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

lGold alloy or other noble metal alloy

lTitanium

lChromium Cobalt

Advantages of metal all on 4 framework

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

lVery strong and difficult to break when made properly.

lIf 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

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

lHeavy 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

lZirconia is a very tissue friendly material.

lIt is white and is very strong.

lIf 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

lTechnique sensitive so not all labs or doctors will know how to work well with it. This is mostly out of the doctors hands. Therefore, labs and doctors are required to have professional skills.

lNeed to ensure using high quality zirconia

lIf the lab does not treat the zirconia right or if they use an inferior zirconia product, zirconia frameworks can break and there isnofixing it.

3. Polymer,PMMA,fiberglass all on 4 framework

Of these frames there are some advantages and disadvantages of each one.

Advantages of the polymer all on 4 framework

lThey easy to mill and furthermore the milling pucks are cheaper to buy.

lAll the polymers and resins are lightweight in comparison to the other categories and therefore are easy for patients to adapt to.

lThey act as a shock absorber since they have some give. This is the best attribute of the material as it likely will help take some of the stress of off other important parts of the system.

Disadvantages of the polymer all on x frameworks

lCan not be repaired if breaks, however, we can re-mill them cheaply.

lNew product so not many labs will know the material well and there is not a lot or research behind it.

lSome must have a composite, acrylic, or porcelain coating to stop fraying, notably Trilor and Trinia.