All on 6 zirconia teeth
All on 6 with zirconia and nanohybrid composite teeth
All on 6 zirconia teeth and composite teeth dental implant prosthesis can have any number of variations. This is case were we have zirconia teeth and nanohybrid teeth on a titanium framework.
Natural looking all on 6 on top and all on 5 on bottom
Steve was looking for an implant supported prosthesis solution which is slightly different than the traditional all on 4 solution. Typically when someone comes to me looking for that they have a vision in mind that is more specific. They often do not want the traditional denture teeth or the perfect denture looking smile. Steve was looking for something more natural that people would not be able to tell that his teeth were fake. It actually takes a lot more work and skill to make the minor inconsistencies that make real teeth look real. We made his teeth with a titanium bar and a mixture of zirconia teeth and nanohybrid teeth with composite gums.
All on 6 framework selection
The options for all on 4 or more frameworks I cover in more detail in a previous post. However, I will briefly say I prefer metal or fiber reinforced resin. In this case we choose to go with a titanium framework. I choose metal here because we are doing individual teeth that are going to be very natural looking. If a tooth was ever to break it will easier for a future dentist to figure out what is going on and to know they can just take an impression and make a new crown to replace it.

X-ray verifying the fit of the all on 6 with zirconia teeth. Metal and zirconia show up the same on x-rays as white. The very white teeth are the zirconia teeth and the less dense white teeth are the nanohybrid teeth.
All on 6 teeth selection
I also have an entire page on all on 4 or more tooth material selection. In this case we went with mostly zirconia for their strength and durability. However, doing the entire case in zirconia can make for some very loud chewing sounds when the tooth jaws hit together. Therefore we chose to do the posterior uppers in nanohybrid composite. This will soften the blow when the two jaws come together. Not everyone is good at making zirconia look natural and I am blessed to have some excellent labs that can do this very well.
The biggest and most expensive question is whether to do individual crowns or connect everything into one piece. The advantages of individual teeth are that it looks a little more natural, also if one ever breaks any dentist can easily fix it without having to send the whole thing back to the lab.
Before and after photos of the all on 6 zirconia teeth
A complete step by step of this case can be seen on our step by step all on 4 prosthesis page. All on 6 high resolution photos can be seen on our high resolution page.
Technical specs of this particular AO6 and AO5 implant supported prosthesis
The teeth are Nacera Q3 zirconia and GC Cerasmart milled hybrid ceramic composite. We use Gradia Gum and a Panthera dental implant bar for both arches.
What options are there for those with metal sensitivity? While I know nickle is a serious problem, I’d hate to get a couple of months or years down the road and have issues requiring removal. My father has a palladium wedding ring. I’m not sure I’d trust any metal. Can there be a test before dental work? Also I have a sensitivity to perfume / scent irritants. How can I be sure to avoid this issue?
Hi , I have many questions and my gf has just gone thru this horrendous procedure with another dentist..We are very Unhappy with the results, my heart literally sank as I saw what she ended up with.We chose all on 4 for her upper.she had her few remaining upper teeth pulled and the 4 implants were put in.When doing this, he literally made an inscision around the whole arch of the gums and peeled it back to insert them.Is that how its normally done? She then had to wait almost 9 months with NO teeth before getting the poorly made end product..He said her fresh installed implants could Not be fully torqued ,so she was not a candidate for immediate prothesis.he offered her a cheapo denture and put polident on it into her mouth that was still bleeding from the surgury.she couldnt stand it and pulled them out after we left office.these dentures were so bad they looked like something you would see in a dollar store for holloween.
so she went with No teeth at all for 6 months.! at that point we were asked to come in and he said we are ready for the final..he needed to make a :jig: i guess u call it, out of titanium that was to be the basis for the final..her implants were put in at the weirdest looking angles i’d ever seen.The 2 in front were close together and the rears were Very close to those in front.the end result was what looked like a Huge cantilever effect,cuz the rear teeth were just hanging out there unsupported by the rear implants..she has a total of only 10 teeth on her upper..id say 2 or more teeth went beyond the back implants.Isnt that bad design and trouble waiting to happen? when I asked him abt this he said dont worry I install them like that all the time, you dont have enough bone in the back thats why the implants are all forward and at angles.When i say angles ,I know the rears are often tilted but some of these are so cockeyed the screws are in the front of the teeth and on the upper part of where it meets the gumline! her lip is catching on where a screw is going thru the Front of the bridges gum area! that cant be normal or acceptable? After things were sent to the lab at the 6 month point,we thought we would hear back in 2 weeks but the lab dragged on and on and 3 more months passed b4 we finally heard teeth were ready! Lastly, and most disconcerting was when we entered the office, he looked all excited, “your teeth have arrived!” and he showed us a little box with the all on 4 zirconia with porcelain overlay for ascetics..he said it was ALL zirconia even the gumline.
it was supposedly made around a titanium bar..is that Normally how zirconia all on 4 is made? I thought they were monolithic zirconia? Anyway ,i examined it and well, it looked pretty nice! i was pleasantly surprised..Good color match, translucency,variation in tooth structure it looked realistic….we go into the dental room and he puts this thing in , and she opens her mouth and i was saddened and shocked, my heart sank. the nice looking quality bridge i was shown did Not at all look like this thing in her mouth,..As i think back on it, the only explanation that comes to mind is that he mentioned that he just received abt 10 other all on 4’s for other patients that had been waiting..Maybe, just maybe he grabbed the wrong box and what he showed us initally may have been for another patient? could have been an honest mistake… But certainly he himself Must then have noticed the radical difference in the one he installed on my gf..why did he not say “im sorry, the one i showed you in the waiting room was for a different patient..THIS one is what ur getting here” he said no such thing and just put it in..the differences were striking compared the what he showed us prior..the teeth she ended up with were a different color, much whiter and larger than what we were shown.the teeth we got were all uniform and identical, i call them doll teeth..no difference or variation. some of the rear teeth were not even fully shaped teeth from crown to gumline..the reflectiveness and translucency of the porcelin overlay was absent on the ones we got and lastly ,even the mounting holes were equally spaced verses the 4 implants crowded in the front area of ours, leaving a huge cantilever effect.I know its a long story Doc, but im shocked and stunned..this was almost 19,000 for just the upper..we were promised all on 4 zirconia with porcelin overlay and these could be acrylic for all i know..they are overly white, generic, no translucency at all and have given her an exaggerated overbite with larger teeth than is right for her and way too much teeth showing when shes talking..her lip is catching in the gumline ridge that protudes and has a screw popping out with filler over it…What can be done when a patient gets results like this? do we have any recourse? she was just going to accept it, dissapointed and all, and live with her”granny denture looking teeth”..I feel so sad for her.
I cant believe that modern dentistry produces results like this! we looked at so many online b4 and after vids of Other people and their dentists results and they seem to have such nice teeth, they walk out so pleased…We so badly wanted to have That experience..I dont even know if what we received is really zirconia… it was built around a titanium bar..Is that how zirconia all on 4’s are made?
how could be verify or Know what we really got? do dentists or labs provide a detailed breakdown of materials used in the building of these things to patients who request it? so many questions…so dissapointed.. any help greatly appreciated..I will check ur website for email response.. I’d love the chance to talk on phone if you would be willing. we need friendly and impartial advice from someone who Cares and has experience.
Sounds pretty normal. All procedural steps sound right. I know $19,000 is a lot of money but if that is what you paid for the implants AND the zirconia teeth then that is about as cheap as this procedure gets and you will likely end up with more of a denture look. It costs about $40,000 per arch or more to get the really natural looking ones. It is very expensive if you have an eye for detail. The vast majority of these done are straight and white and fake looking and most people like that. It seems you have an eye for detail, which is a blessing and a curse. The prosthesis can be removed and adjustments made still. Actually minor adjustments can make a really big difference so follow up with your DDS but you probably also need to lower your expectations some.