All-on-4®

The All-on-4 treatment concept offers an implant-based solution to patients who have lost all of their upper and/or lower teeth. This remarkable method of care helps patients quickly rebuild complete and beautiful smiles. With All-on-4, your new, and complete set of implant-supported replacement teeth feel secure, stable, and much like your very own.

If you currently wear complete upper and/or lower dentures or are slated to have your remaining teeth extracted, you may be a candidate for All-on-4. First Performed by Dr. Paulo Malo in 1998, the All-on-4 treatment concept has helped hundreds of thousands of patients quickly reestablish attractive smiles that look, feel, and function just like a set of natural teeth!

The All-on-4 treatment concept offers a fixed and permanent alternative to removable dentures. Unlike dentures, All-on-4 does not rely on messy dental adhesives or natural suction to hold your new set of teeth in place. With All-on-4, your replacement teeth are permanently secured by dental implants, giving you a smile that looks not only great but also feels secure and stable. You'll feel comfortable and confident as you speak, smile, and chew with ease.

While traditional full arch implants also achieve outstanding results of care, the All-On-4 treatment concept does not involve bone grafting and requires fewer implants to support a full set of teeth. With just four strategically placed dental implants needed to support an entire set of upper or lower teeth, the All-on-4 treatment concept offers a cost-effective and satisfying solution for rebuilding a complete smile. Thanks to this remarkable method of care, patients can experience the satisfaction of having teeth placed the same day as surgery. This key feature allows patients to smile and function with confidence until healing is complete and the permanent restorations installed.

Once it's been determined that you're a candidate for treatment with All-on-4, the process of treatment planning and designing your new smile begins. 3D diagnostic records provide the detailed information required to determine the exact positions of the four supporting dental implants. Then, on the day of surgery, we'll remove any remaining teeth, place the 4 implants, and insert a set of attractive, sturdy, and functional set of temporary teeth. With All-on-4, temporary teeth can be placed right away with a customized, permanent set to follow once the implants become fully integrated with the surrounding bone.

With All-on-4, temporary teeth can be placed right away with a customized, permanent set to follow within just a few months after the implants become fully integrated with the surrounding bone.

Thanks to All-on-4, patients enjoy permanent teeth that look, feel, and function just like real teeth. And with a patient satisfaction rate that exceeds 95%, the All-on-4 treatment concept restores your smile, your confidence, and allows you to enjoy once again the foods you love!

Maintaining your All-on-4 smile requires the same care as a natural smile. By cleaning your teeth twice daily, after meals as possible, and scheduling appointments for routine checkups as well as care, you can keep your new smile strong and healthy for years to come. Our office will demonstrate the most effective methods of oral hygiene and answer all your questions as to how to care for your new smile.

All-on-4® is a full-arch tooth replacement method that secures a fixed prosthesis to a small number of dental implants, typically four per arch. It is designed to provide patients who are missing most or all teeth with a stable, natural-feeling set of teeth that function like fixed restorations rather than removable appliances. Because the prosthesis is attached to implants, it eliminates many of the movement and retention issues commonly associated with traditional removable dentures.

Unlike conventional dentures, an All-on-4® prosthesis transfers chewing forces to the jaw through implants, which helps preserve bone and provides greater chewing efficiency. The treatment streamlines the surgical plan by using strategically angled implants to maximize available bone, often avoiding the need for extensive grafting. For many patients this approach results in quicker restoration of function and confidence compared with building individual implants for every missing tooth.

Candidates for All-on-4® are typically patients who are missing most or all teeth in an arch or who have teeth that are not salvageable and need extraction. Good overall health, a commitment to oral hygiene, and realistic expectations about function and aesthetics are important factors in determining suitability. Your dentist will review your medical history, medications, and any conditions that could affect healing as part of the candidacy assessment.

Bone volume and quality are evaluated with clinical exams and imaging to determine whether the All-on-4® concept can be safely applied or whether adjunctive procedures are necessary. In many cases, angled implant placement allows clinicians to use existing bone effectively and avoid grafting, expanding candidacy to patients who might otherwise require more complex reconstruction. Ultimately, individualized planning ensures the chosen solution aligns with each patient’s anatomy and goals.

Treatment begins with a comprehensive consultation that includes a medical and dental history review, clinical examination, and imaging such as CBCT scans or X-rays to assess bone and soft tissue. The care team develops a personalized plan for implant placement and the design of an immediate provisional prosthesis, explaining the sequence of visits and anesthesia options. On the day of surgery, implants are placed in predetermined positions and a temporary fixed bridge is attached so patients typically leave the office with a full arch of teeth.

Over the following months the implants undergo osseointegration while the provisional restoration provides function and esthetics. Follow-up appointments monitor healing, allow adjustments to the provisional prosthesis, and confirm implant stability before fabricating the final prosthesis. The final restoration is custom-crafted for long-term function, comfort, and appearance once the team determines the supporting tissues are stable.

Initial recovery usually involves some swelling, mild discomfort, and sensitivity in the treated area; these symptoms are common and generally manageable with prescribed or over-the-counter medications and rest. Patients are advised to follow a staged diet, starting with soft foods and gradually introducing firmer textures as healing progresses and comfort allows. Gentle oral hygiene and following post-operative instructions are key to preventing complications and supporting successful integration.

Follow-up visits in the first few weeks allow the dental team to check soft tissue healing, adjust the provisional prosthesis if needed, and address any questions about diet or hygiene. Most patients report meaningful improvement in function and confidence within days, though complete tissue healing and bone integration can take several months. Your dentist will provide specific timelines based on your progress and any individual factors that affect healing.

The immediate provisional prosthesis placed on the day of surgery is designed to restore basic chewing and speech so patients can return to many normal activities right away. While the temporary bridge supports essential function, patients are usually advised to avoid very hard or sticky foods and to follow dietary guidelines to protect the implants and provisional restoration during early healing. Adapting to the new prosthesis may take a short period of practice, and most patients notice a rapid improvement compared with removable dentures.

Speech typically improves quickly as patients become accustomed to the prosthesis, though minor changes in sound production can occur initially and resolve with time and practice. The dental team will provide guidance on eating, speaking, and cleaning the provisional restoration to ensure comfort and function while osseointegration occurs. Any persistent difficulties are evaluated during follow-up visits so adjustments can be made.

The provisional prosthesis is built for immediate function and esthetics while the implants heal; it is often lighter and designed for temporary use during the integration period. Once implants are fully integrated and soft tissues have stabilized, the final prosthesis is fabricated from more durable materials and crafted to optimize long-term function, fit, and appearance. The definitive restoration incorporates refined bite relationships, customized contours, and stronger components intended for daily, long-term use.

During the transition to the final prosthesis, impressions, digital scans, and occlusal records are used to create a restoration that balances strength, comfort, and esthetics for your unique anatomy. The final prosthesis may also include design features to improve hygiene access and longevity. Your dentist will review maintenance expectations and any protective measures to preserve the new restoration.

Long-term success relies on regular home care and professional maintenance. Patients should brush carefully around the prosthesis, use recommended interdental cleaning aids, and follow any instructions provided for cleaning under and around the bridge. Consistent oral hygiene reduces risks of inflammation and helps maintain healthy supporting tissues.

Regular dental checkups and professional cleanings are essential to monitor tissue health, check for wear or strained components, and perform any necessary maintenance on attachments or screws. Early detection of issues through routine care allows conservative corrections that help extend the life of the prosthesis. Your dental team will recommend a maintenance schedule tailored to your needs and show you techniques to keep the restoration clean and functional.

As with any surgical procedure, All-on-4® carries risks such as infection, delayed healing, or implant failure, though careful planning and technique reduce these occurrences. Mild post-operative symptoms like swelling or discomfort are common and typically resolve with conservative care; more serious complications are less frequent but require prompt attention. The dental team screens medical history and medications beforehand to identify factors that could affect healing and to minimize risk.

If complications occur, they are managed according to their cause and severity—this can include antibiotics for infection, adjustments to the prosthesis for fit-related irritation, or in rare cases, revision of implant position. Regular follow-up visits and clear post-operative instructions help detect and address problems early. Open communication with your dental provider ensures that concerns are evaluated and treated in a timely manner.

Implant-supported restorations like All-on-4® transmit biting forces to the jawbone in a manner similar to natural teeth, which helps stimulate and preserve bone volume over time. This functional loading slows the bone resorption that typically follows tooth loss and supports the soft tissues and facial contours. By maintaining bone height and width, implant-supported prostheses can contribute to a more youthful and stable facial profile compared with long-term use of removable dentures.

Strategic implant placement is planned to maximize available bone and provide durable support for the prosthesis, reducing the need for grafting in many cases. Your dentist will explain how implant biomechanics work for your anatomy and how long-term maintenance supports bone health. With consistent care and monitoring, many patients preserve more bone and enjoy improved oral function compared with traditional options.

To begin, schedule a consultation with the DentMax team where your medical and dental history will be reviewed and diagnostic imaging will be taken to evaluate your anatomy and candidacy. During this visit the clinician will discuss your goals, explain the sequence of care, and outline any preparatory steps needed for a safe and predictable outcome. This conversation helps set realistic expectations and identifies the best restorative approach for your needs.

If you proceed with treatment, the team will create a personalized plan that covers implant placement, provisional restoration, and the timeline for the final prosthesis. Follow-up appointments and detailed post-operative instructions are provided to support healing and optimal results. If you have specific questions about the process or want to arrange an evaluation, the DentMax office can guide you through the next steps.