As with any medical/dental procedure, there are pros versus cons for ANY treatment, by ANY clinician. Every option has a "lifespan" or "shelf-life" for how long the restoration should last. Ultimately, the longevity of the restoration heavily relies on patient factors (i.e., genetics, overall systemic health longterm, cleaning recall frequency, home hygiene, clenching/grinding of teeth, smoking, etc. etc.). Prosthodontic care for missing teeth should be thought of in a “chronic condition” context. You must recognize that long-term outcome monitoring is necessary.Think of a prosthetic arm or leg: As with any other body part that needs to be replaced as a result of an amputation, there is maintenance!The overall goal of the All-on-4 (Fixed bridge implant bridge) protocol is to restore a terminal or missing dentition. The dentist/dental specialist restoring the case is giving you a tooth substitute (not replacement). Since we cannot implant natural teeth, the two most common substitutes are: 1. Acrylic or 2. Zirconia. A combination that is used more and more is an upper zirconia bridge opposing a lower acrylic bridge. I've seen some patients that come in for second opinions that have very PRETTY Acrylic bridges, but also some with very UGLY Acrylic bridges. Zirconia bridges are the same, some are very esthetic, others are VERY OPAQUE, dead looking, and can look "Less-natural" than an Acrylic bridge. Ask your dentist to show you some ORIGINAL work, not stock photos.Each have its pros and cons:ACRYLIC: Description: Typically a titanium milled (CAD/CAM) bar connects the four implants. Acrylic denture teeth are set on the bar, tried in for approval of esthetics, and the teeth are processed (connected to the bar) with a pink acrylic. So in essence, there is 3 layers: the bar, the teeth, and the pink acrylic that connects everything. There needs to be necessary room for all layers (14-16mm), otherwise the bridge will not fit in the space provided. Many times repairs/breaks on the acrylic hybrid All-on-4 bridge are a result of the minimized space; either the teeth or the acrylic has to be thinned out, weakening the strength. PROS: Cost is Less (denture teeth come "stock," mass-fabricated)Easier to repair Acrylic is softer, so there is a "give" to the bite, for grinders they will slowly wear away the acrylic, similar to natural teeth. However, if the material is more stiff (Ceramic) a grinder can chip the restoration (too brittle). CONS: Staining more frequentDelamination (Debonding) of tooth from acrylicWear is fasterHigher repair; in a study in the Journal of Prosthodontics, 255 patients were followed up for an average of 13 years, and approximately 58% had one or more prosthetic events (i.e, chipped/broken tooth, loose implants screw) during that recall period. Overall survival rates at 20 years were 86% for prostheses (bridge), 15% survived free of any event, and 92% experienced survival free of biological implant failure. ZIRCONIA:Description: A monolithic, high-strength material that is directly fitted to the 4 implants (without a titanium bar). PROS:Zirconia is Harder than Acrylic (for grinders they will slowly wear away the zirconia compared to acrylic)Can layer porcelain for more esthetic, natural look (should be as minimal layering as possible)No chance for tooth delamination/debonding (All one piece)Can be used in limited space situations (12-16 mm of space)CONS: Cost is Higher (requires expensive milling/sintering machinery, custom hand finishing/detailing)Very Opaque (porcelain can be layered, or added to improve esthetics, but the porcelain can chip)Harder to repair (since the material is all one piece, if a "chip" occurs, the entire bridge needs to be replaced, OR a ceramic veneer can be glued to the front surface of the bridge as an alternative)Too Stiff (because of the incredibly stiff nature of the zirconia there is a potential for catastrophic failure from fracture of the entire zirconia bridge)As with all comments, ask a professional Prosthodontist in your area what treatment best suites your needs.