All-on-4

All-on-4 is a treatment concept in which a complete arch of fixed teeth is supported by just four implants. Two are placed vertically at the front of the jaw; two are angled at up to 45 degrees at the back to maximise contact with available bone and avoid the sinus or nerve.

Advantages over conventional full-arch treatment

• Only four implants needed per arch rather than six to eight
• The angled posterior implants often avoid the need for bone grafting
• A fixed temporary bridge can usually be attached on the day of surgery
• Lower cost than placing six or eight individual implants

Same-day teeth

Because of the angled implant design, immediate loading (attaching teeth on the day of surgery) is often possible. These temporary teeth are replaced with a permanent restoration after 3–6 months of healing.

Not suitable for everyone

All-on-4 requires sufficient bone quality and volume at the implant sites. Heavy smokers, patients with uncontrolled diabetes, and those with very advanced bone loss may need alternative approaches. A thorough CBCT assessment is essential before planning.

Maintenance

The bridge is fixed and cannot be removed by the patient. Cleaning requires interdental brushes, water flossers, and specific flossing techniques to clean under the bridge. Annual professional maintenance is essential.