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All-On-4 Procedure

What is the “All-On-4®” procedure? Simply put, it is a way to replace all the teeth in the upper or lower arch using only 4 implants. All-On-4® is a registered trademark of Nobel Biocare dental implant company. There are many implant companies and many have similar products.

Much research has been done on the All-On-4® concept also referred to by dentists as a fixed removable hybrid restoration. Essentially, a denture with titanium reinforcement is attached to a minimum of 4 implants to restore form and function. This procedure can lower the cost significantly, to patients replacing all their upper or lower teeth. By eliminating more expensive crown and bridge procedures, bone grafting and reducing the number of implants necessary to replace existing or missing teeth, costs can be reduced. In fact, studies have shown that 4 dental implants perform as well as 6 implants.(1)

Whenever possible, we prefer to save teeth. However, many of our patients have struggled for years with painful, infected teeth that severely compromise their quality of life and in some cases their health. By removing all the diseased teeth, placing implants and attaching the teeth in one procedure, we can put our patients on track to a healthier smile. Our goal is for the patient to leave the day of surgery with teeth firmly attached to their implants. This is known as the interim fixed removable prosthesis but in laymen’s terms the “temporary prosthesis”. This “temporary prosthesis” allows healing to occur. After some weeks of healing, final prosthetics can be fabricated. Similar to fitting a wedding dress or a custom suit, steps are taken to assure the best possible fit and esthetics of this final fixed removable prosthesis (All-On-4®).

The All-On-4® procedure has an extremely good success rate with one of the earlier adopters of this procedure, Dr. Paulo Malo showing success rates well over 90% at 10 years of implants in the mandible.(2)

Like tires on a car, the All-On-4® will need to be repaired or in some cases replaced. However, during the repair period, you will not be without teeth. The “temporary prosthesis” can be reattached to the implants. So essentially, patients always have a “pair and a spare”.

The All-On-4® procedure may only be one option available to you. At reStor Dental Implant Center, often we can give you a number of options from dentures to traditional crown and bridge supported by dental implants. 


1.    Branemark PI, Svensson B, van Steenberghe D. Ten-year survival rates of fixed prostheses on four or six implants ad modum Branemark in full edentulism. Clin Oral Implants Res. 1995;6(4):227-31.
2.    Malo P, de Araujo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011;142(3):310-20.