What is All-on-Four? Fixed teeth on four implants explained

For patients who have lost all their teeth or whose remaining teeth cannot be saved, removable dentures were long the only option. But palate-covering dentures offer limited comfort and start to shift over time as the jawbone resorbs. All-on-Four is a treatment approach that restores a full arch on just four implants, anchoring a fixed bridge in place.

The core idea is to use the denser, stronger bone in the front of the jaw. The two rear implants are placed at an angle to make the most of the available bone, which in many patients allows a fixed restoration without additional bone grafting surgery.

Who is All-on-Four suitable for?

• Patients who have lost all their teeth (edentulous)
• Those whose remaining teeth are severely mobile or cannot be saved
• People who are unhappy with the comfort of removable dentures
• Anyone who wants a fixed solution instead of a palate-covering denture
• Adults whose general health is suitable for implant surgery

Suitability is determined through an oral examination, an assessment of bone structure with 3D tomography, and a review of general health. Factors such as diabetes, bone loss or smoking can affect the treatment plan, so every case is evaluated individually.

How does the procedure work?

• Digital planning is carried out using a detailed examination and tomography
• In suitable cases, four implants are placed in a single session
• The procedure is performed by an oral and maxillofacial surgeon, with sedation or general anaesthesia where needed
• A temporary fixed prosthesis can be fitted the same day or shortly after
• The permanent prosthesis is prepared once healing (osseointegration) is complete

Recovery and what to watch for afterwards

Full integration of the implants into the bone usually takes several months, and following the dentist's diet and hygiene guidance during this period is important. Eating soft foods in the early days, maintaining oral hygiene and attending regular check-ups directly affect the success of treatment.

Fixed prostheses offer a chewing comfort close to that of natural teeth. Even so, regular brushing, interdental cleaning and periodic check-ups should not be neglected to keep the gum tissue around the implants healthy.