All-on-4 replaces a full arch of missing or failing teeth with just four strategically placed implants, giving you a fixed, non-removable set of teeth attached at the time of surgery. It is designed for patients who have lost most or all of their teeth and want to avoid extensive bone grafting or a removable denture. At Sola Dental Spa in Staten Island, our implant team plans each case around your bone volume, health history, and long-term goals.
What makes All-on-4 different from traditional implants?
All-on-4 is an implant-supported prosthetic method designed for patients missing most or all of their teeth in an arch. Losing even a single tooth can lead to shifting teeth, bite problems, and a higher risk of gum disease and decay in the surrounding area. When most or all of the teeth in an arch are gone, All-on-4 replaces them with a fixed prosthesis anchored to just four implants, without the extensive bone grafting that older implant techniques often required.
How are the four implants placed?
Two implants are placed upright toward the front of the jaw, while two implants toward the back are angled at roughly 45 degrees. That angle is what lets the posterior implants anchor securely in areas where bone volume is often limited, such as near the maxillary sinus in the upper jaw and the back of the lower jaw. Angling the implants this way reduces the need for bone grafting and shortens recovery compared to older approaches.
What happens at each stage of treatment?
| Stage | What Happens |
|---|---|
| Planning | Comprehensive exam, any needed treatment such as a root canal or extractions, and a detailed implant placement plan |
| Implant placement | Surgery under local anesthesia, tailored to the patient, typically around two hours; sedation available if needed |
| Temporary prosthesis | Impressions are sent to the lab and a temporary fixed prosthesis is placed on the implants within hours, allowing immediate function |
| Permanent restoration | After about six months, once osseointegration is complete, the temporary prosthesis is replaced with a permanent one |
Is the prosthesis really fixed in place?
Yes. Although patients sometimes assume "non-removable" means something less permanent, All-on-4 prostheses are securely fixed onto implants with screws, and removal can only be performed by a dental professional during a checkup. After the healing period, the temporary prosthesis is replaced with a custom permanent one matched to your bite and facial proportions.
How do I care for All-on-4 restorations?
An All-on-4 prosthesis needs consistent care, arguably more than natural teeth. That means brushing regularly with the brushes your dentist recommends, using an oral irrigator, and keeping up with preventive exams and professional cleanings roughly every six months.
“The angled back implants are really what make All-on-4 work for patients who have already lost significant bone. We can often avoid a grafting procedure entirely and still get a result that functions like a full set of natural teeth.”
Dr. Daniel Nejat, DMD, Board-Certified Periodontist (Diplomate, American Board of Periodontology)
Who is a good candidate for All-on-4?
All-on-4 is generally a good option for patients who have lost most or all of their teeth in an arch, especially those who want to avoid a removable denture or extensive bone grafting. A full evaluation, including imaging of your jawbone, determines whether All-on-4 or a different implant approach is the better fit.
Frequently asked questions
How long does All-on-4 surgery take?
The implant placement itself typically takes around two hours per arch, with sedation options available for patient comfort.
Can I eat normally the same day?
You leave surgery with a fixed temporary prosthesis in place, so you can resume talking, smiling, and eating soft foods soon after, though your dentist will guide you on diet during initial healing.
How long until I get my permanent teeth?
The permanent restoration typically replaces the temporary one around six months later, once the implants have fully integrated with the bone.
Does All-on-4 require bone grafting?
Usually not. The angled placement of the back implants is specifically designed to anchor in existing bone, which is why All-on-4 avoids extensive grafting for most patients.
How do I clean a fixed All-on-4 prosthesis?
You brush and use an oral irrigator daily just as you would with natural teeth, and your dentist removes the prosthesis periodically during checkups for a deeper professional cleaning.
What does daily life look like with All-on-4?
Once the temporary prosthesis is in place, most patients return to normal speech and a soft-food diet within days, gradually reintroducing firmer foods as healing progresses. Because the prosthesis is fixed rather than removable, there is no daily in-and-out routine the way there is with a traditional denture, which is one of the most common reasons patients choose All-on-4 in the first place.
What can go wrong, and how is it prevented?
As with any implant surgery, risks include infection, implant failure, or prosthesis complications, though these are uncommon when the case is properly planned with imaging and the patient follows post-surgical care instructions. Smokers and patients with uncontrolled diabetes face a higher risk of implant failure, which is why your dentist reviews your health history closely before recommending All-on-4 over other options.
Will All-on-4 change how I speak?
There is typically a short adjustment period as your tongue and cheeks get used to the prosthesis, similar to adjusting to any new dental work, and most patients speak normally within a couple of weeks.
Is All-on-4 right for the upper and lower jaw?
Yes. All-on-4 can be used on the upper jaw, the lower jaw, or both, and your treatment plan will address each arch based on its own bone volume and condition.
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