Nobel Biocare, the same developers and researchers for the successful All-on-4® procedure, recently release a new permanent dental implant solution called Trefoil. Trefoil is a dental implant surgical protocol for the lower (mandibular) arch. The process includes placing 3 implants using analog guided surgery in a precise location so that a pre-fabricated titanium bar wrapped in acrylic and teeth can be placed within 1 week of dental implant surgery. The Trefoil concept is meant to replace mandibular Snap-on Dentures.
Trefoil is a more affordable option with a shorter treatment time compared to the All-on-4®. Patients who can afford the All-on-4® should, as Trefoil is not meant to replace the All-on-4®; instead, the Trefoil concept is meant to replace snap-on dentures.
The Trefoil Implant Concept reduces the implant cost from $7,000 – $12,000 as a customized milled titanium bar or a zirconia framework is not needed due to the prefabricated bar. Through specialized analog guided surgical techniques, it is now possible to attach the prefabricated bar to the 3 implants. With the All-on-4® , patients must come back for five to six visits to get their framework customized exactly where their implants are located. The All on Four allows the clinician freedom in implant placement which is why all prosthesis must be customized. The cost of treatment for the All on Four is high due to the fully customized nature of the All-on-4® and the 5 appointments needed to make this customized framework.
Patients who can afford an All-on-4® should continue to do so as the benefits still outweigh the Trefoil concept. Instead, the Trefoil concept has many advantages and benefits over a snap-on lower implant denture.
The initial Trefoil process begins with the consultation and a 3D CT Scan. We take impressions for initial records and a temporary prosthesis, which we will deliver the day of the surgery. At surgery, we place the patient under IV Sedation and perform a jaw relation record. You will then come back in a few days for another appointment for a wax try in to confirm the bite and aesthetics. A few days later your wax try in, we deliver your new permanent fixed teeth.
The Trefoil system is an Acrylic Titanium Hybrid prosthesis.
Palo Malo, the creator of the All-on-4® concept, originally investigated his protocol for a 3 implant system, yet it was changed to a 4 implant system. PI Branemark created the Novum implant system – a 3-implant system with a 95% or higher dental implant survival rate. The Novum was utilized from 1998 - 2007 with thousands of cases treated world wide.
The Trefoil system now uses a 5.0 mm diameter implant vs. a 4.3mm diameter which the All-on-4® uses. According to Palo Malo, the number of implants does not make an impact; instead, the size of the implants is important. He said, “[Hypothetically] you could support an entire mandibular arch of teeth with one 1 centimeter implant.”
PI Branemark, the creator of modern dental implant, developed Novum in the mid 1990s. The Novum treatment consisted of placing 3 large diameter implants in the mandibular arch. It boasted placement in the same day or near same day of a acrylic titanium prosthesis on a prefabricated bar. Several thousand patients were treated, yet Novum was taken off the market in 2007 due to only a 20% complication rate with the titanium bar.
With advanced technology, the prefabricated bar has now been redesigned with a compensation mechanism to allow an individualized passive fit. This redesigned bar is stronger then the current CAD/CAM milled bar used in current All-on-4®. The compensation mechanism of the bar fits more passively than the All-on-4® bars today.
Give us a call to set up a Trefoil Implant Consultation at (806) 391-7035 or send an email.