All on 4 framework options

All on 4 framework or all on x framework choices are no longer just a choice between what kind of metal. Advances in material science now allow the use of many new materials and manufacturing techniques are also changing.

All on x or all on 4 framework options

All on x or all on 4 framework options can be broken into three general categories. The first is metal and has been around the longest, the second is porcelain, the final consists of several materials that I am grouping together.

#1 Metal all on 4 or all on x frameworks

• Gold alloy or other noble metal alloy

• Titanium

• Chromium Cobalt

Advantages of metal all on 4 framework

• Long history or use in dentistry and many dental labs and dentists are familiar with the product.

• Very strong and difficult to break when made properly.

• If the all on 4 metal framework breaks, we can be laser weld it back together. This is not easy and maybe impossible if there is porcelain on the metal.

Disadvantages of metal all on 4 frameworks

• Metal costs more than other frames and the noble metal frameworks in particular are far to expensive to be practical.

• Heavy and if need to have a large frame the individual may notice the weight.

#2 Porcelain all on x framework

• Zirconia

On an X-ray the zirconia will look just like metal.

Advantages of zirconia all on 4 framework

• It is white and is very strong.

• Zirconia is a very tissue friendly material.

• If want strong teeth that are hard to break and do not wear down then you can make the framework and teeth one piece and this cuts way down on cost.

Disadvantages of a zirconia all on x framework

• Technique sensitive so not all labs or doctors will know how to work well with it. This is mostly out of the doctors hands.

• Need to ensure using high quality zirconia

• If the lab does not treat the zirconia right or if they use an inferior zirconia product, zirconia frameworks can break and there is NO fixing it.

These images show what the white zirconia framework looks like before and after porcelain is baked on top of it. Ignore the two yellow blobs on top of the zirconia, that is composite we use to verify the bite.

#3 Polymer, resin, fiberglass all on 4 framework

Of these frames there are some advantages and disadvantages of each one. For instance, Trilor and Trinia do not hold up well when we expose them so they must have composite covering them. We can expose Pekkton to the oral environment. We have an entire post that discusses the fiber reinforced framework.

• Pekkton is the strongest material in the high performance polymer family.

• Trilor is a multi-directional glass fiber reinforced epoxy resin

• Trinia seems to be the same or very similar to Trilor.

• Juvora is a PEEK product and I feel the other polymer materials make more sense for frameworks.

Related products: