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 restores a full upper or lower dental arch by anchoring a prosthesis on four strategically placed implants. The method uses implant positions and angulation to take advantage of denser bone and favorable biomechanics. This approach replaces the need to restore each tooth individually and focuses on a coordinated surgical and prosthetic solution.

During planning, clinicians evaluate jaw anatomy and design an implant and prosthesis plan that supports immediate or staged provisional teeth. When implants are placed in optimal positions, the prosthesis can provide stable function while the implants integrate with the bone. The result is a natural-looking, fixed restoration that restores chewing, speech and facial support.

Good candidates typically include patients with multiple failing or missing teeth in one arch or those who are unsatisfied with removable dentures. Clinicians also consider bone volume, gum health, medical history and oral hygiene habits when determining suitability. Age alone is not a contraindication, but systemic conditions that affect healing must be evaluated.

Factors such as uncontrolled diabetes, heavy smoking or active untreated periodontal disease can affect implant integration and may require management prior to treatment. Advanced imaging and a thorough clinical exam help identify whether All-on-4® is appropriate or whether staged approaches are preferable. The treatment plan is individualized to balance surgical feasibility with prosthetic goals.

The process begins with a comprehensive consultation that includes a clinical exam, medical history review and three-dimensional imaging. This diagnostic phase allows the team to assess bone quality, jaw relationships and the condition of remaining teeth. A digital or analog plan is then developed to define implant positions and the design of provisional and final prostheses.

On the day of surgery, implants are placed according to the plan and a provisional full-arch prosthesis is often attached the same day when conditions permit. The provisional protects surgical sites, establishes bite relationships and restores immediate appearance and function. Patients receive specific instructions for activity, diet and oral hygiene to support the early healing phase.

Over several months the implants osseointegrate as bone forms around the titanium fixtures, creating a stable foundation for the final prosthesis. The provisional may be adjusted during healing to optimize comfort and function before fabrication of the definitive restoration. Once integration is confirmed, the final prosthesis is secured and the clinical team transitions the patient to a long-term maintenance program.

Many patients receive a provisional prosthesis on the day of implant placement, allowing them to leave the office with a complete set of teeth. This immediate provisional is designed for protection and function but may have certain dietary and activity restrictions to prevent undue load on the healing implants. The clinician evaluates stability during surgery to determine whether immediate loading is appropriate.

Even when a same-day provisional is provided, the prosthesis is temporary and may undergo adjustments as healing progresses. Final restorations are delivered after osseointegration and are crafted to meet long-term aesthetics and durability goals. Clear communication during the consultation sets realistic expectations for timing and the transition from provisional to permanent prostheses.

Recovery varies by individual, but most patients experience a phased return to normal activities and foods over several weeks following surgery. Short-term care focuses on protecting the surgical sites, managing discomfort with prescribed or recommended measures, and following a staged diet that progresses from soft to firmer textures as healing allows. Follow-up visits monitor healing and allow the team to adjust the provisional prosthesis for comfort and function.

Long-term aftercare includes routine professional recall visits, clinical exams and cleanings focused on implant health and prosthetic integrity. Patients learn specific hygiene techniques for cleaning under and around the fixed prosthesis to minimize the risk of peri-implant disease. Prompt attention to changes in fit, bite or comfort helps address issues early and supports long-term success.

All surgical procedures carry risks such as infection, bleeding, swelling and discomfort in the immediate post-operative period. Implant-specific complications can include failure of osseointegration, nerve irritation or sinus involvement depending on the implant site, and these risks are assessed during planning. Proper case selection, surgical technique and adherence to post-operative instructions reduce but do not eliminate these possibilities.

Prosthetic complications may include loosened components, wear of restorative materials or changes in occlusion that require adjustment or repair. Long-term complications such as peri-implant mucositis or peri-implantitis can threaten implant health if oral hygiene and professional maintenance are neglected. Regular monitoring and early intervention remain the most effective strategies for minimizing complications.

The All-on-4® concept often uses posterior implants placed at an angle to engage available native bone and avoid anatomical structures, which can reduce the need for extensive grafting. Strategic implant angulation and placement take advantage of denser anterior or residual bone to provide stable support for the prosthesis. Digital planning with cone beam CT imaging helps identify optimal implant trajectories and bone volumes.

When bone deficiencies are significant, clinicians may still recommend selective augmentation or staged approaches to achieve implant support and long-term success. The decision to graft is individualized based on patient anatomy, functional demands and prosthetic design objectives. Discussing these options during the planning phase ensures patients understand the rationale and expected treatment sequence.

With proper planning, skillful execution and consistent maintenance, implant-supported full-arch restorations can provide many years of reliable function. The implants themselves can remain stable for decades when osseointegration is successful and the surrounding tissues remain healthy. Prosthetic components are subject to wear and may require periodic repair or replacement depending on materials and use.

Maintenance includes regular recall visits for clinical exams, professional cleaning around implants and inspections of the prosthesis to detect early signs of wear or biological issues. Patients must follow a disciplined home care routine and attend scheduled appointments to support long-term outcomes. Early attention to small problems preserves the health of implants and reduces the likelihood of major interventions.

All-on-4® provides a fixed restoration that delivers greater chewing efficiency and stability than traditional removable dentures, enabling patients to eat a wider variety of foods with more confidence. Fixed prostheses also support facial tissues and can improve speech clarity compared with unstable or ill-fitting removable options. The fixed nature of the restoration eliminates the need for denture adhesives and reduces daily removal for cleaning.

Removable dentures may be appropriate for some patients due to simplicity of treatment, but they generally do not prevent bone resorption in the same way that implant-supported restorations can. Long-term preservation of jawbone and improved function are distinct advantages of implant-retained full-arch solutions. The choice between approaches depends on clinical factors, patient goals and the recommendations developed during a comprehensive evaluation.

A multidisciplinary implant team brings surgical, prosthetic and digital planning expertise together to create individualized treatment plans and predictable outcomes. Precise imaging, careful case selection and coordinated care reduce risks and improve the likelihood of functional and aesthetic success. Specialist experience is particularly valuable when anticipating anatomical challenges or combining implant therapy with other dental needs.

At SimplySmiles our implant team integrates advanced imaging and restorative expertise to plan each case with attention to both long-term health and daily comfort. A dedicated evaluation allows patients to understand the treatment sequence, expected recovery and maintenance requirements so they can make an informed decision about their care.