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.Â
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.Â
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.Â
“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.
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.Â
By maximizing the contact between the implant and the bone, most All-on-4 patients can avoid the need for a bone graft.
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.Â
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.
Pros
Cons
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.
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.
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.
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.
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.Â
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:
Four to six months later, once you’ve healed, these temporaries will be replaced with your permanent new teeth arch.
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.Â
They’re considered a practically permanent solution, but how long your implants last will depend on several factors:Â
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.
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.Â
For the first few days or so, you’ll be restricted to a liquid diet to reduce pain and speed healing.Â
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.Â
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.Â
After a few days, you can add soft foods like scrambled eggs with creamy cheeses, mashed potatoes, and cooked cereals with mashed fruits.Â
By the third week post-op, you’ll transition to a soft food diet.Â
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.
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.Â
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).Â
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.Â
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.
Updated September 1, 2022