to her existing crowns that she learned about the option of dental implants. She was relieved to learn about the All-on-4 option. “I didn’t want to go through the expense and pain of fixing all those crowns.”
(Im)planting the Seed
Dental implants have changed people’s lives by providing a foundation for replacement teeth that look, feel, and function like natural teeth. The patient enjoys more functionality and often gains confidence because the teeth look so real.
The implants also help preserve the patient’s facial structure by preventing bone deterioration that occurs when teeth are missing. “Over time,” Schroeder explains, “stimulation from the implant helps maintain the jaw bone. When you chew and talk, it exerts forces along the teeth that contribute to long-term bone support. Dentures produce only compression.”
That can be an important consideration for younger patients like Dana Hargraves, who underwent the All-on-4 procedure on her lower jaw last December. The Peoria resident and mother of two is only in her 30s, but a previous eating disorder affected her health and her teeth. After the birth of her second daughter, one of her front teeth fell out. “It’s been hard on my confidence, especially raising two girls,” she says.
After moving to Peoria because of her husband’s job, her new dentist, Dr. Nicole Sudholt, referred her to Dr. Schroeder. “They decided that because I’m young, this is a better choice than dentures.” Results like Dana’s are a credit not only to the surgeon, but to the restorative talents of her dentist, Dr. Nicole Sudholt. The two worked closely together to insure the success of all phases of Dana’s treatment.
Hargraves says the implants give her confidence. “I’ve never felt better about my smile,” she reports. But it wasn’t all cosmetic. She calls it the best decision she’s ever made for her health.
Not only does the All-on-4 provide “far superior” results, according to Schroeder, it is also more convenient. Teeth are removed and preparation to the supporting bone is performed while the patient is under anesthesia. After surgery, the patient is fitted with a temporary the same day. “They walk out with a new set of teeth,” he says. “It’s that quick.”
Sometimes described as “titanium root replacement,” dental implants are surgically inserted into the jaw bone to serve as the foundation for a reconstructed tooth. After the bone bonds with the titanium, small posts are attached to the implant to serve as stable anchors for the replacement teeth.
Schroeder explains how the implants are angled and then splinted or linked between front and back. “Cross-arch stabilization is the key to success.” A pre-fabricated denture is converted to a fixed position, connecting the implants.
“Function is minimal at first,” Schroeder continues. Chewing should be limited initially. Rose, who had the first procedure in April but is recuperating from a bone graft because she says there was not enough of her own bone structure on the top, is still blending food despite her rapid recovery. Laughing, she says, “I’m looking forward to salad. I’ve never had so many smoothies!”
At the conclusion of an approximately 12-week recovery period, the patient’s dentist removes the temporary prosthesis. Fabrication of the final prosthesis takes about two weeks. The patient’s dentist then attaches the final teeth, which are typically made of porcelain or zirconia on a milled titanium bar, making them lightweight, durable and aesthetically pleasing.
The Road to Recovery
Hargraves, who also needed bone grafting when she had her upper teeth removed last year, underwent six hours of surgery. “I was in bed for a week. My face was swollen.”
Delighted with the permanent solution, Rose was undaunted by “some swelling and bruising” during her two weeks of recovery. “Don’t be put off; it’s not painful if you follow the regime — just a little uncomfortable.” She will have her top teeth removed in November in preparation for the same procedure in the upper jaw. “I’m not finished yet,” she confirms. “I’m looking forward to it. I can’t wait for the final procedure.”
Schroeder credits part of the positive results with the fact that his patients see the same doctors throughout their treatment. Referring to large implant centers that do a lot of advertising, he says, “They aren’t the only ones doing it; local offices also offer this procedure.”
In fact, he believes that private practice care in conjunction with the patient’s dentist offers a better setting, thanks to long-term follow-up in the community. Specifically, Schroeder believes that the methodology and level of care at Associated Oral & Maxillofacial Surgeons of Peoria provides the best service for optimal outcomes.
Rose appreciated the home-town attention. “Dr. Schroeder is absolutely great,” she declares. “He looked after my husband as if he was family.”
Three in One
Associated Oral & Maxillofacial Surgeons of Peoria has been serving patients in Central Illinois since 1971. Schroeder, a graduate of the University of Florida College of Dentistry who completed his oral and maxillofacial surgical training at the University of Iowa Hospitals and Clinics, where he also earned a master’s degree with a research thesis focused on bone biology and dental implants, notes that all three surgeons on staff perform the All-on-4.
John Otten, MD, DDS, is a 1989 graduate of the University of Nebraska Medical Center College of Dentistry and a 1992 graduate of Louisiana State Medical Center College of Medicine. Originally from Washington, Illinois, he has practiced oral and maxillofacial surgery since returning to Peoria in 1995.
Another Washington, Illinois, native, Larry Otte, DMD, graduated from Southern Illinois University School of Dental Medicine and completed his residency training in oral and maxillofacial surgery at Henry Ford Hospital in Detroit Michigan before returning to Peoria, where he practices full-scope oral and maxillofacials, with special interest in dental implants and orthognathic surgery.
The Tooth Fairy
“It’s one-stop shopping because we work with the patient’s regular dentist,” Schroeder says. The doctors also work with insurance companies to try to help their patients.
“He went above and beyond by writing to my insurance company, claiming this as necessary, not merely cosmetic, because my teeth were crumbling,” Hargraves recalls.
Although ultimately Schroeder considers the All-in-4 an effective solution that can cost half to one-third of other options, he recognizes that “cost is an issue.” The restorative procedure, which has been around nearly 10 years, runs $20,000-$24,000 per arch. “Some of my patients tell me ‘That’s a new car,’ but I tell them they’ll get more mileage from the implants! Most patients receiving this procedure are middle-aged. With proper maintenance and care, they can expect them to last their lifetime.”
Medicare doesn’t cover the procedure and insurance coverage varies. Nevertheless, Schroeder says, “Once a patient sees the benefits, very few don’t choose to go through with it.” And very few don’t like the results.
“It’s not cheap,” Rose states matter-of-factly. “But I’m glad I did it. You can tell the difference between dentures and implants. They are nicer looking teeth. The outcome is so good.”
She goes on to list benefits beyond merely cosmetic, pointing out that a full set of dentures is not anchored and that it covers the roof of your mouth. Not only is that less comfortable, but it decreased her ability to taste.
It looks and functions well, Schroeder reiterates. Once they’ve healed, patients can eat all types of food, including corn on the cob and steak. Hygiene is simple — similar to maintaining a bridge. “You must clean underneath with a water pick or super floss, and you’ll still need to see your dentist.”
Hargraves said she and her husband were at the financial point in their lives when they could afford to do it. As she looks ahead to finishing treatment, she pauses to compliment Schroeder. “He’s young and up to date on techniques. I felt comfortable; I knew I was in good hands.”
Patients are driving this treatment, Schroeder says. For anyone interested in the All-in-4, he advises, “Ask your dentist.” A successful outcome results when the general dentist works in concert with the oral surgeon throughout all phases of treatment.
For more information on implants or to schedule an appointment, contact the Associated Oral & Maxillofacial Surgeons of Peoria, located at 2807 N. Knoxville Avenue, Peoria, IL.Call 309-682-1213 or visit www.aospeoria.com.