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All-on-4 Dental Implants

What are All-on-4 Dental Implants?

The All-on-4 concept is a technique designed to restore an entire arch of missing teeth using only four strategically placed dental implants.

Background and Development

This approach was developed to address the challenges associated with complete edentulism, where patients have lost all of their natural teeth.

The roots of the All-on-4 concept can be traced back to the late 1990s, when Matsson and colleagues in 1999 were exploring new methods of implant-based tooth replacement, laying the foundation for what would become the All-on-4 technique.

Advancement of this work continued in 2000 when Krekmanov and colleagues demonstrated that a tilted implant-supported prosthesis was possible.

In 2003, dentist Paulo Malo developed and analyzed the concept of immediate loading. In Malo’s technique, two implants were placed vertically in the anterior region of the jaw and two implants in the posterior region up to an angle of 45 degrees.

Benefits of All-on-4 Dental Implants

Improved aesthetics and confidence

These innovative implants provide a natural-looking, complete set of teeth, restoring your smile and self-confidence. This transformative dental procedure provides patients with a beautiful, natural appearance that closely replicates real teeth, boosting their self-esteem and overall sense of well-being.

Enhanced chewing and speech

All-on-4 dental implants provide exceptional stability and functionality, allowing patients to comfortably enjoy their favorite foods with confidence and articulate words with clarity.

The secure attachment of the prosthesis to the implants ensures that the teeth remain in place, minimizing discomfort and making everyday activities such as eating and speaking an enjoyable experience.

High Success Rates

All-on-4 implants have demonstrated their remarkable durability and success, making them a trusted long-term dental solution.

Various research and studies on dental implants have revealed that, on average, the success rate of All-on-4 treatment ranges from 94% to 98% over a period of 6 to 11 years

This means that most patients who opt for All-on-4 can expect their new set of teeth to remain stable and functional for a significant amount of time, providing them with confidence and peace of mind.

Preservation of jawbone density

One of the most notable benefits of All-on-4 dental implants is their ability to contribute to the preservation of jawbone density.

When a patient suffers from tooth loss, the roots of the tooth no longer transmit pressure to the jawbone, leading to bone deterioration due to the lack of deterioration.

All-on-4 implants integrate with the jawbone, much like natural teeth. As a result, the implants stimulate the bone, helping to maintain its density and structure, ensuring better oral health.

Immediate results and reduced downtime

Unlike some traditional dental treatments that might require multiple visits and longer healing periods, All-on-4 provides a faster and more efficient solution. With this treatment, patients can have the implants placed and a temporary set of teeth attached in just one appointment, which leads to a shorter downtime and a quicker return to their daily activities.

This procedure minimizes the disruption to the patient’s life and helps them get back to their routine sooner.


How All-on-4 Dental Implants Work

The surgical procedure step-by-step

1. Initial Consultation

Before surgery takes place, you’ll need to have an initial consultation with your dentist. During this consultation, your oral health will be evaluated, and your specific needs and goals will be discussed.

2. Placement of four strategically positioned implants

After anesthesia is administered and takes effect, the four dental implants will be strategically positioned in the jawbone, typically with two implants placed in the front, where the bone is denser, and two implants in the back region placed at an angle of 30 to 45 degrees.

3. Temporary Prosthetic Attachment

Once the implants are placed, a temporary denture will be attached to them, allowing patients to leave the dental office with functional teeth on the same day as surgery.

4. Healing Period

Over the next few months, a process called osseointegration will take place, during which the jawbone fuses with the implants. This is crucial to ensuring the stability of the implants.

5. Attachment of a custom prosthetic bridge

Once osseointegration is complete, the temporary prosthetic will be removed and replaced with a permanent, custom-made set of prosthetic teeth.



Candidates for All-on-4 Treatment

Health Requirements

Determining the suitability for All-on-4 implant treatment involves a thorough evaluation of their oral health and overall well-being. The ideal candidate typically:

  • Has Sufficient Bone Density: A candidate should have adequate jawbone density to support the four dental implants.

  • Has Good Oral Health and Hygiene: It’s essential to have good oral hygiene and healthy gums. Any existing dental issues, such as gum disease, should be addressed before proceeding with the treatment.

  • Is in Good General Health: As All-on-4 implants involve a complex surgery, candidates need to be in overall good health so there are no complications during surgery and the healing period.

Pre-operative Assessments

Before the procedure, you will need to undergo a series of evaluations to ensure the success of the treatment. These may include:

  • Dental Evaluation: Your dentist will evaluate the condition of your teeth, gums, and jawbone. For this, you may need to get some studies done, such as X-rays and 3D imaging.

  • Medical History: You may need to provide a comprehensive medical history, including information about any medical conditions, medications, and past surgeries.

  • Treatment Plan: Your dentist, along with yourself, will develop a personalized treatment plan based on the evaluations done, discuss your expectations, and address any questions or concerns you may have.
  • All-on-4 vs. Traditional Dentures

  • Aesthetics

Traditional Dentures

    • They can provide a natural-looking set of teeth but may not be as realistic as dental implants.

    • Can potentially fit less securely, which results in the possibility of them slipping off.

    • Over time, color and shape may degrade, requiring adjustment.


  • Mimics the appearance of natural teeth for a realistic and aesthetically pleasing smile.

  • They are more stable and secure.


Traditional Dentures

  • Chewing and biting functionality may be difficult, especially with lower dentures, due to potential movement.

  • Due to the fact they work by suction, some patients can have problems keeping them in place.

  • Adhesive may be necessary to improve stability and speech.

  • Over time, the base of the dentures may begin to rub against the gums, causing irritation.


  • Allows patients to comfortably bite and chew, as the implants are comparable to natural teeth.

  • Helps to prevent bone loss.

  • Due to being an implant-supported prosthesis, the risk of slippage during eating or speaking is minimized.

  • They do not cover the palate, improving the sense of taste and making it more comfortable.

Long-term Results

Traditional Dentures

  • In the long run, there might be the need for regular adjustments or replacements due to changes in jaw shape and denture fit.

  • With proper care, they can last a long time.


  • High success rates even after 10 years.

  • Minimal rates of biological and mechanical complications.

  • With proper care and maintenance, they can last 10-15 years.

All-on-4 Aftercare and Maintenance

Post-surgery Care Instructions

Your dentist will give you the following instructions:


  • You will experience swelling during the first day after surgery, so make sure to rest and apply ice packs over the area. Hold on the bruised check for up to 10 minutes at a time with a 20-minute break before applying again.

  • It is crucial to keep your mouth clean to avoid infections. You should gently rinse your mouth twice a day with a non-alcohol mouthwash.

  • It is important to brush your teeth gently, taking care not to damage the implant or gums.


  • During the first 2 weeks after the procedure, you must avoid any kind of strenuous physical activity, as it can cause bleeding around the dental implant.

  • Avoid smoking after the procedure. Vaping is also not recommended. These habits slow the healing process and increase the risk of implant rejection.
  • Maintenance

  • Effective maintenance plays a crucial role in ensuring the success of All-on-4 dental implants. Some recommendations include:

    • Brush twice daily using a soft toothbrush to remove plaque accumulation.

    • Floss as indicated by your dentist. It is recommended to do this after every meal, to remove any trapped food particles.

    • Schedule regular dental check-ups and professional cleanings.

    • Professional cleanings help remove plaque and tartar that may accumulate around the implants and contribute to gum disease.

    • Make sure to follow your dentist’s instructions.

Ron Bethel

British colombia, Canada

All experiences were excellent!! will recommend to friends and family

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