All-on-4®

The All-on-4 treatment concept offers an implant-based solution to patients who have lost all of their upper and/or lower teeth. This remarkable method of care helps patients quickly rebuild complete and beautiful smiles. With All-on-4, your new, and complete set of implant-supported replacement teeth feel secure, stable, and much like your very own.

If you currently wear complete upper and/or lower dentures or are slated to have your remaining teeth extracted, you may be a candidate for All-on-4. First Performed by Dr. Paulo Malo in 1998, the All-on-4 treatment concept has helped hundreds of thousands of patients quickly reestablish attractive smiles that look, feel, and function just like a set of natural teeth!

The All-on-4 treatment concept offers a fixed and permanent alternative to removable dentures. Unlike dentures, All-on-4 does not rely on messy dental adhesives or natural suction to hold your new set of teeth in place. With All-on-4, your replacement teeth are permanently secured by dental implants, giving you a smile that looks not only great but also feels secure and stable. You'll feel comfortable and confident as you speak, smile, and chew with ease.

While traditional full arch implants also achieve outstanding results of care, the All-On-4 treatment concept does not involve bone grafting and requires fewer implants to support a full set of teeth. With just four strategically placed dental implants needed to support an entire set of upper or lower teeth, the All-on-4 treatment concept offers a cost-effective and satisfying solution for rebuilding a complete smile. Thanks to this remarkable method of care, patients can experience the satisfaction of having teeth placed the same day as surgery. This key feature allows patients to smile and function with confidence until healing is complete and the permanent restorations installed.

Once it's been determined that you're a candidate for treatment with All-on-4, the process of treatment planning and designing your new smile begins. 3D diagnostic records provide the detailed information required to determine the exact positions of the four supporting dental implants. Then, on the day of surgery, we'll remove any remaining teeth, place the 4 implants, and insert a set of attractive, sturdy, and functional set of temporary teeth. With All-on-4, temporary teeth can be placed right away with a customized, permanent set to follow once the implants become fully integrated with the surrounding bone.

With All-on-4, temporary teeth can be placed right away with a customized, permanent set to follow within just a few months after the implants become fully integrated with the surrounding bone.

Thanks to All-on-4, patients enjoy permanent teeth that look, feel, and function just like real teeth. And with a patient satisfaction rate that exceeds 95%, the All-on-4 treatment concept restores your smile, your confidence, and allows you to enjoy once again the foods you love!

Maintaining your All-on-4 smile requires the same care as a natural smile. By cleaning your teeth twice daily, after meals as possible, and scheduling appointments for routine checkups as well as care, you can keep your new smile strong and healthy for years to come. Our office will demonstrate the most effective methods of oral hygiene and answer all your questions as to how to care for your new smile.

All-on-4® is a treatment concept that replaces an entire upper or lower arch with a fixed prosthesis supported by four dental implants. Two implants are placed in the front of the jaw more vertically while two posterior implants are positioned at an angle to maximize available bone. This configuration creates a stable foundation that allows a full-arch bridge to function much like natural teeth.

The angled posterior implants often eliminate the need for bone grafting by using existing jawbone and improving force distribution across the arch. Modern workflows pair 3D imaging and precise surgical planning with immediate provisional restorations so patients frequently leave the clinic with functional temporary teeth. All-on-4® is a registered trademark of Nobel Biocare.

All-on-4® is commonly recommended for people who are missing most or all teeth, have failing dentition, or currently rely on removable dentures and want a fixed alternative. Good candidacy depends on overall health, oral condition, adequate bone volume in key implant sites, and realistic expectations about the treatment process. Your medical history, including conditions such as uncontrolled diabetes or smoking, is part of the evaluation because systemic factors can affect healing.

Patients with limited bone in the posterior jaws may still be candidates because the tilted implant approach makes efficient use of available bone. The decision between All-on-4® and other restorative options is individualized and balances surgical considerations, long-term function, and patient goals. A thorough consultation clarifies whether All-on-4® is the most appropriate choice.

Evaluation begins with a comprehensive oral exam, review of your medical history, and diagnostic imaging such as CBCT scans and digital impressions. These tools let the dental team measure bone volume, map anatomical structures like nerves and sinuses, and plan implant positions with a high degree of accuracy. Lifestyle factors and your expectations for function and aesthetics are also discussed to ensure alignment with the proposed treatment.

At Zona Rosa Dental, we integrate imaging with restorative planning to design an individualized approach that anticipates the final prosthesis and the surgical steps needed to achieve it. This coordinated planning reduces surprises, helps select appropriate sedation or anesthesia options, and sets clear milestones for provisional and final restorations. The result is a predictable pathway from consultation to completion.

On the day of surgery, any remaining non-salvageable teeth are removed and the four implants are placed in the planned positions using sterile surgical protocols. Many patients receive local anesthesia with optional sedation to ensure comfort during the procedure, and the surgical team follows the digital plan closely to achieve the intended angulation and depth. Pain control, hemostasis, and immediate post-op monitoring are prioritized to make the experience as smooth as possible.

In many cases a prefabricated or provisionalized temporary prosthesis is attached that same day so patients leave with a complete set of functional teeth. This provisional protects the implants and surgical sites while allowing basic chewing and speaking during the initial healing phase. Your clinician will review wound care, dietary restrictions, and follow-up timing before you go home.

Initial recovery commonly involves a few days of swelling, mild to moderate discomfort, and some bruising, all of which are typically managed with prescribed or recommended medications and careful home care. Patients are usually advised to follow a soft-food diet for the early healing period and to avoid heavy chewing on the new prosthesis until the team gives clearance. Regular follow-up visits during the first weeks allow the clinician to monitor healing, remove sutures if needed, and address any concerns promptly.

As the soft tissues heal and the implants begin to integrate with the bone, most people notice progressive improvement in comfort and function over several weeks to months. Any unusual pain, persistent bleeding, or signs of infection should be reported to the dental team immediately so they can intervene. Adhering to post-op instructions and attending scheduled appointments are essential steps toward a successful outcome.

After implant placement and attachment of a provisional prosthesis, implants typically require a period of osseointegration that can range from several weeks to a few months depending on bone quality and individual healing. During this time the provisional protects the surgical sites while allowing basic function and appearance. Your surgical and restorative team will schedule periodic evaluations to confirm stable integration before proceeding to the final restoration.

The final prosthesis is custom designed for fit, function, and aesthetics and may require multiple appointments for adjustments and verification of occlusion and emergence profile. Once delivered, the definitive prosthesis is intended for long-term use with proper maintenance and regular professional assessments. The exact timeline varies per case, and your provider will outline the expected schedule during planning.

Long-term care focuses on daily oral hygiene around the prosthesis, including thorough brushing of all surfaces, use of interdental brushes or floss threaders beneath the bridge where recommended, and any antimicrobial rinses deemed appropriate by your clinician. Paying attention to plaque control at the implant-abutment interface and along the gumline helps prevent peri-implant inflammation and preserves supporting tissues. Consistent home care reduces the likelihood of complications and supports the longevity of the restoration.

Regular professional maintenance visits are equally important to monitor implant health, evaluate tissue response, and perform professional cleanings that reach areas home care may miss. Minor adjustments or repairs to the prosthesis can be made as necessary to maintain optimal fit and function over time. At Zona Rosa Dental we provide individualized maintenance plans and patient education to help protect your investment in oral health.

All-on-4® delivers a fixed, stable arch that eliminates many common issues associated with removable dentures, such as slipping, adhesive use, and limited chewing efficiency. Because the prosthesis is anchored to implants, patients are generally able to eat a wider variety of foods and speak with greater confidence and clarity. The fixed restoration also provides consistent support for facial tissues, which can improve esthetics and contribute to a more youthful profile compared with ill-fitting dentures.

The technique’s strategic implant placement preserves available jawbone and provides predictable long-term function without the need for implants at every tooth site. Maintenance is focused on hygiene around the prosthesis and regular professional care rather than nightly removal and soaking. For many patients, these functional and lifestyle benefits make All-on-4® an appealing alternative to removable options.

As with any surgical procedure, All-on-4® carries potential risks such as infection, bleeding, delayed healing, implant failure, or complications related to anatomic structures like nerves or sinuses. Proper case selection, meticulous surgical technique, and thorough preoperative planning significantly reduce these risks. Patients are screened for systemic conditions and lifestyle factors that could impede healing, and modifications to the plan are made when necessary to enhance safety.

Early identification and management of complications through scheduled follow-ups is critical to preserving implant health and prosthesis function. Treatments may include local or systemic interventions, targeted cleaning and debridement, or, in rare cases, implant revision or replacement. Clear communication with your dental team about any unusual symptoms helps ensure timely care and mitigates long-term consequences.

Digital planning and CBCT imaging provide three-dimensional visualization of the jaws, which allows clinicians to precisely measure bone volume, locate vital structures, and determine optimal implant angulation and depth. This level of detail supports the All-on-4® approach by identifying the best sites for anterior and tilted posterior implants while minimizing risk to nerves and sinuses. Combining digital impressions with 3D imaging also helps coordinate the surgical and restorative phases for a smoother workflow.

Using surgical guides and virtual planning reduces intraoperative guesswork and increases the predictability of implant placement, often resulting in improved prosthesis fit, shorter surgical times, and fewer adjustments later. These technologies enhance communication between surgical and lab teams and support delivery of well-fitting provisional and final restorations. As a result, digital workflows contribute to higher consistency and better overall patient experiences in modern implant care.