All-on-4: Full-Arch Implants on Four Posts
March 29, 2021 · 3 min read
The All-on-4 implant system from Swiss company Nobel Biocare is a modern method for restoring an extensive gap in the dental arch using 4 implants. The original protocol can correct a gap of up to 10 teeth, though a 12-crown prosthesis is more commonly fitted.
Indications & Limitations
The All-on-4 system is a reliable solution for restoring toothless jaws and can be used in 90% of cases. The implants are made of a titanium alloy formulated to minimize the chance of rejection — osseointegration is achieved in 99% of cases.
- insufficient bone tissue volume;
- complete or partial tooth loss;
- a long-standing toothless gap;
- age — mostly patients over 50.
The technique is used for restoring upper-jaw teeth with bone atrophy or limitations that rule out a sinus lift. The implants are placed at an angle, which increases the contact surface area and rules out potential damage to the sinuses. For conditions like diabetes, heart failure, or uncontrolled hypertension, that condition is treated first; autoimmune diseases are also a contraindication.
How the Implantation Is Performed
Two implants are anchored in the front section, and two others at a 45° angle, which avoids the need for additional surgery in cases of upper-jaw bone atrophy. Implantation begins with a comprehensive examination: photo diagnostics, a CT scan, digital impressions. Based on this data, a guided surgery template is made, which shortens the operation and reduces the risk of incorrect placement.
The implants are screwed in during a single visit under anesthesia or sedation. A temporary prosthesis can be fitted within hours, and the permanent restoration is placed roughly 3 months later — enough time for successful osseointegration.
Advantages & Price
- the ability to restore a complete dental arch even after age 50;
- reliable anchoring in bone tissue;
- high speed — temporary crowns within a single day;
- high strength, suitable for chewing hard food;
- a full return to quality of life, even after age 80.
All-on-4 implantation with the premium Straumann implant system starts at 6,500 euros per jaw.
Are There Any Downsides
The downsides include the existence of contraindications, the need for computer modeling and precise planning, a high level of surgical complexity, and the need for close coordination with the dental lab. With thin bone tissue, it's recommended to use pricier Nobel Zygoma or Straumann Roxolid implants — inexperience or imprecision raises the risk of peri-implantitis and rejection.
Restoring a toothless gap with implants is far better than a post-supported bridge or a removable denture: your own remaining teeth stay untouched, gums don't recede over time, and there are no chewing restrictions. With successful osseointegration, an implant's lifespan is unlimited — only the crown or prosthetic structure might ever need replacing.