ANSWERS

Who is a good candidate for All-on-X?

Good All-on-X candidates are adults with full-arch tooth loss or failing dentition, sufficient bone volume or graftable sites, controlled systemic health (diabetes A1c under 7, no active bisphosphonate complications), and non-smoker status or willingness to quit.

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How much bone volume is needed before you can plan an All-on-X case?

As a lab, we recommend evaluating a CBCT before finalizing the prosthetic plan. Adequate bone height and width to place four to six implants with primary stability is the baseline. Deficient sites may require grafting, zygomatic implants, or a tilted posterior implant design. Send the DICOM with your case submission and we can help with prosthetically driven planning before surgery.

Which systemic conditions should make me reconsider an All-on-X patient?

Uncontrolled diabetes with A1c above 7, active IV bisphosphonate or antiresorptive therapy, recent head and neck radiation, uncontrolled periodontal disease, and heavy active smoking are the most common concerns. Autoimmune conditions and immunosuppression warrant medical clearance. These factors affect osseointegration and long term prosthetic success, so document clearance before we fabricate the definitive prosthesis.

Can a patient with a failing dentition transition directly to All-on-X?

Yes, terminal dentition cases are common All-on-X candidates. Extractions, alveoloplasty, and implant placement can be staged same day when primary stability allows for an immediate load provisional. We fabricate the interim prosthesis from your surgical plan and diagnostic wax up. Confirm opposing arch condition, vertical dimension, and parafunction before committing to the definitive material.

What material do you recommend for the definitive full arch prosthesis?

For most All-on-X cases we recommend monolithic zirconia on a titanium bar or direct to multi unit abutments. It offers strength for full arch loading, resistance to fracture, and good esthetics when layered anteriorly. PFM and acrylic hybrid options remain available for specific clinical situations. Share your occlusal scheme and opposing dentition and we will confirm the best material for the case.

How do parafunction and opposing dentition affect candidacy?

Heavy bruxism, clenching, and an opposing natural or fixed arch increase load on the prosthesis and implants. These patients are still candidates, but we may recommend additional implants, a more conservative cantilever, monolithic zirconia, and a nightguard. Document parafunction on the Rx so we can adjust connector thickness and occlusal design during fabrication.

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