All-on-4®1 is a full-arch rehabilitation technique that replaces an entire upper or lower set of teeth using just four strategically placed dental implants and a fixed prosthesis. Designed for people who have lost most or all of their teeth—or who need extractions—this approach delivers a stable, immediate solution so you don’t have to go without teeth while healing occurs.
Unlike traditional removable dentures, the All-on-4® method provides a fixed, non-removable prosthesis that restores everyday activities—chewing, speaking and smiling—with more predictable comfort and stability. Because the provisional prosthesis can be attached on the day of surgery, many patients leave the office with fully functioning teeth the same day as their procedure.
At the office of 360 Dental of Mill Creek, we pair modern imaging and careful treatment planning with proven implant protocols so patients understand the process and realistic outcomes before they begin. Our goal is to help you make an informed decision about a long-term solution for missing teeth that balances function, appearance and oral health.
The All-on-4® concept was developed to maximize the use of available jawbone while minimizing surgical complexity. Posterior implants are often placed at angled trajectories, which increases support for the full-arch prosthesis without the need for extensive bone grafting in many cases. This approach can shorten treatment time and simplify the pathway to a stable restoration.
Clinical follow-up and scientific literature report consistent success when implants are placed using careful diagnostics and sound prosthetic design. The technique focuses on distributing bite forces across four implants and a well-designed framework, which supports a durable prosthesis that performs similarly to natural teeth in everyday function.
Because each patient’s anatomy and health profile are different, the All-on-4® protocol is customized to achieve the best long-term outcome. That customization includes digital planning, precise surgical guides, and close coordination between the clinician and the dental laboratory to ensure the prosthesis fits and functions correctly.
For those with complex dental histories, the concept can be adapted—such as using additional implants or alternative prosthetic designs—so the treatment plan fits the individual’s needs and goals while still aiming for a predictable, comfortable result.
The process begins with a comprehensive consultation and imaging. A clinical exam, dental X-rays or cone-beam CT scan, and a discussion of medical history allow the dental team to map bone anatomy, evaluate the bite and design a prosthesis that meets both functional and esthetic goals. Treatment planning also identifies whether extractions, preparatory procedures, or a same-day provisional restoration will be part of your care.
On the day of surgery, the treatment typically involves placing four implants into the jaw and attaching a provisional full-arch prosthesis. If remaining teeth need removal, extractions are performed and implants are placed during the same appointment in many cases. Because the provisional restoration is secured to the implants, patients usually have immediate chewing ability and a natural-looking smile while the implants integrate with the bone.
The healing phase requires routine follow-up appointments to monitor integration, soft-tissue healing and prosthetic function. Early days after surgery may include dietary and activity recommendations to protect the newly placed implants and allow comfortable healing. Once the team confirms stable integration, a final prosthesis—crafted to refine esthetics and long-term durability—is fabricated and delivered.
Long-term success depends on routine maintenance: regular dental checkups, professional cleanings, and consistent home hygiene. With appropriate care, full-arch implant restorations can offer years of predictable function and an improved quality of life compared with removable options.
While the esthetic improvement is often the most noticeable change, the All-on-4® approach provides practical functional advantages. A fixed prosthesis restores chewing efficiency, making it easier to enjoy a wider variety of foods and to maintain a balanced diet. Speech is generally clearer and more natural when a stable, well-fitted prosthesis replaces missing teeth.
From a biological standpoint, dental implants help preserve jawbone by providing the stimulation that natural tooth roots once gave. This preservation can slow the facial bone resorption that commonly follows tooth loss, helping to support facial contours and overall oral health in the long run.
In addition to functional and health gains, many patients appreciate the routine convenience of a fixed implant-supported prosthesis. Daily care is focused on good oral hygiene and professional maintenance rather than the frequent adjustments and adhesive use that can be necessary with removable dentures.
Candidacy for the All-on-4® approach depends on several factors including overall health, jawbone quality, oral hygiene habits and personal goals. Many adults who have suffered extensive tooth loss or who are unhappy with removable dentures are potential candidates, but a clinical evaluation is required to identify the safest and most effective plan for each person.
During an evaluation, the dental team will review medical history, assess bone volume and quality, and discuss expectations for function and esthetics. Some patients may require preparatory treatments—such as tooth extractions or minor bone grafting—while others can proceed directly to implant placement and same-day provisional teeth.
There are alternative approaches to full-arch replacement, including more implants, hybrid designs or tissue-supported dentures; the best option is the one tailored to your anatomy and lifestyle. A clear, individualized treatment plan explains why a particular approach is recommended and outlines the sequence of care and follow-up.
To explore whether All-on-4® is appropriate for your situation and to learn what the process would look like for you personally, schedule a consultation with a qualified implant provider who can review your case and answer specific questions.
In summary, All-on-4®1 is a streamlined full-arch restoration option that can return immediate function and a stable smile for many people with significant tooth loss. If you’d like to learn more about how this treatment is planned and delivered, please contact the office of 360 Dental of Mill Creek for more information.
1All-on-4 is a registered trademark of Nobel Biocare
All-on-4® is a full-arch rehabilitation technique that replaces an entire upper or lower set of teeth using four strategically placed dental implants and a fixed prosthesis. The prosthesis is secured to implants and is not removable by the patient, which differs from traditional dentures that rest on the gums and are removed for cleaning. Because the All-on-4® concept often allows a provisional prosthesis to be attached on the day of surgery, many patients have functional teeth immediately after the procedure.
The fixed nature of an All-on-4® restoration typically provides greater stability for chewing and speech compared with removable options. Implants also help preserve jawbone by transmitting functional forces into the bone, which reduces the bone resorption commonly seen with tissue-supported dentures. Treatment planning and prosthetic design are tailored to restore both function and esthetics for each patient.
Candidacy for All-on-4® depends on a combination of oral and general health factors rather than a single criterion. Suitable candidates often include adults with significant tooth loss, failing dentition, or patients who are dissatisfied with the stability of removable dentures, provided they have adequate medical health to undergo implant surgery. Certain systemic conditions, tobacco use, or uncontrolled medical issues may require management before implant therapy is recommended.
A comprehensive evaluation including a clinical exam and cone-beam CT or dental X-rays helps the clinician assess bone volume, anatomy and potential risks. The dental team will also review oral hygiene habits and discuss realistic expectations for function and appearance. When All-on-4® is not ideal, alternative full-arch approaches or staged treatments can be considered based on the individual’s needs.
Preparation begins with a detailed consultation that includes medical history, a dental exam and three-dimensional imaging to map bone anatomy and plan implant placement. Your clinician may advise adjustments to medications, request medical clearance from a physician for certain conditions, and provide preoperative instructions about eating, drinking and arrival times. Patients should arrange for transportation on the day of surgery if sedation or general anesthesia is planned.
Digital treatment planning and fabrication of surgical guides or provisional prostheses are common preparatory steps that improve accuracy and predictability. At the office of 360 Dental of Mill Creek, treatment planning emphasizes clear communication about the sequence of care, expected recovery, and the provisional and final prosthetic phases. Following preoperative instructions helps reduce risks and supports a smoother surgical experience.
On the day of surgery, the clinician places four implants in the jaw using planned trajectories that often include angled posterior implants to maximize bone support. If remaining teeth require extraction they are typically removed during the same appointment and implants are placed in the prepared sites. A provisional full-arch prosthesis can frequently be attached to the implants the same day, providing immediate esthetics and basic chewing function while the implants begin to integrate with the bone.
Immediate provisionalization does not mean the implants are fully healed; patients must follow postoperative guidelines to protect the restoration during osseointegration. Scheduled follow-up visits allow the team to monitor healing, adjust the provisional prosthesis as needed, and plan for the final restoration once integration and soft-tissue healing are satisfactory. The final prosthesis is crafted to optimize long-term function and esthetics.
Early recovery commonly involves swelling, mild to moderate discomfort, and dietary changes for several days to weeks as tissues begin to heal. Patients are usually advised to follow a soft or blended diet initially, practice gentle oral hygiene around the surgical sites, and attend scheduled postoperative appointments to assess healing and prosthetic function. Pain control, cold therapy and activity modification are typical parts of the immediate recovery plan.
Osseointegration, the process by which implants fuse with the jawbone, typically takes several months and requires periodic clinical and radiographic checks. During this period the provisional prosthesis provides function but may be adjusted to protect the implants. Once adequate integration and soft-tissue stability are achieved, the final prosthesis is delivered to improve long-term durability and esthetic refinement.
Dental implants themselves are designed to be a long-term tooth replacement when they successfully osseointegrate and the surrounding tissues remain healthy. The longevity of the implant-supported prosthesis depends on multiple factors including oral hygiene, regular professional maintenance, the design and materials of the prosthesis, and the patient’s bite forces and general health. Routine dental visits allow clinicians to monitor implant stability and address wear or minor issues before they become major problems.
Prosthetic components such as acrylic teeth or veneering materials may require repair, replacement or maintenance over time even when the implants remain stable. A well-planned maintenance schedule and timely adjustments extend the service life of the restoration and support predictable function. If complications arise, the restorative team can often make conservative repairs or, when necessary, replace prosthetic elements while preserving the underlying implants.
One advantage of the All-on-4® concept is its ability to maximize existing bone by using angled posterior implants, which can reduce the need for extensive bone grafting in many cases. Because of this design, many patients who might otherwise require grafting for traditional implant placement can proceed without it, streamlining the treatment process. However, bone grafting may still be recommended when there is severe bone loss, unfavorable anatomy, or when additional implants are planned for enhanced support.
Decisions about grafting are made after careful imaging and assessment of jawbone volume and density. When grafting is indicated, it may be performed before, during or after implant placement depending on the clinical situation and treatment goals. Your implant team will explain the rationale for grafting and how it affects the overall timeline and outcomes.
All surgical procedures carry risks, and All-on-4® implant treatment can be associated with complications such as infection, bleeding, nerve irritation, sinus involvement for upper implants, or failure of an implant to integrate. Early detection through close postoperative monitoring and prompt management of symptoms reduces the likelihood of long-term problems. Thorough preoperative assessment, careful surgical technique and appropriate patient selection all help mitigate these risks.
In some cases prosthetic complications such as screw loosening, fracture of prosthetic materials or wear of veneering surfaces can occur and require repair or adjustment. Clear postoperative instructions and adherence to follow-up care improve outcomes and allow the clinical team to intervene quickly when problems arise. Patients should contact their provider if they experience persistent pain, swelling, or changes in sensation after surgery.
Oral hygiene for an All-on-4® fixed prosthesis combines home care and professional maintenance to preserve peri-implant health. Daily cleaning typically includes thorough brushing of the prosthesis, interdental cleaning beneath and around implant-supported frameworks with floss or interdental brushes, and adjunctive rinses as recommended by the clinician. Regular professional hygiene appointments are important to remove plaque and inspect soft tissues and prosthetic components.
Removable dentures require cleaning outside the mouth and attention to tissue health beneath the denture base, and they may need periodic adjustments for fit as the jawbone changes. Fixed implant-supported restorations eliminate the need for adhesives and nightly removal, but they require meticulous daily care and ongoing professional monitoring to prevent peri-implant disease. Your dental team will teach specific techniques and recommend cleaning tools tailored to your prosthesis design.
All-on-4® and All-on-6® are both full-arch implant concepts that use a fixed prosthesis supported by implants, with the primary difference being the number of implants used for support. All-on-6® uses additional implants which can offer increased distribution of forces and may be chosen when bone volume and patient anatomy allow for more implant placement. Other full-arch options include implant-retained removable overdentures or hybrid prostheses; each approach has distinct surgical and prosthetic considerations.
The optimal solution depends on individual anatomy, functional demands, esthetic goals and the clinician’s assessment of long-term predictability. During a consultation the dental team will review imaging and discuss why one approach may be preferable to another for your situation. To explore your options and receive a tailored recommendation, schedule a consultation with the office of 360 Dental of Mill Creek where clinicians can review your case and outline a personalized treatment plan.
