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 restorative concept that replaces an entire upper or lower set of teeth with a fixed prosthesis supported by four strategically placed dental implants. The approach uses angled posterior implants and vertical anterior implants to maximize bone support and distribute chewing forces efficiently. Advanced planning with 3D imaging and CAD/CAM technology guides implant placement so the final prosthesis aligns with both function and esthetics.

The treatment is prosthetically driven, meaning the planned tooth positions determine optimal implant locations before surgery. When indicated, a provisional fixed prosthesis is often attached at the time of implant placement to provide immediate function. Over the healing phase the implants integrate with the jawbone, after which the definitive prosthesis is fabricated and delivered.

Candidates for All-on-4® are generally people who are missing most or all teeth in one arch or whose remaining teeth are not salvageable due to decay, periodontal disease, or trauma. The concept is particularly useful for patients with moderate bone loss because angled implant placement can often avoid the need for extensive grafting. A comprehensive evaluation that includes medical history, oral health status and 3D imaging determines candidacy.

Systemic health factors such as uncontrolled diabetes, active cancer treatment, or habits like heavy smoking can affect healing and may influence treatment decisions. Age alone is not a disqualifier; suitability is based on overall health, bone quality, and the patient’s ability to maintain oral hygiene. The final recommendation should come from a multidisciplinary team after a personalized assessment.

Traditional removable dentures rest on the gums and rely on suction or adhesives for stability, which can limit chewing efficiency and cause sore spots. In contrast, an All-on-4® prosthesis is secured to implants and behaves more like natural teeth, providing greater bite force and a stable fit for eating and speaking. Because the restoration is fixed, patients do not need to remove it for daily wear.

All-on-4® also helps preserve facial support by transferring load to the jawbone through implants, which can reduce the bone resorption commonly seen with long-term denture wear. Maintenance differs as well: implant-supported arches require routine home care around implant components and periodic professional inspections. While both options restore appearance, the functional and biomechanical differences are significant and should be discussed during planning.

At Nova Dental the evaluation begins with a thorough medical and dental history, a clinical exam and digital imaging such as cone-beam CT to map bone anatomy and vital structures. The team reviews restorative goals and uses 3D planning to simulate implant positions that support the desired tooth arrangement. This prosthetically driven workflow helps ensure the final result balances function, esthetics and long-term predictability.

Patients are shown the proposed sequence of care, including whether a provisional fixed prosthesis will be delivered the day of surgery and what to expect during healing. The plan also outlines follow-up visits for monitoring and any necessary prosthesis refinements prior to the definitive restoration. Clear, evidence-based explanations help patients make an informed choice about their treatment path.

The surgical visit usually involves placing four implants per arch according to the digital plan; posterior implants are often angled to optimize support and avoid anatomical structures. When appropriate, a temporary fixed prosthesis can be attached at the same appointment to provide immediate function and aesthetic improvement. The procedure is performed under local anesthesia with options for sedation depending on the patient’s needs and the surgical team’s recommendation.

Early recovery focuses on protecting the implants during initial osseointegration, controlling inflammation and following dietary and hygiene instructions provided by the clinical team. Patients can expect some swelling and discomfort for a few days, which is typically managed with prescribed or recommended medications and cold packs. Follow-up visits are scheduled to assess healing, verify implant stability and adjust the provisional prosthesis as needed.

Many patients receive a provisional fixed prosthesis at the time of implant placement, which allows for immediate improvement in appearance, speech and some chewing ability. While the provisional provides functional teeth, patients are usually advised to follow a progressive diet and avoid excessive force on the new implants during the initial healing period. Full return to unrestricted chewing typically occurs after the implants have integrated and the definitive prosthesis is delivered.

Speech adaptation often happens quickly because the provisional prosthesis restores normal tooth position and lip support, but some patients may need a short adjustment period. The clinical team will provide guidance on eating, speaking and cleaning to help protect the implants and provisional restoration. Regular follow-up lets your provider monitor adaptation and advise when the permanent prosthesis can be placed.

Functionally, an All-on-4® restoration improves chewing efficiency, stabilizes the arch and restores facial support, which can enhance comfort and confidence compared with removable dentures. The fixed prosthesis allows patients to speak and eat more like they did with natural teeth and reduces sore spots associated with denture bases. The treatment can also reduce the number of surgical stages and avoid complex grafting in many cases.

Limitations include the fact that All-on-4® is a full-arch solution and may not be appropriate for patients who desire to preserve individual natural teeth that are still healthy. Long-term success depends on consistent oral hygiene and routine professional care, and some patients may require maintenance or component replacement over time. Individual anatomy and health considerations can also necessitate modifications to the standard All-on-4® concept.

Daily care for an All-on-4® prosthesis includes brushing the prosthetic teeth and cleaning around implant abutments or access sites using interdental brushes, floss designed for implants or water irrigation as recommended by your clinician. Gentle removal of plaque and food debris at the gumline and under the prosthesis prevents peri-implant inflammation. Using an antimicrobial rinse may be advised in selected situations to help control bacterial load.

Regular professional maintenance is essential and typically involves scheduled visits for implant and prosthesis inspection, hygiene appointments that can access areas below the prosthesis, and occlusal checks to verify force distribution. Your dental team will provide a personalized home-care routine and review techniques at each visit. Consistent hygiene and recall care are key factors in maximizing the longevity of the restoration.

As with any surgical procedure, All-on-4® carries risks such as infection, bleeding, implant failure and delayed healing, particularly in patients with uncontrolled systemic conditions or tobacco use. Mechanical complications, including loosening of implant components or wear of the prosthetic materials, can occur and may require repair or replacement. Careful planning, sterile technique and adherence to post-operative instructions reduce many of these risks.

Long-term complications can sometimes include peri-implant mucositis or peri-implantitis, which are inflammatory conditions that require prompt professional management to prevent bone loss. Ongoing maintenance, good oral hygiene and regular clinical monitoring help detect and treat problems early. Your provider will discuss risk factors during evaluation and tailor the care plan to minimize complications.

Nova Dental employs a multidisciplinary approach that pairs surgical expertise with restorative planning to ensure implants are placed to support the final prosthesis and the patient’s goals. Coordination typically involves dentists, oral surgeons or implant specialists, and dental laboratory partners who collaborate using digital plans and provisional try-ins to refine esthetics and function. This integrated workflow reduces surprises and aligns each step with predictable outcomes.

Care coordination continues after surgery with scheduled follow-ups to monitor healing, adjust the provisional prosthesis and prepare for the definitive restoration. The team provides clear instructions for recovery, hygiene and diet and reviews long-term maintenance requirements at each visit. Local patients can receive ongoing care at the North Haven or Cromwell office for continuity throughout the treatment process.