All-on-4 — a fixed full arch on four implants
All-on-4 restores a completely edentulous jaw with a fixed full-arch bridge on four implants, the back two placed at an angle of 30–45 degrees.
- Procedure time
- 2–4 hours
- Anaesthesia
- Local anaesthetic + sedation
- Recovery
- 5–10 days · final bridge at 3–6 months
- Sessions
- Surgery + temporary bridge + final bridge
- How long it lasts
- Long-lasting; annual review and professional cleaning essential
Why four implants
In a completely edentulous jaw, placing a separate implant for every tooth is both unnecessary and, in terms of bone volume, usually impossible. In the All-on-4 technique the front two implants go in vertically and the back two at 30–45 degrees.
That angulation allows a fixed bridge in patients with bone loss at the back without additional surgery such as a sinus lift. Where the bone is dense, the number of implants can rise to six.
Temporary and final bridge
Where the initial stability of the implants is good enough, a temporary fixed bridge can be fitted within 24–72 hours of surgery. That is not possible in every patient; the decision follows the torque value measured during surgery, so it cannot be promised in advance.
Once integration is complete, the final bridge is made within 3–6 months. The material — zirconia or hybrid acrylic — is chosen with you, taking into account your cleaning habits and the state of the opposing jaw.
How many trips it takes
All-on-4 is completed in two trips. The first covers surgery and, where appropriate, the temporary bridge; set aside 7–10 days for it.
The second trip comes after integration, about 3–6 months later. Allow a further 7–10 days for impressions, try-in and fitting the final bridge.
- First trip — 3D scan, surgery, temporary fixed bridge if appropriate (7–10 days)
- Interval — 3–6 months for bone integration
- Second trip — impressions, try-in, fitting the final bridge (7–10 days)
Cleaning and follow-up
A fixed bridge cannot be removed by the patient. Cleaning underneath it therefore has to be done daily, with a water flosser, interdental brushes and superfloss.
At least once a year the bridge is removed by a dentist, cleaned underneath and the tissues around the implants assessed. Skip that check and bone loss around the implants can progress silently. If you are not returning to Istanbul annually, arrange it with a dentist where you live and give them the record of the system used — most practices can do it, but they need to know what they are unscrewing.
Who this is not for, and what not to expect
All-on-4 loads a whole arch onto four implants. Where there is not enough bone to carry them, the technique cannot be used; more implants or a different prosthetic plan is needed.
Walking out with fixed teeth on the same day is not possible for every patient and is not promised in advance. A fixed bridge also does not give the feel and chewing sensation of your own teeth; adapting takes a few weeks.
- Advanced bone loss that cannot carry the minimum implant length — angled placement will not provide enough anchorage either
- Uncontrolled diabetes — integration and soft tissue healing are impaired, so metabolic control comes first
- Patients on intravenous antiresorptive therapy — no surgery is planned without a written opinion from the relevant specialist
- Heavy smoking — raises the risk of failure with multiple implants and is assessed separately
- Patients unable to clean daily under the bridge — removable options are discussed instead of a fixed one
This page is general information and does not replace a clinical examination. The method, dose and timescale that apply to you are decided by a doctor after examining you.
Frequently asked questions
Can I walk out with teeth on the same day?
Can the bridge be taken out?
Are four implants really enough for a whole jaw?
Why does the final bridge wait 3–6 months?
Who looks after it when I am back home?
Pre-assessment
Describe your situation and we will answer with a measurement
Send a photograph or an X-ray. A doctor in the relevant speciality will reply with a graft range, a number of teeth or a dose range in units. If you are not suitable, we say so plainly.