All-on-4® is an implant-supported solution designed to replace an entire arch of missing or failing teeth using a small number of strategically placed implants. Instead of restoring each tooth individually, this approach supports a full-arch prosthesis that looks like natural teeth and restores everyday functions such as eating, speaking, and smiling with confidence. For many patients, the biggest advantage is the ability to leave the clinic the same day with a fixed, functional set of provisional teeth.
This treatment is intended for adults who need a comprehensive solution for an upper or lower arch due to tooth loss, decay, or advanced periodontal disease. It’s also a dependable option for people who have struggled with traditional removable dentures and want improved stability and comfort. While every patient’s needs are different, All-on-4 is often recommended when a durable, long-term restoration is the goal.
The immediate restoration that follows implant placement allows patients to maintain normal facial support and social confidence during healing. That provisional prosthesis is carefully planned to provide balanced function and a pleasing appearance while bone and soft tissue integrate with the implants. Once healing is complete and any necessary refinements are made, a final prosthesis is fabricated to deliver lasting esthetics and strength.
The All-on-4 approach relies on four implants per arch placed in locations that maximize available bone and mechanical support. Two anterior implants are placed more vertically, while two posterior implants are often angled to take advantage of denser bone and to avoid anatomical structures. This strategic positioning reduces the need for extensive bone grafting in many cases and creates a stable foundation for a full-arch prosthesis.
Advanced imaging—such as CBCT scans—plays a central role in treatment planning. These three-dimensional images let the dental team precisely evaluate bone volume, nerve locations, and sinus positions so implant placement can be both safe and predictable. A carefully designed surgical plan also guides the creation of a provisional prosthesis that can be attached at the time of surgery.
During the procedure, implants are placed and the provisional restoration is secured to the implants that same day, allowing immediate function. Over the following months, the implants integrate with the jawbone in a process called osseointegration. Once integration is confirmed, the provisional is replaced or refined with a definitive prosthesis crafted for long-term durability, comfort, and esthetics.
Because All-on-4 prostheses are fixed to implants, they eliminate common challenges associated with removable dentures—such as slipping, sore spots, and dietary restrictions. The secure connection to the implants restores biting strength and offers more predictable speech and chewing performance. Patients often report an increased ability to enjoy a wider variety of foods and greater confidence in social situations.
Beyond function, a well-designed full-arch prosthesis restores facial contours and supports lip and cheek tissues, helping to preserve a natural, youthful profile. The replacement teeth are custom-made to complement the patient’s facial features, skin tone, and smile goals, so results are both functional and esthetic. Because the prosthesis is fixed, routine care resembles natural dental hygiene: daily brushing and regular professional maintenance.
Maintenance and follow-up care are straightforward. Regular checkups allow your dental team to monitor implant health, evaluate the prosthesis, and perform preventive maintenance to extend the life of the restoration. With proper care, implant-supported restorations can provide years of dependable service and an improved quality of life compared with conventional removable options.
Initial evaluation begins with a comprehensive oral exam and imaging to determine candidacy and to plan treatment. Diagnostic records—photographs, impressions, and a CBCT scan—help the team design a prosthesis and map optimal implant locations. Treatment planning also includes a medical review and discussion of personal goals so the plan reflects the patient’s needs and expectations.
On the day of surgery, patients receive local anesthesia and, when appropriate, sedation to ensure comfort. The implants are placed according to the preoperative plan, and the provisional prosthesis is then secured to the implants. The first few days after surgery are focused on comfort, healing, and following post-operative instructions; most people can return to light activities within a short period, while eating is gradually advanced based on the clinician’s guidance.
Follow-up visits during the healing phase allow the dental team to assess integration and soft-tissue healing and to make any necessary adjustments to the provisional prosthesis. Once bone and tissue stability are confirmed, your definitive prosthesis will be fabricated with durable materials and personalized esthetic detail. The result is a fixed, tailored restoration optimized for function and appearance.
After your final prosthesis is in place, a structured maintenance program helps protect your investment. Routine professional exams include implant assessments, prosthesis checks, and hygiene visits designed to remove plaque and inspect components. Daily home care—brushing, interdental cleaning, and attention to gum health—remains essential for implant longevity and overall oral health.
Certain habits and health factors can influence the long-term performance of implant restorations. Smoking, uncontrolled diabetes, and neglecting regular hygiene visits can increase risk, so your clinical team will recommend strategies to support favorable outcomes. If small adjustments are needed over time, they can usually be performed efficiently in the office to preserve comfort and function.
At M. Kurt Berky, DDS, PC, we combine modern imaging, careful planning, and restorative expertise to guide patients through every phase of treatment. Our goal is to deliver predictable, natural-looking results and to make the process as comfortable and clear as possible from the first consultation through long-term maintenance.
In summary, All-on-4® is a predictable, implant-based solution for replacing a full dental arch with a fixed prosthesis that restores function, appearance, and confidence. If you’d like to learn whether this treatment is appropriate for you, please contact us for more information and to schedule an evaluation. 1All-on-4 is a registered trademark of Nobel Biocare.
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 dental implant solution that uses four strategically placed implants to support a complete prosthetic arch. The posterior implants are often angled to maximize contact with available bone, which can reduce the need for bone grafting. A provisional prosthesis is typically attached on the day of surgery so patients leave with functional teeth the same day. Over the following months the implants integrate with the jawbone and the provisional is replaced with a refined permanent restoration.
This treatment restores chewing function, speech, and facial support while offering a natural appearance. Implant-supported arches distribute biting forces more like natural teeth than removable dentures. Clinical experience with the All-on-4® concept shows it can be an efficient and predictable option for appropriately selected patients.
Good candidates are adults who have lost most or all of their teeth in an arch or who face extraction of remaining teeth due to decay, periodontal disease, or trauma. Candidates should have acceptable general health for oral surgery, including controlled chronic conditions and nonsmoking or willingness to follow smoking cessation guidance. A comprehensive evaluation, including clinical exam and CBCT imaging, helps determine whether bone quality and quantity are sufficient for implant placement.
Patients with limited bone in the posterior jaw often benefit from the All-on-4® approach because the angulated implants engage available bone. Conversely, some medical conditions or habits may require additional planning or alternative treatments. A personalized consultation will identify the best restorative path based on oral and overall health.
During the procedure, any necessary extractions are performed and four implants are placed in each treated arch according to a predetermined plan guided by imaging. The posterior implants are commonly tilted to maximize bone engagement while the front implants are placed vertically for stability. A laboratory-fabricated or milled provisional prosthesis is then attached to the implants, allowing immediate function and appearance for the patient on the same day.
Following implant placement, the provisional prosthesis is adjusted for fit and occlusion to protect healing implants. Patients receive instructions on diet, oral hygiene, and medications to support recovery. After osseointegration is confirmed, the provisional is replaced with a definitive prosthesis that is tailored for long-term function and esthetics.
One of the hallmark benefits of the All-on-4® approach is immediate provisionalization, which means a functional set of temporary teeth is attached the same day as implant placement. This allows patients to speak and eat with greater confidence during the healing period compared with going without teeth or using removable temporaries. The temporary prosthesis is designed to protect the implants while allowing limited, careful function.
Full integration of the implants into the jawbone takes several months, during which dietary and care instructions should be followed closely to avoid undue stress on the implants. Once healing and bone integration are confirmed with follow-up visits and imaging, the provisional is replaced with the final prosthesis. Regular maintenance visits after placement help ensure long-term success and function.
All-on-4® provides a fixed, implant-supported restoration that is anchored to the jaw, whereas traditional dentures rest on the gums and are removable. Implant-supported arches offer greater stability for chewing and speaking and reduce the movement and sore spots commonly associated with removable dentures. The fixed prosthesis also helps preserve jawbone by transmitting functional forces to the implant sites, which can slow the bone resorption that occurs under conventional dentures.
While removable dentures may feel familiar to some patients, implant-supported restorations generally improve comfort and confidence during daily activities. Maintenance routines differ: implant-supported arches require consistent oral hygiene and professional follow-up to monitor implants and prosthetic components. A consultation can clarify which option aligns best with a patient’s anatomy, expectations, and lifestyle.
Initial recovery involves swelling, mild discomfort, and a healing period during which soft tissues begin to recover and implants begin osseointegration. Patients are typically advised to follow a soft-food diet for several weeks, avoid heavy chewing on the treated arch, and maintain careful oral hygiene around the prosthesis. Pain or swelling is usually managed with prescribed or recommended medications and cold compresses, and most patients return to routine activities within a few days to a week depending on individual healing.
Follow-up visits are important to monitor healing and to make adjustments to the provisional prosthesis as needed. The clinician will schedule periodic checks and imaging to confirm implant integration before transitioning to the final restoration. Adhering to post-operative instructions and attending follow-up appointments helps promote predictable healing and long-term stability.
Long-term care for an All-on-4® prosthesis includes daily oral hygiene to remove plaque and prevent peri-implant inflammation, professional cleanings at recommended intervals, and regular clinical exams. Patients should use recommended brushing and interdental cleaning tools to reach around implant abutments and the prosthetic base. Avoiding tobacco and maintaining overall oral health supports implant longevity and reduces risk of complications.
Routine maintenance appointments allow the dental team to evaluate the condition of implants, prosthetic components, and surrounding tissues, and to perform adjustments or repairs when necessary. Vigilance for changes such as persistent redness, swelling, discomfort, or loosening of prosthetic parts should prompt earlier evaluation. With consistent home care and professional follow-up, many patients enjoy long-term function and esthetics.
As with any surgical procedure, All-on-4® carries risks including infection, bleeding, and temporary or, less commonly, permanent changes in nerve sensation. Implant failure is possible if integration with the bone does not occur, and peri-implantitis (inflammatory bone loss around implants) can develop if oral hygiene and maintenance are insufficient. Careful case selection, precise surgical technique, and diligent aftercare reduce these risks significantly.
Some patients may experience complications related to prosthetic components such as screw loosening or wear of the restoration over time, which require professional attention. The treatment team will review risks specific to an individual’s health profile during consultation and provide clear instructions to help minimize complications. Prompt communication with the dental office about any concerning signs improves the chance of a favorable outcome.
The implants used in the All-on-4® concept can last for decades when they achieve and maintain osseointegration and are supported by good oral hygiene and regular professional care. The prosthetic arch itself may require servicing, adjustments, or component replacement over time due to wear or changes in oral tissues. Factors that influence longevity include oral hygiene, systemic health, smoking status, and adherence to maintenance visits.
Routine professional evaluations allow the dental team to address minor issues before they affect long-term success, and repairs or refinements can extend the functional life of the restoration. While individual experiences vary, many patients enjoy reliable function for many years with appropriate care and follow-up.
Your consultation at the office of M. Kurt Berky, DDS, PC will begin with a thorough medical and dental history review, an oral exam, and imaging such as CBCT to assess bone anatomy and implant planning. The clinician will discuss your goals, explain the All-on-4® treatment phases, and review what to expect before, during, and after surgery. This appointment also provides an opportunity to ask questions about candidacy, procedural steps, recovery, and long-term maintenance.
After the clinical assessment, the team will present a personalized treatment plan that addresses your functional and esthetic needs and outline the sequence of appointments for extractions, implant placement, provisionalization, and final restoration. The practice will provide clear preoperative and postoperative instructions to support a smooth experience. Follow-up scheduling and care coordination are handled by the team to ensure continuity throughout your treatment journey.
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