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For many people who have lost most or all of their teeth, the idea of regaining a natural-looking, dependable smile can feel out of reach. The All-on-4® treatment concept is designed specifically to address that need by using a strategic implant approach to support a complete arch of replacement teeth. Rather than relying on removable dentures that can shift or require frequent adjustments, this method provides a fixed prosthesis anchored by just a few implants, allowing patients to eat, speak, and smile with renewed assurance.
Because the technique emphasizes implant placement in areas of stronger bone and angulation that maximizes support, patients often leave the clinic with a provisional arch on the same day as surgery. That immediate function is one of the primary advantages of All-on-4®, permitting normal daily activities while the jaw heals and the final restoration is crafted. For individuals seeking predictability and stability, this solution is a major step beyond traditional approaches.
Tailoring care to each patient’s anatomy and goals is essential. At Towne Dental & Orthodontics we evaluate bite relationships, bone quality, and esthetic expectations to design a plan that balances form and function. The result is a durable, cohesive smile that is intended to blend seamlessly with a patient’s facial characteristics and lifestyle needs.
The All-on-4® approach relies on careful implant placement to maximize support using as few as four implants per arch. Two implants are placed vertically in the anterior (front) jaw where bone density tends to be higher, and two posterior implants are angled to increase the surface area of contact with available bone. This intentional angulation can often bypass areas with reduced bone volume and minimize the need for additional procedures like bone grafting.
Once implants are positioned, a precisely fabricated provisional bridge is secured, providing immediate function. This temporary prosthesis protects the surgical sites, establishes proper tooth position and bite, and enables patients to test esthetics and phonetics while the implants integrate with the bone. After a period of healing, typically several months, the final prosthesis is customized for long-term wear and refined appearance.
The engineering behind All-on-4® focuses on distributing chewing forces across the arch so the restoration performs like natural teeth. Modern materials and CAD/CAM fabrication techniques allow laboratories to produce durable, esthetic frameworks and teeth that withstand daily use while remaining attractive and biocompatible.
All-on-4® is well suited for people who are missing most or all teeth in an arch, are experiencing denture-related difficulties, or who have failing dentition due to periodontal disease or extensive decay. It is also an option for patients who prefer a fixed solution over removable restorations and are seeking predictable function and improved chewing efficiency. A thorough clinical and radiographic evaluation determines candidacy by assessing bone availability, overall health, and individual treatment goals.
Medical history and lifestyle factors—such as systemic health conditions, smoking, or certain medications—can influence treatment planning and risk profiling. These considerations do not automatically disqualify a patient, but they do shape the approach and any preoperative steps. Our clinicians focus on creating a comprehensive plan that mitigates risks and supports favorable healing and long-term outcomes.
Importantly, candidacy is determined through collaborative discussion. We review alternatives, explain the phases of treatment, and outline realistic expectations so patients can make informed decisions that align with their personal priorities and oral health needs.
The All-on-4® pathway starts with diagnostic imaging and models to plan implant positions precisely. On the day of surgery, implants are placed under local anesthesia—with sedation options available for patient comfort—and the provisional arch is attached, restoring immediate esthetics and function. The procedure is performed with an emphasis on atraumatic technique and surgical accuracy to promote reliable integration of the implants.
Initial recovery typically involves mild to moderate soreness, swelling, and temporary changes in sensation, all of which are managed with standard postoperative care instructions and medications as needed. Patients are given guidance on soft-food diets and oral hygiene practices to protect the surgical sites while osseointegration occurs. Follow-up visits monitor healing and ensure the provisional restoration is functioning properly as adjustments are made.
Once integration is confirmed, the transition to the final prosthesis takes place. The permanent restoration is crafted to refine esthetics, occlusion, and comfort. Because the final prosthesis is designed for durability and easy maintenance, most patients experience a straightforward adaptation period followed by full return to normal eating and social activities.
Long-term success with All-on-4® depends on sound surgical technique, high-quality prosthetic design, and consistent maintenance. Routine dental visits, professional cleanings, and daily oral hygiene are essential to preserve the health of the implants and surrounding tissues. Regular checkups also allow clinicians to detect and address wear, fit, or tissue changes early, helping to extend the life of the restoration.
Clinical studies and patient follow-ups demonstrate favorable outcomes in terms of function and satisfaction when treatment is executed by experienced teams. Longevity is influenced by factors such as oral hygiene, systemic health, and adherence to follow-up care, so ongoing collaboration between patient and provider is important. Modern implant materials and manufacturing processes contribute to reliable performance over time when paired with appropriate maintenance.
Choosing a practice with specialized experience in full-arch implant care ensures thorough planning and predictable results. Towne Dental & Orthodontics combines advanced imaging, restorative expertise, and patient-centered planning to deliver comprehensive All-on-4® treatment tailored to each individual’s needs.
1All-on-4 is a registered trademark of Nobel Biocare
Summary: All-on-4® offers a streamlined, fixed-implant solution for patients seeking a dependable, natural-feeling restoration for a full arch. If you would like to learn more about whether this approach is right for you, please contact us for more information.
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 full-arch tooth replacement concept that uses a small number of strategically placed dental implants to support a fixed prosthesis. Two implants are typically placed in the front of the jaw and two are placed at an angle in the back to maximize contact with available bone and avoid grafting when possible. The implants serve as stable anchors for a provisional bridge that can often be attached the same day as surgery.
This approach restores chewing function and esthetics while distributing chewing forces across the arch. The provisional restoration protects surgical sites and establishes tooth position while the implants integrate with the bone. After a healing period, the provisional is replaced with a customized final prosthesis designed for long-term function and appearance.
Unlike removable dentures, All-on-4® provides a fixed restoration that is anchored to implants and does not need to be taken out daily. This fixed design improves chewing efficiency, speech, and overall stability compared with conventional dentures that can shift or require adhesive. Implant-supported arches also help preserve jawbone by transmitting functional forces to the bone, which reduces the bone loss that often accompanies long-term denture wear.
Because the prosthesis is permanently secured, patients typically experience fewer dietary restrictions and greater confidence in daily activities. Maintenance focuses on hygiene around the implants and regular professional care rather than repeated adjustments or relines. The result is a more predictable, long-term solution for full-arch tooth replacement in appropriate candidates.
Good candidates for All-on-4® are patients who are missing most or all teeth in an arch or who have dentition that is failing due to decay, periodontal disease, or trauma. Adequate overall health and commitment to oral hygiene and follow-up care are important factors for successful outcomes. Bone availability is assessed with clinical examination and radiographic imaging; the All-on-4® concept is often advantageous when posterior bone is limited because of its angled implant placements.
Certain medical conditions, smoking, and some medications can affect healing and treatment planning, but these factors do not automatically rule someone out. The candidacy decision is made through a comprehensive evaluation that includes medical history, imaging, and a discussion of expectations and options. Your clinician will recommend the best pathway—whether All-on-4® or alternative treatments—based on those findings.
Treatment planning begins with a thorough clinical exam and advanced imaging, commonly a cone beam CT scan, to evaluate bone volume, nerve locations, and anatomical landmarks. Digital planning tools and models are used to determine optimal implant positions and prosthetic emergence for function and esthetics. This planning phase also includes bite analysis and discussions about tooth shape, color, and overall facial harmony.
Guided surgical techniques and custom surgical guides are often fabricated from the digital plan to improve placement accuracy. Prosthetic planning occurs in parallel so the provisional restoration can be fabricated and delivered efficiently at the time of surgery. Clear communication between the surgical and restorative team helps ensure the provisional and final prostheses meet functional and esthetic goals.
On the day of surgery, implants are placed under local anesthesia with sedation options available for additional comfort. The provisional bridge is typically attached to the implants at the same appointment, restoring appearance and basic chewing function immediately. Patients may experience soreness, swelling, and temporary changes in sensation, which are managed with prescribed or over-the-counter medications and postoperative instructions.
Initial healing emphasizes a soft-food diet and careful oral hygiene to protect the surgical sites and provisional restoration. Follow-up visits are scheduled to monitor healing, adjust the provisional as needed, and address any concerns. Most patients find the immediate restoration allows them to return to many normal activities during the integration period with appropriate precautions.
Osseointegration—the process where bone bonds to the implant surface—typically takes several months and is carefully monitored with follow-up appointments. During this healing period, the provisional prosthesis provides function and esthetics while allowing clinicians to evaluate bite, phonetics, and soft-tissue responses. Adjustments to the provisional may be made to optimize comfort and function before the final restoration is started.
Once the implants demonstrate stability and surrounding tissues are healthy, impressions or digital scans are taken to fabricate the final prosthesis. The final restoration refines esthetics, occlusion, and material selection for long-term wear. After placement of the definitive bridge, patients begin a maintenance schedule focused on hygiene and periodic professional evaluations.
Long-term success with All-on-4® depends on daily oral hygiene and regular professional care to maintain healthy tissues around the implants. Patients should follow a routine that includes brushing with an appropriate brush, cleaning beneath the prosthesis as instructed, and using interdental aids recommended by the dental team. Routine dental visits and professional cleanings allow clinicians to monitor implant health, tissue stability, and prosthesis fit.
Wear or mechanical issues with the prosthesis can occur over time, so periodic adjustments or component replacements may be necessary. Avoiding tobacco and managing systemic health conditions also supports implant longevity. A proactive maintenance plan and open communication with your dental provider help preserve function and detect problems early.
As with any surgical procedure, All-on-4® carries risks such as infection, implant failure, peri-implantitis (inflammation around implants), and transient nerve or sinus-related symptoms depending on anatomy. Risk can be higher in patients with uncontrolled systemic conditions, heavy tobacco use, or poor oral hygiene. Early identification and management of complications through monitoring and appropriate interventions reduces the likelihood of long-term problems.
Careful treatment planning, precise surgical technique, and coordinated restorative care are critical to minimizing risk. Patients are counseled about potential complications and the steps they can take to support healing, including following postoperative instructions and attending scheduled follow-up visits. When issues arise, the clinical team works to address them promptly to protect implant health and prosthesis function.
Final prostheses for All-on-4® can be fabricated from a variety of materials, including acrylic teeth on a metal or titanium framework, screw-retained hybrid prostheses, and monolithic zirconia options for enhanced strength and esthetics. CAD/CAM fabrication allows for precise, repeatable frameworks and tooth forms, and material selection is guided by functional needs, esthetic goals, and patient-specific factors. Each material has trade-offs related to weight, wear resistance, repairability, and cost of maintenance.
The restorative team will explain appropriate options and recommend a design that balances durability and appearance for an individual patient. The chosen design also influences hygiene access and long-term upkeep, so clinicians consider maintenance implications when planning the definitive restoration. Proper fabrication and fit are essential to achieve predictable performance and patient satisfaction.
Towne Dental & Orthodontics combines modern diagnostic imaging, digital planning, and restorative expertise to deliver coordinated full-arch implant care tailored to each patient’s needs. Our boutique practice emphasizes thorough planning, patient comfort, and a collaborative approach between surgical and restorative teams to optimize outcomes. We prioritize clear communication about the treatment sequence, healing expectations, and long-term maintenance so patients can make informed decisions.
Choosing a team experienced in full-arch workflows helps reduce uncertainty and supports consistent results through each phase of treatment. If you are interested in exploring whether All-on-4® is a suitable option, a comprehensive evaluation including clinical examination and imaging is the first step toward a personalized plan. Our staff is available to answer clinical questions and outline the diagnostic process so you understand the pathway ahead.