A PATIENT S GUIDE TO UNDERSTANDING ALL-ON-4 Dr. Wayne Brueggen
The decision to get dental implants is rarely quick or easy for most people. Few adults start life with a plan to replace all their teeth. It starts with a few cavities, a crown or two, a root canal, a bridge... Before they know it, thousands of dollars have been spent on procedure after procedure to try and save their teeth. This book is designed to give you a better idea of how the process works and what you can expect. Meet Trevor Meet Trevor. He is our patient for today and we ll be following him through the exciting journey of getting All-on-4 Dental Implants.
Trevor had been suffering for years with dental problems. He d had teeth pulled, crowns and bridges and now his dentist was suggesting dentures. Being a teacher and having an active lifestyle, Trevor couldn t imagine himself in dentures. Trevor was extremely frustrated. He was physically uncomfortable and in pain every time he ate. He had recently been passed over for a promotion he felt that he deserved. His self-esteem was at an all-time low. He simply wanted to be able to eat again and not to be embarrassed by his smile. After searching for a solution online, Trevor came across dental implants and a procedure called All-on-4. The more he read, the more excited he got. He decided to schedule an exam with Dr. Brueggen at Brueggen Dental Implant Center. The All-on-4 ends the cycle of repetitive and progressive dental procedures. It gives you a full, beautiful, natural-looking and feeling smile, restoring 90% of your natural bite force and eliminating painful dental issues.
Trevor s CT Scan When Trevor arrived at the office, he met with a treatment coordinator, who explained that their job is to collect medical and digital information that Dr. Brueggen will need for his exam. After asking Trevor a few questions about his medical history, a dental assistant arrived to take a CT scan of Trevor s jaw. The dental assistant explained that a CT scan provides a 3D image of his jaw. This image enables Dr. Brueggen to see the height, width and density of his jaw. The CT scan is completely painless and takes about 2 minutes.
The Exam Once the CT scan was completed, the dental assistant took Trevor to the exam room. Trevor had been to many dentists and was apprehensive about the exam being painful. Immediately, Dr. Brueggen reassured him patting his shoulder and smiling: Nothing that I m going to do is going to be painful, I m simply gonna take a look at your teeth and gums. Are you having any pain or discomfort? Trevor went on to tell him about his problems eating, being embarrassed to smile and that his teeth were loose and sore. Dr. Brueggen, finished up the exam and told Trevor: You seem to be a good candidate so far for All-on-4. Let s take a look at your CT scan and we ll discuss all of your options. Follow me Trevor, we ll take a look at your CT scan. The exam is extremely gentle. The teeth and gums are examined, a TMJ (temporomandibular joint) exam is performed and a head and neck cancer screening is done.
Trevor was excited; he felt like he had finally found the answer. He followed Dr. Brueggen into the consult room. Up on the wall, a huge TV screen displayed Trevor s CT scan. Dr. Brueggen pointed to the CT scan and showed Trevor his lower and upper jawbones. Trevor, he said smiling and pointing at the CT scan, what I look for is height, width and density of the jawbone. You have plenty of height and width and your bone quality is excellent. There is no practical remaining solution available to save your remaining natural teeth. You are a perfect candidate for All-on-4. Trevor was filled with excitement. When can I begin?!! We can get things started right away. I ll get a dental assistant and we ll take impressions. The CT scan is extremely important because this (3D x-ray) lets Dr. Brueggen know if you have enough bone, height and width for him to be able to place implants. It also allows him to identify vital structures such as nerves and vessels so he can perform the surgery safely. The CT scan enables him to tell his patients immediately if they are a candidate for dental implants.
Trevor s Impressions Dr. Brueggen shakes Trevor s hand and congratulates him. He knows how difficult it is for people when they have had a lifetime of bad experiences with dentists and their teeth. A few moments later, a dental assistant arrives. Hi Trevor, I m Cindy. We re going to take some impressions of your mouth. We ll use these impressions to help guide us as we make your new teeth. Dental impressions are made so that our on-site lab has a mold of the patient s mouth and teeth. Once impressions are made, they are immediately sent to our on-site lab. Peter, our certified master lab technician (trained personally by Dr. Brueggen), will begin to make a brand-new set of teeth.
The Importance of Pictures After finishing the impressions, Cindy tells Trevor that she s going to take a few pictures. Trevor, I m going to take some pictures of your smile and your face. These pictures will go to Peter. He s the artist that will be designing your new teeth. Trevor frowned, Cindy smiled reassuringly at him. This is everyone s least favorite part, but in a few days, you won t be able to stop smiling. Trevor laughed. Thank you, Cindy, he smiled, knowing this was the last photo he would take without a perfect smile. Taking pictures is extremely important because it allows Peter to see the patient s personality, the shape of their face and important things such as how much of their teeth or gum show when they smile. A fully custom set of teeth will be ready for the patient the day of their surgery.
Trevor s Surgery The day of Trevor s surgery arrived. Trevor was excited, but nervous as well. Dr. Brueggen patted Trevor on the shoulder and smiled. You re gonna be just fine. I know, smiled Trevor. I ve been waiting for this for a long time. Dr. Brueggen spent a few minutes answering Trevor s questions, helping to put Trevor at ease. Dr. Brueggen gave Trevor some nitrous oxide (laughing gas) to help him relax. Once Trevor was comfortable, Dr. Brueggen began his IV sedation. Dr. Brueggen took extensive post-doctoral training to become IV certified. IV sedation enables Dr. Brueggen to be extremely exact with the dosage he is administering. IV Sedation puts you in a state of twilight sleep where you can understand and respond to requests. IV sedation induces a state of deep relaxation and time will appear to pass very quickly. Most patients remember nothing at all after the procedure.
The Difference between Oral and IV Sedation Most dentists have not gone through the extensive post-doctoral training that Dr. Brueggen went through, and they rely on oral sedation. This type of sedation is not as reliably effective as IV sedation. With IV sedation, the dosage can be tailored to meet the individual s needs. With oral sedation, the effects can be very unreliable and vary greatly. Also, the level of sedation is much deeper with IV sedation than with oral sedation and as the level of training and experience required to administer IV sedation is much greater than for oral sedation, it is exceptionally safe.
Placing the Implants Once Trevor is comfortably sedated, Dr. Brueggen gently removes Trevor s remaining teeth. Next, Dr. Brueggen places 4 titanium implants. Dr. Brueggen tests each implant to make sure it is extremely secure. Once he has placed 4 implants in the top jaw, he then places 4 implants in the bottom jaw. Unlike other dentists, Dr. Brueggen must be extremely gentle when removing teeth, as he needs to preserve bone and soft tissue to provide beautiful recipient sites for your new implants. The All-on-4 procedure is incredibly strong because he places two implants at an angle, and two vertically in each jaw.
On-Site Lab While Dr. Brueggen is in surgery, Peter, our certified master lab technician, uses stateof-the-art technology to add finishing touches to Trevor s new teeth. Trevor will wear his new teeth for 6 months while his implants integrate.
Trevor s New Teeth Are Ready After the surgery, Trevor will slowly awaken. Peter will begin aligning Trevor s new teeth to the implants. Peter will work diligently to make sure that they align and fit perfectly. The new teeth do not have a palate, so Trevor won t have to worry about anything covering the roof of his mouth. Peter creates 4 very small holes in the new teeth that match the exact positioning of the implants. Very small screws will secure the new teeth in place. The new teeth will look completely natural and will return the patient s bite back to about 90% of the bite force they had when their original teeth were healthy and strong.
After adjusting the new teeth, Peter lets Dr. Brueggen know that Trevor s teeth are ready! Trevor, you did great, says Dr. Brueggen, patting him on the shoulder. Trevor looks up and smiles. Thank you, Dr. Brueggen. Dr. Brueggen has Trevor gently bite and grind his teeth. He does this to make sure that the bite is even and his teeth are aligned. After a few adjustments, Trevor is ready to see his new smile! Are you ready to see your new teeth? asks Dr. Brueggen smiling. Dr. Brueggen hands Trevor a mirror. Emotion fills Trevor s voice. They are beautiful. Thank you. You re welcome, Trevor. You were amazing. Trevor stared into the mirror again. He knew he would never have to be ashamed of his smile again. His new teeth looked incredibly natural and they felt like his own teeth. This is Trevor s first set of teeth; in 6 months, he will get a second set of teeth. Dr. Brueggen told Trevor that there would be very little or no pain the next day and that most people only take an ibuprofen or two. Most of our patients are able to go home and in the morning, eat a breakfast with sausage, eggs, toast and grits. Believe it or not, many patients go to work the next day. The majority of our patients have endured years of dental procedures and dental problems that caused them pain and discomfort and most are extremely surprised at how comfortable and painless the All-on-4 procedure and recovery are.
Implant Integration (Osseointegration) Over the next 6 months, Trevor s implants will go through a process called osseointegration. This is a fancy word that describes the process of bone growing around the implants. The bone acts like cement and secures the implants in place. These implants should last Trevor the rest of his life.
Trevor s Perfect Smile It s been six months and Trevor is ready for his second set of teeth. Everyone notices that Trevor laughs more and smiles more. His smile truly matches his personality. Trevor s first set of teeth were created to help his implants fully integrate. Now Trevor is getting his final set of teeth. Trevor got to play a huge role in the way he wanted his second set of teeth to look. Trevor had the opportunity to work with Peter, Dr. Brueggen s master craftsman, to create his final set of teeth. Trevor was given the opportunity to change the color, shape, size and the look of his teeth. Trevor loved his first set of teeth, he said the shape was perfect and natural, but he asked Peter to change the color one shade lighter. Most people are so happy with the first set that they don t want any physical changes made. Peter creates the second set of teeth and infuses a specially milled titanium bar throughout the teeth to make them incredibly strong.
A New Smile, A New Life Trevor was amazed by how many people noticed his new smile. He said he was overwhelmed by how much happier he felt. He said his life had completely changed he could live life naturally without feeling judged. Trevor is a culmination of all of our patients. Our patients feel that they are getting a second chance at a new life. They ll never have to be embarrassed by their smiles. They ll be able to eat healthy foods again. They will not be overlooked for job opportunities. And they ll never miss another chance to take pictures with their family because they ll no longer feel ashamed of their smile. To all of the Trevors out there, we can t wait to help you smile again!
Dr. Wayne Brueggen Dr. Wayne Brueggen is a pioneer in the world of dental implants. Dr. Brueggen brought the All-On-4 protocol to North America and has placed countless thousands of implants and performed over 7,000 All-On-4 surgeries.