Oral Surgery

All-on-4 Dental Implants

All-on-4 replaces a full row of missing or failing teeth with a fixed, non-removable bridge held by four implants per arch. It suits patients missing most or all of their teeth who want a fixed alternative to dentures.

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At a Glance

Four implants, one bridge

Two implants sit straight at the front, two angled at the back into denser bone — often avoiding the bone grafting individual implants sometimes need.

Five or more visits

Planning, surgery, a temporary-bridge stage where possible, healing check-ups and a final delivery visit — spread across several months, not one appointment.

Local anaesthesia, sometimes sedation

Implant placement is done under local anaesthesia. For longer or more involved cases, sedation is sometimes added so an anxious patient stays comfortable throughout.

A temporary bridge, sometimes same day

Where implants gain enough initial stability, a temporary fixed bridge can sometimes be attached soon after surgery. This isn't guaranteed — some cases need a longer healing period.

What All-on-4 Involves

All-on-4 suits patients missing most or all of their teeth, including cases where remaining teeth are too damaged or loose to save. Instead of replacing each tooth with its own implant, four implants per arch anchor a full fixed bridge — an option some patients prefer over removable dentures because it doesn’t rely on suction or adhesive. It particularly suits people who don’t have enough bone throughout the jaw for individual implants, but do have adequate bone in the front-of-jaw positions the technique relies on.

Bridge Material and Loading

Acrylic-and-metal hybrid

One material option for the final bridge: a metal framework with an acrylic gum-and-tooth layer on top, with its own trade-offs in strength, appearance and long-term maintenance versus zirconia.

Zirconia framework

A metal-free ceramic alternative for the final bridge, with different trade-offs in strength, appearance and maintenance than the acrylic-and-metal hybrid.

Immediate loading

Some cases proceed with a temporary bridge soon after surgery, sometimes called immediate loading. It depends on the implant stability achieved during surgery, not preference.

Delayed loading

Other cases need a longer healing period before any bridge, temporary or final, is placed — the safer route when stability at surgery isn't sufficient.

How All-on-4 Works

Consultation and 3D imaging

A CBCT scan maps bone volume, density and the position of the sinuses and nerves, which determines the exact number, angle and position of the four implants.

Extraction and implant placement

Any remaining unsalvageable teeth are removed, often on the same day implants are placed — two vertical at the front, two angled at the back, under local anaesthesia (sometimes combined with sedation; see oral surgery).

Temporary bridge and healing

Where implants gain enough stability, a temporary bridge is attached so the patient isn't left without teeth. The implants then integrate with the bone over several months.

Final bridge fitted

Once healing is confirmed by exam or imaging, a permanent, custom-fabricated bridge replaces the temporary one and completes treatment for that arch.

Before you decide

Not sure whether this applies to your teeth?

The only way to know is an examination. Ask a question first if you would rather understand the options before booking anything.

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When All-on-4 Isn't the Answer

All-on-4 is major treatment and isn’t right for every patient missing a full arch of teeth. It depends on achieving enough implant stability at the time of surgery — without that, immediate loading isn’t possible and a longer healing period is needed instead. Uncontrolled diabetes, active oral infection, heavy smoking, and severe, unmanaged bruxism can also rule it out or complicate healing. A full medical and dental history review during consultation determines individual suitability.

FAQ

Frequently asked questions

All-on-4 vs. All-on-6 — which one do I need?

It depends on your bone volume and bite, not personal preference alone. All-on-4’s angled back implants are designed to work with less available bone, while All-on-6 is often chosen when more bone is present or extra support is judged beneficial. A 3D scan and consultation is how this is actually decided for your case.

Is All-on-4 done in one day?

Sometimes a temporary fixed bridge can be attached soon after surgery, but this depends on achieving enough implant stability during placement — it isn’t guaranteed for every patient, and a longer healing period before any bridge is fitted is sometimes the safer choice for a given case.

How long does an All-on-4 bridge last?

Long-term durability depends on oral hygiene, bite forces, and regular maintenance visits, and it varies by patient — there’s no fixed lifespan that applies to everyone. Your dentist can give you a more specific outlook based on your bone quality, bite, and habits like grinding.

Can I eat normally after All-on-4?

Not immediately. A soft-food period is standard while the implants begin to integrate. Once the final bridge is fitted and healing is confirmed, most patients return to a fairly normal diet, though very hard foods may still be discouraged.

What if I don't have enough bone for All-on-4?

All-on-4 is specifically designed to work with less bone than individual implants require, by angling the back implants into denser bone. If bone volume is still insufficient even for this approach, bone grafting or All-on-6 may be discussed as alternatives during consultation.

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