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All‑on‑4® is a restorative approach that replaces an entire upper or lower arch using just four strategically placed dental implants to support a full prosthesis. Designed to restore the look, function, and comfort of natural teeth, this solution is often chosen by patients who want to avoid removable dentures and regain confidence when eating, speaking, and smiling. The technique emphasizes efficient use of available bone by angling the posterior implants to maximize stability.
Originally developed to expand treatment options for people with significant tooth loss, All‑on‑4® has become a widely recognized method for full‑arch rehabilitation. The treatment combines precise surgical planning with modern prosthetic design so patients can leave the office with provisional teeth the same day as implant placement. That immediate restoration helps preserve facial contours and daily function during the healing period.
Because success depends on meticulous planning and surgical skill, it’s important to work with a team experienced in full‑arch implant care. Our approach uses advanced diagnostics and a coordinated team workflow to reduce surprises and deliver predictable results, helping patients move from compromised dentition to a functional, long‑lasting restoration.
All‑on‑4® is a solution for adults who need full‑arch replacement due to extensive tooth loss, failing dentition, or non‑restorable teeth. Candidates range from those already living with partial or complete dentures to patients preparing for extractions. That said, candidacy depends on oral and overall health factors—gum condition, bone volume, systemic health, and habits such as smoking are all considered during evaluation.
At the initial consultation, we review medical history and perform a comprehensive oral exam supported by 3D imaging when appropriate. A cone beam CT scan allows us to evaluate bone quality and anatomical structures with precision so we can determine optimal implant positions and minimize the need for adjunctive procedures. This digital planning phase is crucial to ensure stable implant placement and a well‑fitting prosthesis.
Because All‑on‑4® often avoids the need for extensive bone grafting by using tilted posterior implants, many patients who were previously told they lacked sufficient bone can now be treated. Still, each case is individualized: some patients require preparatory procedures, while others proceed directly to implant placement and provisionalization on the same visit.
Treatment typically follows a structured sequence: consultation and planning, imaging and prosthetic design, surgery with implant placement, and delivery of a provisional prosthesis. On the day of surgery your clinician places four implants in the arch and secures a temporary fixed bridge. This provisional restoration restores immediate function while soft tissues heal and implants integrate with the jawbone.
The surgical appointment is performed under appropriate anesthesia and sedation options to ensure patient comfort. Implant placement is guided by the digital plan to achieve precise angulation and load‑bearing distribution. The provisional bridge is fabricated ahead of time or adapted on the day of surgery so you can leave with a complete, functional smile in place of missing teeth.
During the first few months after surgery, osseointegration—the process by which bone bonds to the implant surface—occurs. Patients are advised on a phased diet and specific oral hygiene practices to protect the healing sites and the provisional restoration. Routine follow‑ups allow the team to monitor healing, make any necessary adjustments, and confirm that the implants are integrating as expected.
Once healing and integration are complete, typically a few months after the initial procedure, the provisional bridge is replaced with a custom final prosthesis. The definitive restoration is crafted for durability, speech optimization, and a natural appearance that complements facial aesthetics.
An All‑on‑4® restoration provides the stability of a fixed prosthesis, which translates into more confident chewing, improved speech clarity, and a maintenance routine similar to natural teeth. Unlike removable dentures, a fixed bridge attached to implants eliminates slipping and the need for adhesives, restoring a sense of normal function for everyday activities.
Aesthetically, full‑arch implant prostheses are designed to support facial structure and provide a lifelike tooth arrangement that balances form and function. Prosthetic teeth can be shaped and shaded to create a natural, harmonious smile that complements an individual’s facial features while addressing worn or missing dentition.
Long‑term, implant‑supported restorations reduce the bone resorption associated with tooth loss because implants transmit chewing forces into the jawbone. With appropriate maintenance and periodic professional care, these restorations offer a durable solution that helps maintain oral health and facial support over time.
Maintaining an All‑on‑4® restoration requires regular home care and scheduled professional visits. Daily cleaning around the prosthesis, use of recommended interdental aids, and routine dental checkups help preserve tissue health and detect issues early. Periodic professional cleanings and exams allow for assessment of implant stability, prosthesis fit, and surrounding gum health.
While All‑on‑4® has a strong track record, like any surgical treatment it carries potential complications, such as peri‑implant inflammation or mechanical wear of the prosthesis. Early detection and prompt management are key; our clinical protocol includes regular monitoring and a clear plan for addressing concerns so patients retain long‑term function and comfort.
Our team leverages digital imaging and prosthetic expertise to plan each case with attention to both surgical predictability and cosmetic outcomes. At GD Dentistry we prioritize patient education and transparent communication throughout the process so people understand what to expect before, during, and after treatment.
If you’re considering full‑arch implant restoration, an informed consultation is the first step. Contact us to learn whether All‑on‑4® is the right path for restoring your smile and oral function.
1All‑on‑4® is a registered trademark of Nobel Biocare.
All-on-4® is a full-arch dental restoration technique that uses a fixed prosthesis supported by four strategically placed dental implants. The implants are positioned to maximize contact with available bone and to provide a stable foundation for a full set of replacement teeth. Patients receive a provisional prosthesis the same day as implant placement so they leave the procedure with functional teeth.
The final prosthesis is fabricated after implants integrate with the bone and healing is complete, delivering improved speech, chewing function, and appearance. This approach recreates the look and feel of a natural smile while eliminating the instability common with removable dentures. Treatment planning relies on precise imaging and a coordinated surgical and restorative workflow.
Candidates typically include people who are missing most or all teeth in one arch or who have failing dentition that is not predictable to retain. Adequate general health, good oral hygiene ability, and a realistic expectation of treatment outcomes are important factors in candidacy. Certain systemic conditions and habits such as uncontrolled diabetes or heavy smoking can influence candidacy and are evaluated during the consultation.
A complete evaluation with clinical exam and three-dimensional imaging helps determine whether All-on-4® is appropriate or if adjunctive procedures are needed. In some cases minimal bone grafting or alternative implant strategies may be recommended to achieve a predictable foundation. The final decision is based on individualized assessment and a comprehensive treatment plan.
The process begins with a clinical exam, medical and dental history review, and CBCT imaging to assess bone volume and anatomy. A personalized treatment plan is created that outlines implant placement, any necessary extractions, and the prosthetic design, with consideration for function and esthetics. On the day of surgery implants are placed and a provisional fixed prosthesis is attached so the patient leaves with a complete smile.
During the healing phase the implants integrate with the bone, and the provisional prosthesis is monitored and adjusted as needed. Once osseointegration is confirmed and soft tissues have matured, the final prosthesis is fabricated and delivered to optimize fit, esthetics, and occlusion. Follow-up visits ensure ongoing function and long-term success.
Surgery is performed under local anesthesia with sedation options available to ensure patient comfort, and the procedure typically takes several hours depending on complexity. Implants are placed at planned positions and angles to maximize bone support, and a provisional prosthesis is secured to provide immediate function. After the procedure patients are observed briefly and given postoperative care instructions to manage swelling and promote healing.
In the first days after surgery patients can expect mild to moderate swelling, controlled discomfort, and dietary modifications to protect the provisional restoration. Short-term restrictions on vigorous activity and careful oral hygiene are important to reduce complications and support healing. Regular follow-up appointments are scheduled to monitor progress and address any concerns promptly.
The prosthetic teeth themselves are made from durable materials but will experience wear over time and may require periodic maintenance, repairs, or replacement of components to preserve function and esthetics. Regular examinations allow the dentist to identify and address wear, screw loosening, or soft-tissue changes before they become significant problems. With consistent care, many patients enjoy stable function and appearance for a decade or longer.
Daily care begins with careful twice-daily brushing of the prosthesis and the surrounding gum tissue to remove plaque and reduce the risk of peri-implant inflammation. Interdental cleaning with floss designed for implants, interdental brushes, or a water flosser helps clean beneath and around the prosthesis where bacteria can accumulate. Maintaining excellent oral hygiene and a balanced diet supports healing and long-term implant health.
In addition to home care, routine professional cleanings and examinations are essential to monitor the condition of the implants and prosthesis. The dentist or hygienist will remove hard deposits and evaluate soft-tissue health, prosthetic fit, and occlusion at regular intervals. Patients with bruxism or heavy biting forces may be advised to use protective appliances to reduce wear on the restoration.
All-on-4® provides a fixed, stable restoration that closely resembles natural teeth in function and appearance and eliminates many of the common drawbacks of removable dentures such as slipping and the need for adhesives. Because the prosthesis is supported by implants, patients typically experience improved chewing efficiency, clearer speech, and greater confidence when eating and smiling. Immediate provisionalization allows patients to leave the surgical visit with a complete set of teeth.
Compared with placing many individual implants, the All-on-4® approach often reduces surgical complexity by using fewer implants placed at strategic angles to engage available bone. This can lower the need for extensive grafting in some cases and streamline the restorative workflow, though the optimal approach is always determined by individualized planning. The technique emphasizes predictable support and efficient rehabilitation for full-arch replacement.
As with any surgical procedure, All-on-4® carries potential risks such as infection, bleeding, temporary or persistent numbness from nerve irritation, and the possibility of implant failure. Careful planning with three-dimensional imaging, sterile surgical technique, and appropriate patient selection help minimize these risks. Early recognition and management of complications, including antibiotics or minor surgical revisions when indicated, improve the likelihood of successful resolution.
Long-term complications can include peri-implant mucositis or peri-implantitis, which are inflammatory conditions that affect the tissues around implants and require professional care. Consistent oral hygiene, regular maintenance visits, and prompt attention to any signs of soreness or mobility are key to reducing the risk of late complications. The clinical team will provide personalized postoperative instructions and a maintenance schedule to support long-term health.
All-on-4® was developed to make efficient use of available jawbone by angling posterior implants to engage denser bone, which can reduce the need for extensive bone grafting in many patients. However, when bone loss is extreme or anatomy is unfavorable, additional procedures such as bone grafting, sinus augmentation, or alternative implant strategies may be necessary to provide a predictable foundation. Zygomatic or pterygoid implants and other implant-supported solutions are sometimes considered in complex cases.
Comprehensive evaluation with CBCT imaging is essential to determine bone quantity and quality and to compare viable treatment options. The chosen approach depends on each patient’s anatomy, medical history, and restorative goals, and the treatment plan is tailored to deliver the safest and most durable outcome. Discussing alternatives and potential adjunctive procedures during planning helps set clear expectations.
During an initial consultation at the office of GD Dentistry the team will review your medical and dental history, perform a thorough oral examination, and obtain three-dimensional imaging to evaluate bone anatomy and prosthetic needs. The dentist will discuss your goals, explain how the All-on-4® process works, and outline the diagnostic and surgical steps involved in creating a personalized treatment plan. Sedation options and postoperative expectations are reviewed so patients understand the pathway from provisional to final prosthesis.
Following the consultation you will receive a detailed plan that identifies any preparatory procedures, expected follow-up visits, and maintenance requirements to protect long-term results. The practice emphasizes careful planning and coordinated restorative care to achieve predictable function and esthetics. Patients are encouraged to ask questions and to bring up any health concerns so the team can tailor care to individual needs.
