A fixed prosthesis placed using the All-on-4 or All-on-6 technique is built on a small number of implants, but how long it lasts depends heavily on daily care. Even though the prosthesis doesn't cover the palate and can't be removed by the patient, there are areas underneath it and around the implants that need special attention. In this article we look at how to care for this type of prosthesis day to day, what affects its lifespan, and why regular check-ups matter.
Why Does This Prosthesis Need Special Care?
Even though the fixed prosthesis is a single piece, there are narrow spaces between the prosthesis and the gum, and around the implants, that are prone to plaque buildup. These areas are hard to reach with regular brushing alone; without regular, proper cleaning, the risk of inflammation around the implants increases.
How Should Daily Cleaning Be Done?
- Interdental (interproximal) brushes: Small brushes specifically designed to clean the spaces between the prosthesis and the gum.
- Super floss: Floss with stiff and soft sections that can clean the areas underneath the prosthesis.
- Electric toothbrush: Effective for the daily cleaning of the prosthesis's visible surfaces.
- Oral irrigator (water flosser): Uses water pressure to help remove debris from areas brushes and floss can't reach.
The dentist or dental hygienist demonstrates the cleaning technique specific to the patient's prosthesis design in person during the first check-ups; this training is essential to the prosthesis's long-term health.
Factors That Affect Its Lifespan
- Oral hygiene: Regular, proper cleaning is the single biggest factor.
- Bruxism (teeth grinding/clenching): Untreated excessive biting force can place more load than expected on the prosthesis and implants.
- Smoking: A significant risk factor that negatively affects tissue health around the implants.
- How often check-ups happen: Missed check-ups can mean early-stage problems are caught later than they should be.
- Prosthesis material: Acrylic-based prostheses can be more prone to wear and discoloration over time compared to zirconia-supported ones.
How Often Are Professional Check-Ups Needed?
At intervals set by the dentist, the prosthesis needs to be removed for professional cleaning underneath, the screws holding the implants need to be checked for tightness, and gum health needs to be assessed. These check-ups catch early-stage problems that daily care alone won't reveal.
The Biggest Risk: Peri-implantitis
Inadequate cleaning around the implants can lead to an inflammatory process that, over time, affects the bone surrounding the implant; this is called peri-implantitis and is the most significant long-term risk for this type of fixed prosthesis. See our article on what peri-implantitis is for details on its signs and treatment.
When Should the Prosthesis Be Replaced?
Cracks, fractures, or noticeable wear in the prosthesis; changes in the bite relationship over time; or loss of color can all be signs that replacement may be needed. How often replacement is needed depends on the material used and the patient's habits; the most reliable guidance on this comes from the dentist during regular check-ups.
Two Common Questions
Should the prosthesis be removed at night? No, All-on-4 and All-on-6 prostheses are fixed and can't be removed by the patient; temporary prostheses used during healing may be an exception to this, and guidance from the dentist should be followed in that case.
What's the average lifespan of the prosthesis? It varies depending on care and material, but with regular maintenance and check-ups it can be used for many years without issue; rather than a fixed number, regular follow-up is what's recommended.
Summary
All-on-4 and All-on-6 prostheses are fixed, durable solutions, but their long-term success depends largely on daily care and regular dental check-ups. Proper cleaning with tools like interdental brushes, super floss, and an oral irrigator plays a key role in preventing peri-implantitis, the most significant risk.
This article is intended for general information purposes. Consult your dentist for a care routine specific to your prosthesis.
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