Question 1

What are All-on-4 dental implants?

Accepted Answer

All-on-4 implants are a dental implant treatment created by Nobel Biocare. A type of ClearChoice implant, this surgical procedure replaces a full arch of upper or lower teeth with a new set of fixed prosthetic teeth.

These arches, or implant bridges, are attached to the upper or lower jawbone with four dental implants, tiny metal screws that replace the original tooth roots. Once in place, these four implants act as a support mechanism for the full All-on-4 arch.

This initial procedure can be performed with a temporary bridge in a single appointment, so it’s often called “teeth in a day.” These temporary teeth are replaced by a permanent bridge a few months later.

Each All-on-4 arch contains 10 to 14 teeth, enough for a complete set of teeth on the upper or lower jaw.

“The temporary prosthesis, which is made of acrylic, is supposed to last about six months, to allow the gums to settle down and find their final anatomical position,” Miami periodontist Dr. John Paul Gallardo explains. ”Then a final impression is made for a final prosthesis.” These replacement teeth are made of titanium (often covered with acrylic), zirconia, or porcelain.

Cosmetic dentists recommend All-on-4 dental implants to replace missing teeth or those that need to be pulled due to failed root canals, decay, or infection. Because an entire arch is replaced at once, your new smile can be very natural-looking.

Question 2

How do All-on-4 dental implants differ from conventional dental implants?

Accepted Answer

Traditional implant restoration requires 6–8 implants to support a full fixed bridge. Because these titanium screws are placed straight into the jawbone, conventional full-arch teeth replacement often requires bone grafting, to build up the upper jawbone density.

With the All-on-4 technique, just 4 implants can attach an entire top or bottom set of teeth. The implants are placed at an angle, so they don’t require the same density of bone to be secured into the jawbone.

By maximizing the contact between the implant and the bone, most All-on-4 patients can avoid the need for a bone graft.

Question 3

How do All-on-4 dental implants differ from snap-on dentures?

Accepted Answer

Snap-on dentures, also called implant-supported dentures or overdentures, are an alternative to traditional, removable dentures. Rather than resting on the gumline, these dentures “snap” into place using post-like implants that are surgically placed into the jawbone. The snap-in dentures are removable, but the posts aren’t.

Snap-on dentures are an option for people who want to avoid accidental removal or shifting of dentures. Otherwise, they look and feel the same as traditional dentures.

In contrast, All-on-4 dental implants can only be removed by a dental professional. They’re stronger than dentures, and they look much more like natural teeth.

Question 4

What are the pros and cons of All-on-4 dental implants?

Accepted Answer

Pros

All-on-4 dental implants eliminate the inconvenience of removable dentures, which can become loose and uncomfortable.
In many cases, it’s possible to receive a full set of new teeth in one day.
The All-on-4 technique reduces the need for time-consuming and painful bone grafting surgery, so even patients who have upper jaw bone loss or sinus issues can be good candidates.
But the All On 4™ technique has made a huge difference. And this is great news for patients with Osteoporosis or a lack of jaw bone.
You’ll have limited disruption to everyday life and minimal food restrictions once your full mouth has healed.
Especially if you need a full set of teeth, All-on-4 implants may be more cost-effective than individual implants/
A majority of RealSelf members who have All-on-4 implants say their procedure was “Worth It,” restoring their teeth, confidence, and quality of life.

Cons

Although it’s uncommon, there’s some risk of a failed implant if the bone doesn’t grow properly around the implanted screw.
Some RealSelf members report they had speech difficulties post-surgery. This happens because implant supported-bridges are thick and can feel bulky, so you may need to relearn how to say sounds like “D,” “N,” and “T.”
You’ll need to wear a mouthguard at night to protect your new teeth against clenching and grinding.
All-on-4 dental implants can be very expensive, so you may want to consider financing options.
Some RealSelf members say they had tender gums and difficulty eating for much longer than expected, as long as one month post-surgery.

RealSelf Tip: Some patients have reported that the ClearChoice Center tried to upsell them on more implants than they needed. If you go in to have just a few teeth replaced and All-on-4 implants are recommended, get an outside opinion from a prosthodontist who's unaffiliated with ClearChoice.

Question 5

How much do All-on-4 dental implants cost?

Accepted Answer

Your cost will depend on whether you get prosthetic teeth for just one or both arches. Prices also vary by the experience level of your All-on-4 dental implant dentist, their locations, and whether or not you have local or general anesthesia.

You may incur additional costs from follow-up visits.

You can finance your treatment with CareCredit.

See our complete guide to All-on-4 dental implant costs

Question 6

All-on-4 dental implant before and after pictures

Accepted Answer

The All-on-4 dental implant photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 7

Will insurance cover All-on-4 dental implants?

Accepted Answer

Your insurance may cover a portion of the cost of dental implants, especially if you have medical complications as a result of tooth loss—but you’ll have to coordinate that directly with your insurance provider.

ClearChoice Centers don’t accept dental insurance, though they do offer payment plans and accept third-party financing options.

Question 8

What should you expect during All-on-4 dental implants surgery?

Accepted Answer

In your initial consultation, you’ll meet with an implant dentist (trained in implantology) or oral surgeon who specializes in cosmetic dentistry, who will determine whether you’re a good candidate for this dental implant procedure.

X-rays or a CT-scan may be used to help determine whether this is the right treatment option for you.

If you’re missing only a few teeth and otherwise have many healthy ones, your dentist may instead recommend a different treatment plan, such as traditional dental implants.

If you go ahead with All-on-4 treatment, you’ll most likely have the implants inserted and your new temporary prosthetic teeth attached in the same procedure.

Here’s what to expect on the day of surgery:

Depending on the extent of your procedure, you’ll be under either general anesthesia or local anesthesia with IV sedation (the most common option.
First, your dentist will pull any remaining teeth and remove infected gum tissue to prepare your mouth for implant placement.
Then they will place two screws (usually titanium) toward the front of the mouth and two toward the back of the mouth, to anchor the new prosthetic teeth.
You’ll be given a temporary arch while your jaw heals and the implant screws fuse to the bone. This process, known as osseointegration, has the added benefit of preventing bone loss and can help your facial structure look more youthful over time.

Four to six months later, once you’ve healed, these temporaries will be replaced with your permanent new teeth arch.

Question 9

How long do All-on-4 dental implants last?

Accepted Answer

All-on-4 implants can last from 5 years to more than 40 years, but 20 years are the average, with diligent care and maintenance.

They’re considered a practically permanent solution, but how long your implants last will depend on several factors:

The material from which they’re made. Many dentists say that zirconia or hybrid-acrylic/titanium materials are the most durable and last longer than porcelain.
Your oral health hygiene. Brush and floss them regularly, as you would your natural teeth, and make sure you see a reputable provider for regular dental care and professional cleanings.

Preventing chips or cracks. They can be repaired, but it’s best to try to avoid them. Wearing a mouthguard at night will protect your new teeth from grinding and pressure that can lead to cracks.

Question 10

What are the problems with All-on-4 dental implants?

Accepted Answer

All-on-4 implants have a high success rate, and the surgery is considered safe.

However, as with any surgical procedure, there are risks and drawbacks.

The most common risks are infection, nerve damage, or gum damage.
It’s also possible that your prosthetic teeth could break, particularly if the bite is off. Talk with your dentist if you have any concerns about your implant placement.
Getting this type of implant may limit your options down the road, if it doesn’t work out. “The typical All on 4 case requires significant bone reshaping in order to make room for the prosthesis. Once this is done, the bone is reshaped for life," says Dr. Gallardo. "In some of these cases, if the All on 4 procedure does not work, the patient may need to accept a removable full denture as the only alternative."

Question 11

What can you eat after All-on-4 dental implants?

Accepted Answer

For the first few days or so, you’ll be restricted to a liquid diet to reduce pain and speed healing.

Good food options include smooth soups like clear broths or creamy vegetable soup, meal replacement drinks, fruit smoothies without many seeds, milkshakes, and protein drinks.

Avoid using a straw for the first month (sucking can dislodge blood clots, cause bleeding, and delay recovery), and limit citrus drinks like orange juice—they’re high in acid that can damage the enamel on the new implants.

After a few days, you can add soft foods like scrambled eggs with creamy cheeses, mashed potatoes, and cooked cereals with mashed fruits.

By the third week post-op, you’ll transition to a soft food diet.

For the next few months, stick with foods that need little chewing: The jaw is still healing and bonding with the implants to become a natural part of your mouth, and hard, crunchy, chewy foods can disrupt this process.

Question 12

How do you clean All-on-4 dental implants?

Accepted Answer

Even though All-on-4 dental implants look, feel, and function like natural teeth, the routine for keeping them clean is slightly different than just brushing and flossing.

Specifically, for each step in your dental hygiene regimen, you’ll need to pay closer attention to the gum area around your implants, since food particles can get caught where they attach to your jawbone (though not under the implant post).

Your dentist will give you specific cleaning instructions, including the use of specialized tools to make it easier to clean dental implants and around the gumline. These include a water flosser (like a WaterPik), Oral-B Super Floss, and a sulcus brush, a small round toothbrush designed to reach around the gumline.

Along with practicing proper oral hygiene, it’s important to schedule regular visits with your dentist for cleanings and check-ups. Good oral health habits can help extend the lifespan of your implants.

ALL-ON-4 DENTAL IMPLANTS

Mike Golpa, DDS

Deanna Pai

Mike Golpa, DDS

Deanna Pai

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Mike Golpa, DDS

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Mike Golpa, DDS

Deanna Pai

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