Trefoil - an exciting new treatment from Nobel Biocare!


What is Trefoil?

Trefoil is a new permanent dental implant solution from Nobel Biocare, the same developers and researchers for the successful All-on-4® procedure. Trefoil is a dental implant surgical protocol for the lower (mandibular) arch only.

The process involves placement of 3 implants utilizing analog guided surgery to place 3 dental implants in a very 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 aim of this new implant concept is to replace mandibular Snap-on Dentures.

Advantages of Trefoil

The advantage of Trefoil is a lower treatment cost and a shorter treatment time versus the All-on-4®. It is NOT meant to replace the All-on-4®, and patients who can afford the All-on-4® should do so. The Trefoil concept aims to replace snap-on dentures which are about the same cost as the Trefoil concept.

The Trefoil dental implant concept can reduce the cost $7,000 – $12,000!

How much does it cost?

The cost savings occurs due to no longer making a custom milled titanium bar or a zirconia framework. Through the use of specialized analog guided surgical techniques, a prefabricated bar attaching to the 3 implants is possible. With the All-on-4®, patients need to come back for 5-6 visits to get their framework specially made to exactly where their implants are. The high number of visits and the fully customized nature of the All-on-4® is where many of the costs of treatment lie.

The Trefoil dental implant concept can reduce the cost from $7,000 – $12,000! This is a remarkable cost savings. Please note: patients who can afford anA ll-on-4® should do so as there are some major benefits over the Trefoil concept. However, with the Trefoil concept, there are many advantages and benefits over a snap-on lower implant denture.

What is the process?

The initial process starts with a consultation and a 3D CT Scan. Then we will take impressions to fabricate your initial records and a temporary prosthesis which we will deliver the day of the surgery. At surgery, we will place you under IV Sedation and perform a jaw relation record. We will see you back in a few days for a wax try in to confirm the bite and esthetics of the set up – then a few days later, we will deliver your new permanent fixed teeth. The Trefoil system is an Acrylic Titanium Hybrid prosthesis.

Is there concern regarding 3 dental implants used versus 4?

Palo Malo, the creator of the All-on-4® concept, originally had designed his protocol for a 3 implant system. It was later changed. PI Brannenmark had the Novum implant system a 3-implant system, with a 95% or higher dental implant survival rate. So yes, the literature is there.

The Trefoil system uses a 5.0 mm diameter implant versus a 4.3mm diameter with the All-on-4®. At a recent conference, Palo Malo said that the number of implants does not matter, but instead, it is the size of the implants that make a difference. He noted, “You could support an entire mandibular arch of teeth with one 1 centimeter implant.” (1 cm= 10 mm) This is an incredibly large implant and is not feasible, but it highlights the point that there is no concern regarding 3 implants versus 4.

A modern twist on an older concept developed by the father of Dental Implants.

PI Brannenmark who created the modern dental implant, developed Novum in mid 1990s. The Novum treatment consisted of placement of 3 large diameter implants in the mandibular arch with placement of a same day or near same day acrylic titanium prosthesis on a prefabricated bar. Several thousand patients were treated; however, implant success Novum was taken off the market in 2007 due to a 20% complication rate with the titanium bar.

Now, the prefabricated bar has been redesigned with a compensation mechanism to allow for an individualized passive fit. This redesigned bar is stronger then the current CAD/CAM milled bar utilized in our current All-on-4® In fact, literature shows that due to the compensation mechanism of the bar, they fit more passively than the current All-on-4® bars today!

Want to get started?

Give us a call for a Trefoil Implant Consultation Today! For the Dallas office Call 972-808-6008 and for Fort Worth call 817-336-2121.