Final on four prosthesis

all on 4 full arch hybrid

Final on four – immediate metal-resin full arch dental implant supported prosthesis

Final on four is another name for a denture prosthesis that attaches to the jaw with four dental implants.


Delivery of the final on four prosthesis just 2-3 days post surgery is possible BUT

As this OSU (Yilmaz Aug 2015) case shows it is possible to deliver a final prosthesis shortly after the surgery.  The case example they show is ideal for the situation as it is mandibular case against an upper denture.  The major potential issue that they discuss is unpredictable soft tissue healing thus leaving unpredictable space between prosthesis and soft tissue.  On the lower jaw that is not a major issue, but this can create limited area to allow hygiene or excessive space allowing air flow in the space.  These problems are rarely an issue in the mandible.  Also since the acrylic is highly unsupported with this metal set-up it is fortunate to be going against a denture.  Natural teeth or a fixed upper and it would not take long to have issues with teeth breaking off.

Image of old school final on four
Comparison of this OSU case and my linked post of Ti substructure posted below.  This design is vastly inferior.

Final on four material improvements

The same concept could easily be improved simply by designing the metal the same way Uwe does in my post of lab work for Ti substructure.  Also it is not a good idea to use acrylic as a long term solution, we now know this.  Better to go with porcelain, but for immediate situation like this composite teeth and Gradia gum are a good choice.

Image of final on four
Zirconia framework porcelain implant supported bridge

I have seen a German lecturer that uses a protocol to seat final zirconia prosthesis at same time as surgery.  Amazing and sad to say quiet away ahead of what we can do here in America.  If you are in the Chicago land area or Wheaton Glen Ellyn area and have an interest in final on four dental implant prosthesis call us for a complimentary consult. In our practice, one doctor completes the entire procedure from start to finish.