When is it time to consider utilizing implants to support dentures that are secured in the mouth creating an attractive functional smile? Perhaps you already have some form of removable denture that does not function as well as you had hoped. Perhaps you have chronically failing dental health resulting in pain or discomfort. Or, you are embarrassed by your smile. For patients across Chelan, Douglas, Grant, and Okanogan Counties who have these problems, the question is no longer whether to act but how to act in a way that can restore a beautiful, functional smile.
At Wenatchee Dental Arts, Dr. John Divis, DDS, FAGD, has been in practice over 30 years and planning and placing full-arch restorations for patients from Wenatchee and the surrounding region for over 10 years. His approach to full-arch restoration integrates Instarisa 3D facial scanning with intraoral scanning and i-CAT 3D cone beam imaging, merging all three data sets into a single planning environment before a single implant is placed. If you have been researching your options, our dental implants page covers the broader implant philosophy behind this work.
What Is All-on-X, Exactly?
The “X” in All-on-X refers to the number of implants used to support a fixed, full-arch prosthesis. The original protocol used four implants per arch, and the term All-on-4 still appears frequently. All-on-X simply acknowledges that some patients need five or six implants, depending on available bone volume and arch anatomy. In either form, the outcome is a durable, non-removable set of teeth secured to the jaw rather than sitting on top of the gums.
This is a meaningful distinction from conventional dentures and partial dentures. A traditional removable denture rests on the gum ridge and shifts during eating and speaking. An All-on-X prosthesis is screw-retained to the implants, which means it does not move. Patients who have worn removable appliances for years consistently describe the stability as the most immediately noticeable change.
Who Is a Candidate for Full-Arch Restoration?
People who are in fair to good health with the exception of their oral health are generally candidates that can consider All on X tooth replacement. Most patients who consult with Dr. Divis about All-on-X fall into one of a few categories. Some have failing dentition across most of an arch, with teeth that cannot be saved individually. Others are already wearing a complete denture and want a fixed alternative. A smaller group has been edentulous for many years and still has sufficient bone to support implants without grafting. Each person has unique variations in health and bony anatomy. Only a thorough examination with the proper imaging such as 3D CBCT and a health screening can determine what needs to be done for any individual.
The evaluation visit at Wenatchee Dental Arts includes a CT scan, Instarisa facial scan, and intraoral scan. Dr. Divis, who holds a Fellowship with the Academy of General Dentistry, utilizes sophisticated processes that merge three data sets to build a virtual model of the patient’s oral and facial anatomy that allow the creation of a smile that “fits the person’s face.”. It is like creating a blueprint for a new smile. The following factors are typically reviewed during that process:
- Bone volume in the jaw, which determines how many implants are needed and whether any preparatory grafting is required
- Medical history, including conditions that affect healing, such as uncontrolled diabetes or active smoking
- Prosthetic design, including tooth shape, color, gum line position, and how the final arch will look in motion
That last point is where Instarsa changes the conversation. Most practices plan implant placement from a CT scan alone, working backward from the bone. Dr. Divis uses Instarisa to capture how the patient’s face moves through different expressions first, then maps the tooth position to the facial anatomy. The lab creates a blueprint built from all three scans that can be viewed and evaluated by the doctor and patient before treatment begins.
What the Treatment Process Looks Like
For most patients, treatment involves a surgical appointment during which the remaining teeth are removed, the bone is leveled if needed, and the implants are placed. A “healing temporary” prosthesis is delivered the same day or within a few days, depending on the specifics of each case. The result is often an emotional and breathtaking improvement in a person’s appearance. Patients will be limited to soft food while the bone heals to and creates a firm connection to the surface of the implants. Most people return to a normal diet at about 3 months. When the surgical healing is looking good then another temporary is made that fits to the new shape of the healed bone and soft tissue. It is referred to as the “Prototype temporary” and serves as a trial run for the final Zirconia restoration. Changes could still be made at this point but if it looks and feels good, the final restoration is made in short order. The temp is then swapped for the final and the patient has their strong new Smile.
Dr. Divis completed an in-hospital IV sedation training program through the Society for the Advancement of Anesthesia in Dentistry in 1999, one of the oldest dental societies in the country, and has performed sedation dentistry for hundreds of patients since. Full-arch surgery at Wenatchee Dental Arts is performed under IV sedation, which means patients do not experience the procedure consciously. The recovery period involves soft foods and careful hygiene for the first several weeks, after which normal eating gradually resumes.
Cost and Insurance Considerations
Full-arch implant restoration is a significant investment. Cases in our practice typically involve comprehensive planning, surgical placement, IV sedation, and both a temporary and a final prosthesis. CareCredit financing is available for patients who want to spread the cost over time, and our team can walk through the financing options during a consultation.
Dental benefits rarely cover the full cost of implant-based restoration, though some plans contribute to components of the treatment. Wenatchee Dental Arts is in-network with Delta Dental and Premera Blue Cross. For patients whose plans do not include those carriers, we work as an out-of-network provider, and our team assists patients in submitting their own claims.
Schedule an All-on-X Consultation at Wenatchee Dental Arts
Dr. John Divis has spent over 30 years building a practice in Wenatchee that handles the full scope of restorative and cosmetic dentistry, from a single implant to a complete arch reconstruction. His Fellowship with the Academy of General Dentistry reflects a commitment to continuing education well above what licensure requires, and his 1999 in-hospital sedation training through the Society for the Advancement of Anesthesia in Dentistry means patients who need complex, anxiety-sensitive care do not have to look elsewhere. The Instarisa and i-CAT-based planning workflow that Dr. Divis and the lab use together is not standard practice at most general dental offices in North Central Washington.
If you are considering full-arch restoration and want to understand what the process would look like for your specific situation, reach out through our appointment request form to schedule a consultation.
