All-on-4® is a modern approach to full-arch tooth replacement that prioritizes stability, function, and a natural appearance while minimizing the number of implants needed. By placing four strategically angled implants, this method supports a full fixed prosthesis for either the upper or lower jaw, allowing many patients to avoid the complexity of traditional implant protocols. The focus is on predictable support and efficient healing so you can return to everyday activities with confidence.
This solution is appropriate for people who are missing most or all of their teeth, or for those whose remaining teeth are failing and need removal. Rather than relying on removable dentures that can shift or rub, the All-on-4® prosthesis is anchored to the implants, creating a secure foundation for chewing, speaking, and smiling. Because the prosthesis is fixed in place, it behaves more like natural teeth and often feels more comfortable for patients who want a long-term restorative option.
Clinicians value the technique for its balance of surgical simplicity and restorative outcome. Fewer implants and careful angulation can reduce the need for additional bone grafting in many cases, shortening treatment timelines and simplifying the surgical plan. At the same time, the restorative design is focused on esthetics and function, so the final result aims to look natural and allow patients to enjoy a broader range of foods and activities than removable solutions typically permit.
The All-on-4® process begins with a thorough evaluation that includes imaging and a detailed treatment plan tailored to each person’s anatomy and goals. Advanced 3D imaging helps the dental team determine the optimal implant positions and prosthetic design before surgery, which improves predictability and shortens time in the treatment chair. Planning is a collaborative step: your clinician will review options, outline the sequence of care, and explain what to expect at each visit.
On the day of implant placement, teeth that need removal are extracted and four implants are placed into the jaw in predetermined positions. The implants are angled in a way that maximizes contact with available bone, which can eliminate the need for grafting in many patients. Immediately after surgery, a temporary fixed prosthesis is attached to the implants so you do not have to go home without teeth; this provisional prosthesis restores function and esthetics while healing takes place.
After a period of osseointegration—when bone bonds to the implant surfaces—the temporary prosthesis is replaced with a final restoration designed for durability and appearance. The final prosthesis is custom-crafted to fit your mouth, match your facial proportions, and deliver a natural-looking smile. Throughout the process, adjustments are made as needed to ensure comfort, proper bite alignment, and long-term stability.
Ideal candidates are adults who are missing most or all of their teeth in one or both arches, or who have teeth that are not salvageable and would be best replaced by a fixed solution. Candidates should have reasonably healthy soft tissues and adequate bone structure for implant support; however, many people who were once told they were not candidates for implants may still qualify for All-on-4® because of the technique’s strategic implant angulation and placement.
A comprehensive assessment is important to determine candidacy. The evaluation considers medical history, oral health, jawbone condition, and lifestyle factors such as tobacco use that can affect healing. For patients with more complex needs, the treatment team may recommend additional procedures to optimize outcomes, but many patients find that the All-on-4® approach offers a practical path to a fixed, full-arch restoration without extensive preparatory surgery.
Age alone is not a limiting factor; rather, the focus is on overall health, commitment to follow-up care, and realistic expectations about the process and maintenance. Patients who are motivated to restore oral function and quality of life, and who are prepared to follow postoperative and long-term care recommendations, often see the best results from this type of rehabilitation.
Procedure day is organized to promote comfort and efficiency. Before surgery begins, your team will review the plan and address any last-minute questions. Many practices offer sedation options to help patients remain relaxed and comfortable during the procedure. Once implants are placed, a provisional fixed prosthesis is attached so you leave the office with functional, esthetic teeth; this immediate temporary helps maintain speech and chewing ability while the implants integrate.
Early recovery focuses on managing swelling, discomfort, and dietary changes. Soft, nutrient-rich foods are typically recommended for the initial healing period, and activity should be moderated to support tissue repair. Follow-up appointments are scheduled to monitor healing, make any necessary adjustments to the provisional prosthesis, and ensure that the implants are integrating properly. Clear instructions from your dental team will help you navigate these early weeks with confidence.
As healing progresses, many patients notice steady improvements in function and comfort. The temporary prosthesis will be replaced by the final restoration once the team confirms stable integration and verifies the fit, bite, and esthetics. Long-term success depends on following postoperative guidance and attending routine maintenance visits so the prosthesis and surrounding tissues remain healthy over time.
Long-term care for an All-on-4® restoration combines daily hygiene with professional maintenance. Although the prosthesis is fixed, it still requires thorough cleaning to protect the implants and surrounding gum tissue. Daily brushing with non-abrasive tools and flossing or using oral irrigators as recommended by your clinician are essential habits. Proper home care helps reduce the risk of inflammation and supports the longevity of the implants and prosthesis.
Regular dental visits are an important part of maintenance. During these appointments, the team checks implant stability, reviews hygiene techniques, and performs professional cleanings designed for implant-supported restorations. Periodic evaluations also allow early detection and management of any wear, mechanical issues, or tissue changes so small problems can be addressed before they become more significant.
While no treatment is entirely maintenance-free, many patients experience years of reliable function and a natural appearance when they commit to consistent home care and professional checkups. Thoughtful design, material selection, and ongoing monitoring all contribute to a predictable, long-lasting outcome for full-arch implant restorations.
In summary, the All-on-4® approach offers a streamlined, fixed solution for people seeking to replace a full arch of missing or failing teeth with greater stability and comfort than removable alternatives. If you would like to learn whether this treatment might be right for your situation, contact the office of Dr. Aaron Tropmann & Dr. Gary Oyster for more information and to schedule a consultation.
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.
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Connecting with our team is simple! Our friendly staff is here to help with appointment scheduling, answer any questions about your treatment options, and address any concerns you may have. Whether you prefer to give us a call, send an email, or fill out our convenient online contact form, we’re ready to assist you. Take the first step toward a healthier, brighter smile – reach out to us today and experience the difference compassionate, personalized dental care can make.
We serve the Raleigh-Durham area, including Cary, Apex, Chapel Hill, Morrisville, Wake Forest, North Hills, North Raleigh and more.
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