What Is the All-on-4 Fixed Prosthesis?

The All-on-4 fixed prosthesis, a form of implant-supported treatment, is a relatively short surgical procedure that provides essential dental function, aesthetic improvement, and speech clarity, thereby boosting self-confidence and greatly enhancing patients’ quality of life. It has become a highly effective option, particularly in cases where conventional implant treatment is not feasible.

In patients with partial tooth loss, implants can often be placed easily. However, in cases of complete edentulism (no remaining teeth), traditional treatments may be more time-consuming and costly. At this point, the All-on-4 technique offers a fast and efficient solution by eliminating the need for bone grafting in most cases.

What Is the All-on-4 Technique?

Oral and dental health is directly linked to one’s quality and longevity of life, leading to the development of various advanced dental treatments. The All-on-4 technique has been scientifically validated and is now widely and reliably used.

In essence, the technique involves placing four dental implants at strategic angles in a fully edentulous jaw, followed by the attachment of a fixed (non-removable) prosthesis. This treatment is primarily used to rehabilitate patients with no remaining teeth in one or both jaws.

How Is All-on-4 Treatment Performed?

The same titanium screw mechanism used in conventional implants is applied here; however, the distinguishing factor lies in the implant placement angles and locations. While conventional full-arch restorations might require 8–10 implants per jaw, the All-on-4 method uses only four implants—two placed vertically in the front region and two tilted posteriorly (approximately at a 45-degree angle) to maximize bone contact and support.

After implant placement, temporary prostheses are usually delivered on the same day. If extractions are necessary, they are performed under local anesthesia, and the implants are placed in the same session. Final prostheses are delivered approximately three months later, allowing time for osseointegration, during which temporary prosthetics serve both aesthetic and functional purposes.

What Are the Advantages of the All-on-4 Technique?

• Minimally invasive and time-efficient: The procedure is typically completed in one day, making it especially ideal for international patients or those with time constraints.

• Cost-effective: Compared to traditional full-mouth implant approaches, All-on-4 is generally more affordable.

• Fewer implants required: Only four implants per arch.

• No need for bone grafting in most cases.

• Improved stability: The tilted implant placement increases contact with dense bone areas.

• Long-lasting: With proper care, the prosthesis can last 10–15 years in the lower jaw and 5–10 years in the upper jaw.

• Improved quality of life: Restores chewing function, aesthetics, and speech with a fixed solution.

• Simplified hygiene routines compared to removable dentures.

Who Is a Candidate for All-on-4 Implants?

This treatment is suitable for patients who:

• Are completely edentulous or at risk of total tooth loss.

• Do not have medical contraindications to implant surgery.

• Have sufficient bone volume (confirmed by clinical and radiographic evaluations).

What Are the Steps of All-on-4 Treatment?

1. Pre-treatment Planning: Radiological evaluations, including CBCT scans, are performed to analyze bone structure and plan implant positions.

2. Surgical Phase: Four implants are placed—two anteriorly and two posteriorly, often in a single appointment.

3. Prosthetic Phase: A temporary fixed prosthesis is placed immediately. After a healing period of around three months, a permanent prosthesis is delivered.

Will There Be Pain After the Procedure?

Like any surgical intervention, mild pain and swelling are possible after All-on-4 implant placement. These symptoms are typically manageable with prescribed medications and cold compresses. Most patients resume daily activities quickly.

Anesthesia Options

This procedure is most often performed under local anesthesia. However, patients with dental anxiety may benefit from sedation or general anesthesia, administered in a fully equipped surgical facility under medical supervision. Recovery is generally swift, and patients are typically discharged on the same day.

What Is the Post-Treatment Diet?

After implant placement, temporary prostheses are immediately functional. However, osseointegration (bone-implant fusion) is critical. For the first three months, patients must follow a soft-food diet, personalized by the dental team. Once permanent prosthetics are placed, the patient may return to normal dietary habits.

Is the All-on-4 a Reliable Procedure?

Yes. Numerous studies and long-term clinical follow-ups have demonstrated the high success rate and reliability of All-on-4 implants. It is a preferred method for full-arch restoration due to its efficiency, comfort, and cost-effectiveness.