Question about Allon-Four dental implants.

I am missing all my upper teeth and was considering the all on four procedure. A dentist told me i don't have enough bone for all on four. He said he could put two implants located where the incisors (eye teeth) used to be would work. I'm concerned that it may not be stable. Please advise

Doctor Answers 11

Second Opinion Recommended.

For the All-on-4 procedure, sometimes we have to rebuild the bone prior to implant placement. I'd find out if that is an option for you. With the All-on-4 procedure, the implant for the back teeth are angled to accommodate areas with less bone.

If you end up getting an overdenture with 2 implant anchors, it can be a good option. However the All-on-4 procedure would be the most stable and the most ideal.

Austin Dentist
5.0 out of 5 stars 4 reviews

All-on-4 Dental Implants

Thank you for your question regarding All-on-4. All-on-4 has been designed as a procedure to use the existing bone structure and as few implants as possible to retain a set of teeth. If you do not have enough bone, then it would have to be regenerated. With today's technology, we can regenerate bone structure so that two more implants can be added and you can be an All-on-4 candidate. I would suggest you seek a periodontist that is trained in bone tissue regeneration and dental implants, and explore these options. Good luck!

William P. Lamas, DMD, MS
Miami Dentist
5.0 out of 5 stars 13 reviews

Bone and Stability Are Important Considerations

This is a valid concern. The bone where the incisors are, in the front of the face in the upper jaw, called the maxilla, meaning that you would have stability in the anterior (or front) of the mouth, and no stability in the posterior (back) of the mouth. This means that the pressure is all being place on the front implants, which also are placed in the pre-maxilla bone, which is the softest bone you have in the body. Without the load being shared, there is a much higher rate of failure in these implants.

We can also add bone tissue to the pre-molar or molar areas using a technique called a sinus lift to create enough bone tissue for implants and to give better stability and better retention, as well as better force distribution.

Sometimes implants can be placed at the same time as the sinus lift and you can be fitted with a non-removable healing denture, but this is not always the case.

George Sepiashvili, DDS
Westchester Dentist

Implant Solution for Patients with Severe Bone Loss

Not to worry, even with low bone levels the All On 4 procedure is possible for you. Options could be sinus lifting and bone grafting to augment the bone for implant placement, however this is a procedure that may or may not work due to your current levels of bone and lifestyle choices. 

One great option that we are able to provide to our patients at our clinic is the option of placing Zygomatic Implants. We have one of two certified Maxiliofacial surgeons in Mexico that are qualified to do this type of surgery. (Not just any oral surgeon is qualified to do this procedure.)

These implants are much longer in length and are anchored in the Zygoma bone, or Cheekbone. Noble Biocare makes Zygomatic implants which we use for this procedure.
This procedure is more invasive than normal implant placement and requires that you be operated on in a hospital as this is a inpatient procedure. The great thing about Zygomatic implants is that is the last solution for patients with severe bone loss due to trauma, or years of being endentulous.
If you were told you are not a candidate for the All On 4 procedure you can get a second opinion from a Maxiliofacial surgeon who is qualified to do this procedure. 

Irma Gavaldon, DDS, MS
Mexico Dentist
5.0 out of 5 stars 16 reviews


Yes for the upper jaw you need a minimum of 4 dental implants. In your case this may require sinus bone grafting to allow for implant placement it sounds like. 

Garett Seeba, DMD, MD
Webster Dentist
5.0 out of 5 stars 1 review

Get a second opinion

Often patients are told they do not have enough bone for traditional dental implants. By using the G4 Implant Solution, we are able to provide patients permanent teeth, even when they have been told no.

Mike Golpa, DDS
Las Vegas Dentist
4.8 out of 5 stars 49 reviews

All on 4 on compromised areas

The All on 4 procedure is very adaptable.  After a proper evaluation, you still can be a candidate for an All on 4 prosthesis by placing zygomatic implants if certain areas of bone are insufficient.  Bone Height alone is not the only consideration.  Bone quality is also an important factor for the All on 4 procedure.  With a Cone Beam CT, a Doctor can best determine the best treatment options for you. 

Thomas R. Gonzales, DDS
Las Vegas Dentist
5.0 out of 5 stars 1 review


ALL ON 4, by Nobel  is your best option if you want something to be fixable, 
and can be done in just a couple of days, 
if your doctor, does not perform ALL ON4, and did not a CT SCAN, of the upper maxilla, then he cannot tell you you cannot place implants,
you can also try, snapindentures, they work amazing when you have not enough bone, also.
there are several techniques that you should consider before you make a decision.

No bone for all on 4

That's why the commercial says "come in to see if you qualify."

You can still have cemented teeth. You will need sinus bone augmentation on both sides. Then you may have the implants placed 6 months later.

Victor Sanz, DDS
Chicago Dentist
5.0 out of 5 stars 3 reviews

No bone

When there is poor bone on the upper jaw you have two options for implant placement for the all-on-4:

1. Grow more bone: Bilateral sinus augmentation (sinus lifts). 
2. Zygomatic implants. Extra long implants that traverse the maxillary sinuses, and are placed in the zygomatic bone (Cheek bone).

Prior to treatment, your dentist may recommend a CBCT (CAT-scan), to evaluate your bone three-dimensionally. 

As with any information on the internet, be sure to get an individualized consultation prior to deciding on any medical treatments.

Hope that helps!

Ace Jovanovski, DMD
Round Rock Prosthodontist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.