What Is All-on-4™?

This is a term given to a denture or porcelain bridge that is attached to 4 implants on the upper arch or the lower arch or both, that allows a patient who needs a denture to have a prosthesis that is attached to the ridge and does not cover the whole palate (roof of the mouth).

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How much does an ALL-ON-4™ denture cost?

It is hard to give specific numbers because each patient has different needs and comes with different issues that have to be dealt with. You can figure at least 10 times the cost of a single denture, but that is like trying to compare a bicycle to a car.

Who is a candidate for an ALL-ON-4™ denture or bridge?

First of all the patient must be examined by a qualified surgeon that is familiar with this procedure. The patient must have adequate bone in the front half of the ridge. Smoking, diabetes and other medical conditions can sometimes be a contraindication as healing is slower.

  1. Patients who have teeth that are failing and are not restorable and who do not want a removable denture that is not as secure and covers the whole palate.
  2. Patients who have had a previous denture and are just not happy with the fit and comfort of the old denture.
  3. Patients who have a gag reflex and have a hard time adjusting to a full palate covered denture.
  4. A patient that is ok with the old denture but wants something that is rigid so that they can chew better.
  5. A patient that desires the palate to not be covered so that the patient can better taste their food.

How is an ALL-ON-4™ denture or bridge made? How long does it take?

First the surgeon does an exam and x-rays and will often order a 3-D image of the ridge to see if there is adequate bone. Once it is determined that you are a good candidate, your surgeon will work with a dentist that is familiar and qualified to make your prosthesis. We work with the surgery office in our complex, next door, (Brookside Oral and Maxillofacial Surgery), so your treatment is easily coordinated between the two offices. A good lab that is familiar with this process is also critical.

Below are some of the steps for an ALL-ON-4™ appliance.

  1. Impressions will be taken of the ridge or ridges on which the ALL-ON-4™ will be placed on.
  2. It will be determined where the ridge must be adjusted, so there is adequate room for the denture and bar or Zirconium Bridge. (There is a titanium bar inside the denture for strength. If porcelain or Zirconium Bridge is made, then a base is milled that will become the bridge).
  3. A conventional temporary denture will then be made.
  4. If there are any remaining teeth in the arch, the surgeon will remove the remaining natural teeth.
  5. The surgeon will then adjust the ridge to allow room for the implants and prosthesis and place the implants.
  6. The temporary immediate denture will be adjusted and attached to the implants. You do not go home without teeth! This is where some get the term: TEETH-IN-A-DAY™!
  7. The bone around the implants MUST heal for a minimum of 4 months prior to proceeding any further.
  8. Once your surgeon has determined that the implants are ready (in that they are integrated with the bone, it is time to proceed to the next step.
  9. Then your dentist will start the process for the final denture or bridge that will be attached to the implants.
  10. If you are having an acrylic denture, a titanium bar will be fabricated once the teeth are set and you are pleased with the esthetics. This bar is for strength of the appliance.
  11. If a zirconium bridge is being made, then it will be milled by the lab and then the teeth are formed over it with porcelain, coloring and glazing for a beautiful esthetic result.
  12. Prior to final processing, the denture will be relined so that as the tissue has healed, there are minimal gaps under the appliance.
  13. Your final appliance should be checked and cleaned at least once a year by your dentist. At this time the whole appliance will be removed so the implants can be checked and cleaned. The success depends on your diligence of cleaning under the appliance daily after each meal.

What are the disadvantages of ALL-ON-4™?

Cost is probably the biggest factor.

You cannot have a “full set of teeth”, or the same number of teeth as typically in the arch. Once the implants are placed, you can only go back half as much the distance behind the last implant as the distance between the front and back implants. This means that you might get one bicuspid and one molar or just two bicuspids. But, you won’t get two bicuspids and two molars.

For most patients, this is not an issue, but it is something you need to know as the expectation is always, I want “all my teeth back”.

It is more difficult to clean under the appliance that is attached to the ridge and you must be diligent in your home care.

What are advantages of ALL-ON-4™?

All-on-4 is often much nicer esthetics than a traditional denture. The appliance is fixed and does not move around, which can lead to better speaking, chewing, and comfort and ability to taste foods better. Your appliance is not going to “pop out” when you speak or chew.

Schedule A Consultation

If you are interested in ALL-ON-4™ or want to see if it is right for you, call our DEER PARK DENTAL dentists and schedule an exam at 209-478-3036 or fill out a contact form.

Before & After Photos

ALL-ON-4™ IMPLANTS™ case done by Dr. Scott

ALL-ON-4™ IMPLANTS™ case done by Dr. Scott