When all teeth have been lost, permanent dentures can be affixed to implants for maximum restoration. These implants can be placed in sets from two to eight, these are resin prostheses that can only be removed by dentists. In essence, these implants are overdentures.
The modern implantology techniques performed at the Flikier Institute of Dental Rehabilitation are known as All-On-4, All-On-6, or the All-On-8 technique in Costa Rica. In the case of the All-On-4, it is a brand name used to describe a specific implantation technique. All these implantations follow methods that are less invasive than traditional implants. The number that follows the “All-On” names of these procedures denotes the number of fixed bridges that ar permanently set as a replacement dentition.
Overdentures are made from acrylics and special composites that can be fixed to implants but can also be removed if needed. Female connectors are placed on the prosthesis, which is subsequently anchored to the malec connectors of dental implants. The resulting connection is strong yet removable. This technique allows for easy maintenance of oral hygiene with regard to the prosthesis.
A mandibular prosthesis can be fabricated to hold more than two implants. The more implants placed, the stability will be higher for some patients. The All-On-4 technique is generally preferred in Costa Rica, but implants can be added to the fixed prosthesis to restore speech, chewing and the natural smile.
At the maxillary level, four or five implants can be placed. The advantage here is that this prosthesis does not carry an artificial palate, allowing food to be tasted. In patients who cannot tolerate dentures due to nausea in the palate this is a sensible solution
A few major steps are involved in the All-On-8 implantation in Costa Rica:
First of all, prospective dental tourists contact the Flikier Institute. The goal is to understand the needs of the patient and the objectives of the dental team, and this is a conversation that can be conducted via email or voice calls. A collaboration with a local dental clinic in the patient’s country may be needed, and dental imaging files may be sent to Costa Rica as digital attachments.
A tentative treatment plan is drafted. Dental counselors in Costa Rica guide the patient through the process of booking flights, making hotel reservations, arranging ground transportation, and making visits to the clinic in San Jose. Pricing may be discussed at this stage, but with the understanding that it may be subject to change based on the evaluation.
In general, dental tourists get preferential treatment at the Flikier Institute because the dental team knows that the patient’s time is limited. Thereby, the initial visit and treatment consultation may be combined, particularly if 3D digital imaging was conducted ahead of the visit in the patient’s country of origin. The treatment plan and pricing can be agreed to in this step so that surgery may proceed.
Depending on the treatment plan outlined for surgery day, minimal bone grafting and extractions may be required. Dental tourists should not be surprised by the doctor’s recommendation of the All-On-4 technique instead of All-On-8. It is always wiser to choose the least invasive and most cost-effective technique for the benefit of the patient.
As surgery is being performed, the patient is being evaluated for implant choices. It is important to discuss details such as the tone of the new teeth, their shape, the amount of gum tissue that will be shown with each smile, etc. Digital molds are extensively used these days, but a prior determination of physical molds may be made in some cases.
Once the teeth are set in the final step, post-surgical x-rays are taken and the patient is counseled on follow up visits at home as well as on how he or she will take care of the new dentition.