All on 4

The Ultimate Guide to All on 4

Last fact-checked: 25 January 2021

Replace a whole arch of teeth in one day with the All-on-4® treatment concept and save up to 75% at one of Dental Departures' global providers

This innovative mouth restoration treatment, provided by Nobel Biocare®, uses four implants to support a fixed dental prosthesis, which is attached on the same day of surgery. 

What Is the All-on-4® Treatment Concept?

This mouth restoration technique uses four dental implants to support an entire arch of replacement teeth in either the upper or lower jaw, or both (dual arch).

After a consultation to ensure healthy bone structure and absence of infection, patients are able to undergo the initial surgical phase of the treatment in one day, leaving the dentist's office with a natural-looking provisional fixed bridge that can be used to eat semi-solid/soft foods almost immediately. 

The concept is unique in that the two rear implants are longer compared to other methods; these are inserted into the jaw at near-45-degree angles rather than the 90-degree angle that traditional implants are placed. This negates the need for bone-grafting.

After the implants have properly fused with the jawbone (healing phase), the patient returns to the dentist, normally four to six months later, to have their provisional (temporary) fixed bridge replaced with a permanent one, thus completing the treatment and restoring teeth function to approximately 90%. 

Suitable Candidates for the All-on-4® Treatment Concept

If you have lost several or most of your teeth or want to replace ill-fitting dentures with a comfortable, stable and natural-looking set of permanent teeth, you may be a suitable candidate for this mouth restoration technique.

It should be noted that:

  • Prospective patients should be in good overall health in order to undergo surgery.
  • For those with gum disease or other oral health issues, a dentist will clear any infections and address other problems before surgery. 
  • Patients who have bone loss may still be suitable candidates as the All-on-4® treatment concept requires less bone density compared to other treatments thanks to the unique positioning of the four implants. 
  • Age generally does not determine whether a person is a suitable candidate for dental implants. 

What Does the Course of Treatment Entail?

Pre-surgical appointment: 

The patient first attends a pre-surgical appointment, during which the dentist will determine their suitability for the All-on-4® treatment concept. Several tests, such as x-rays, 3D cone beam images and photo evaluations, will be taken so that the dentist can formulate a detailed treatment plan. 

Custom-made immediate denture is processed:

Using information from the pre-surgical appointment and impressions of the patient's mouth, a specialist dental laboratory processes an immediate denture which will be attached during the surgical phase.

Surgical phase:

Before the placement of the implants, any remaining teeth are extracted. The implants can then be inserted at predetermined positions in the jaw.

Using abutments and coping cylinders screwed onto the implants, an immediate denture is attached. This is then trimmed down to become a fixed implant bridge to complete the surgical phase. 

Note:

  • The procedure may be carried out under local anesthesia with IV sedation, or under general anesthesia in the case of longer, more complex surgeries. Other sedation options may also be available, depending on the clinic and its facilities. 
  • Both jaws can be operated on during the same session (dual arch surgery). 
  • Surgery can take between two and six hours, depending on the complexity of the procedure.

Healing phase:

After surgery, the patient returns home with their new, natural-looking teeth. However, it should be noted this is the provisional (temporary) restoration. 

Over the next three to four months, the implants fuse with the bone (a process called osseointegration), during which time the patient is generally advised to follow a diet of semi-solid/soft foods, as well as adhere to a hygiene and maintenance routine as prescribed by the dentist. 

Final restoration phase:

After four to six months, the patient returns to the same dental clinic to have their temporary bridge removed and replaced with the permanent one (final prosthesis). 

This stage may involve further tests and adjustments; however, the process is non-invasive, as the temporary bridge is simply unscrewed before being replaced. 

A detailed step-by-step full arch rehabilitation guide (PDF) by Nobel Biocare can be found here

Is the All-on-4® Treatment Concept Suitable for Dental Tourists?

This mouth restoration procedure is an excellent option for dental tourists thanks to the innovative way in which the implants are placed—reducing the overall treatment time and number of steps involved. 

The primary reason most patients cross borders for their treatment is affordability—with full mouth restorations like these costing upwards of USD $25,000 in the US.

However, by heading abroad, patients can make savings of between 50-70% at one of our verified All-on-4® treatment concept providers. 

It should be noted that, in general, patients will have to make two separate trips to their chosen destination (the surgical phase and final restoration phase). 

Patients should also talk with their dentist and follow their advice before booking flights. For instance, it would be advisable to rest for a few days following surgery before flying (or driving) home. 

Does the Fixed Bridge Require Special Care? What Else Should I Consider?

  • When your implants have first been placed and you have a temporary fixed bridge, you will be advised to eat soft food for a while–certainly not anything chewy or hard that could interfere with the osseointegration process.
  • A rule of thumb is anything that can be cut with a fork can be eaten. 
  • For the first two weeks, patients are instructed to use a special mouth wash. After around 14 days, cleaning with a soft bristle toothbrush can resume. 
  • Teeth function increases to approximately 90% after the attachment of the final prosthesis, allowing patients to eat practically anything they want. 
  • Apart from maintaining a healthy oral hygiene regime–with careful brushing, flossing and regular check-ups, you should not have to do anything different following the completion of the treatment. 

What Are the Costs for the All-on-4® Treatment Concept Around the World?

In the United States, implant-supported mouth restorations like this cost, on average, $25,000 (CAN $33,000; UK £20,000; EUR €23,000; AUS $32,000; NZ $35,500). For more complex treatment with extractions and dual arch surgery, overall costs can exceed $40,000

Savings of up to 75% can be made at one of our global partner clinics. See below for price comparisons:

  • At a Mexico dentist: US $10,000 (CAN $13,600; UK £7,600; EUR €8,900; AUS $13,400; NZ $13,400)
  • At a Thailand dentist:  US $11,000 (CAN $15,000; UK £8,400; EUR €9,800; AUS $14,800; NZ $15,800)
  • At a Bali dentist: US $4,200 (CAN $5,700; UK £3,200; EUR €3,700; AUS $5,600; NZ $6,000)
[Note: These are estimated prices calculated at the time of writing and treatment costs vary depending on a number of factors. Please see our clinic listings for up-to-date prices.]

What About the Quality of Dental Care Abroad? Is it Reliable?

World-class dental clinics can be found in many international destinations, provided you select a suitable dentist with care. This includes the obvious, such as vetting dentist qualifications; specifically, we look at: How long they have been qualified as a dentist? Have they had specialist training? Are they members of any overseas professional organizations, for example, the International Congress of Oral Implantologists?

You should also check out the clinic. Is it accredited locally or internationally? Do the premises look cared for? Is the clinic signed up to any international protocols, like the International Organization for Standardization?

One way of ensuring you are heading to a quality-checked clinic is by booking with Dental Departures.

We conduct background checks on dentist qualifications, professional memberships and clinic affiliations. We also perform onsite visits, collect verified patient reviews, and publish them on our website. With clinic photos, pricing, maps and other useful information, you can search for a dentist and destination, compare prices and book an appointment in confidence.

How Do I Get Started?

Determine your desired destination, then search our site to find Nobel Biocare-authorized All-on-4® treatment concept specialists in the area.

Know before you go: read our verified patient reviews, view clinic photos and take virtual tours of our clinics. Then contact our Customer Care Team or book with us online for great care at the best available prices!

Sources:

David Soto-Penaloza. The All-on-Four Treatment Concept: a Systematic Review. Journal of Clinical and Experimental Dentistry, 2017. Website accessed: 25 January 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347302/

International Congress of Oral Implantologists. Website accessed: 25 January 2021. http://www.icoi.org/

International Organization for Standardization. Website accessed: 25 January 2021. http://www.iso.org/iso/home.html

Siadat H, Rokn A, Beyabanaki E. Full Arch All-on-4 Fixed Implant-Supported Prostheses with 8.5 Years of Follow-Up: A Case Report. J Dent (Tehran). 2018;15(4):259-265. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218463/

All-on-4® treatment concept. Nobel Biocare. Website accessed: 25 January 2021. https://www.nobelbiocare.com/en-us/all-on-4-treatment-concept

Soto-Peñaloza, David & Zaragozí-Alonso, Regino & Penarrocha-Diago, MA & Penarrocha, Miguel. (2017). The all-on-four treatment concept: Systematic review. Journal of Clinical and Experimental Dentistry. 9. 10.4317/jced.53613. https://www.researchgate.net/publication/315370698_The_all-on-four_treatment_concept_Systematic_review

Full Arch Rehabilitation: All-on-4™ Restorative Steps, Roadmap for Success. Nobel Biocare. PDF accessed: 25 January 2021. http://iddentallab.com/wp-content/uploads/2017/02/Nobel-Biocare-All-on-4-Restorative-Steps-Roadmap.pdf

Babbush CA, Kanawati A, Kotsakis GA, Hinrichs JE. Patient-related and financial outcomes analysis of conventional full-arch rehabilitation versus the All-on-4 concept: a cohort study. Implant Dent. 2014 Apr;23(2):218-24. doi: 10.1097/ID.0000000000000034. PMID: 24394342. https://pubmed.ncbi.nlm.nih.gov/24394342/

IDTranslation
@@homeHome
@@aboutUsAbout Us
@@rewardsRewards
@@articlesArticles
@@addYourClinicAdd your clinic
@@locationsLocations
@@treatmentsTreatments
@@affiliateBecome an affiliate
@@customerServiceCustomer service
@@faqsFAQs
@@popularCountriesPopular Countries
@@popularCitiesPopular Cities
@@topClinicTop Clinics
@@mediaRoomMedia Room
@@sitemapsSitemap
@@newsletterSubscribeErrorsUnable to subscribe
@@seeMoreSee More
@@contactContact
@@more More
@@gpcGlobal Patients' choice
@@treatmentFinanceTreatment Finance
@@treatmentInsuranceTreatment Insurance
@@promotions Promotions
@@destinationsArticles Destinations
@@proceduresArticles Procedures
@@resourcesArticles Resources
@@clinicsArticlesClinics
@@freeQuoteFree Quote
@@reviewBreadcrumbsReview
@@freeExamFree Exam
@@freeWifiFree Wifi
@@freeWaterFree Water
@@freeCoffeeFree Coffee
@@freeParkingFree Parking
@@freeHotelTransportationFree Ground Transportation to Hotel
@@freeAirportTransportationFree Ground Transportation to Airport
@@freePhoneCallsFree Phone Call
@@freeXraysFree X-rays
@@freeWheelChairWheelchair Accessible
@@searchBreadcrumbsSearch
@@alertImageTypeErrorOnly images are allowed
@@reviewVeryBadVery Bad
@@reviewBadBad
@@reviewOkOk
@@reviewGoodGood
@@reviewVeryGoodVery Good
@@clinicMetaDescription **clinic** provides a wide range of medical treatments including **procedures** and more. Save up to 70% off on your treatments.
@@bookMetaTitleBook your appointment with **clinic**
@@faqMetaTitle Frequently Asked Questions
@@faqBreadcrumbs FAQs
@@aboutMetaTitle About Dental Departures
@@aboutBreadcrumbsAbout us
@@affiliateIndexMetaTitleJoin the Dental Departures Affiliates Program
@@affiliateIndexMetaDescriptionJoin Dental Departures' affiliate program and get paid to refer patients to our network of global doctors in more than 12 countries. We pay top dollar!
@@affiliateSignupMetaTitle Affiliate Sign Up Form
@@affiliateSignupMetaDescriptionJoin Dental Departures
@@affiliateBreadcrumbs Affiliate
@@affiliateTermsMetaTitle Terms & Conditions
@@affiliateTermsMetaDescriptionTerms and Conditions for affiliate partners of Dental Departures - the #1 site for finding and booking dental care with our global network covering more than 12 countries.
@@affiliateTermsBreadcrumbs1 Join
@@affiliateTermsBreadcrumbs2 Affiliate Terms & Conditions
@@bookBreadcrumbs Schedule your appointment
@@articleBreadcrumbs Articles
@@articleDestinationsMetaTitle Dental Destinations
@@articleDestinationsMetaDescriptionLearn more about popular dental destinations around the globe. Discover how to find a doctor in: Mexico, Costa Rica, Thailand, Philippines, Hungary, Czech Republic, Spain, Turkey and many more.
@@articleResourcesMetaTitle Dental Travel Resources
@@articleResourcesMetaDescriptionLearn more about dental tourism and uncover tips on visiting a doctor overseas.
@@articleProceduresMetaTitle Dental Procedures
@@articleProceduresMetaDescriptionLearn more about dental procedures overseas and discover the dental options you have available.
@@articleClinicsMetaTitle Dental Clinics: Spotlight
@@articleClinicsMetaDescriptionFinding the right Clinic for you.
@@articlesMetaTitle Dental Articles
@@articlesMetaDescriptionLearn more about dental tourism, popular dental destinations and dental procedures.
@@clinicContactBreadcrumbs Get your free quote
@@clinicContactFormErrorAn error occurred while submitting the form. Please try again.
@@clinicQuoteBreadcrumbs Free quote
@@contactMetaTitle Send an email to Dental Departures
@@contactBreadcrumbs Send us an email
@@financeMetaTitle Dental Financing
@@financeMetaDescriptionDental financing helps you get the dental care you need today at competitive interest rates.
@@financeBreadcrumbs Dental Finance
@@financeCaMetaTitle Dental Financing
@@financeCaMetaDescriptionDental financing helps you get the dental care you need today at competitive interest rates.
@@financeCaBreadcrumbs Canada
@@financeUsMetaTitle Dental Financing
@@financeUsMetaDescriptionDental financing helps you get the dental care you need today at competitive interest rates.
@@financeUsBreadcrumbs United States
@@freequoteMetaTitle Get A Free Quote On Your Dental Treatment
@@freequoteMetaDescriptionGet a free quote with Dental Departures and see how much you can save with a Doctor abroad. We\'ll get back to you as soon as we can for assistance.
@@freequoteFormError form error
@@gpcYearMetaTitleBest Clinics for **year** - Global Patients' Choice Awards
@@gpcYearLocationMetaTitle Best Clinics in **location** **year** - Global Patients' Choice Awards
@@gpcYearLocationMetaDescriptionDD The best dental clinics and dentists in **location** of **year**. The Global Patients' Choice Awards recognizes the best reviewed clinics by our patients.Check out our award winning clinics now!
@@gpcBreadcrumbs Global Patients' Choice
@@gpcIndexMetaDescriptionThe best dental clinics and doctors of 2018. The Global Patients' Choice Awards recognizes the best reviewed clinics by our patients.Check out our award winning clinics now!
@@homeTestimonialCustomer1Name Jeffery
@@homeTestimonialCustomer1LocationVictoria, Canada
@@homeTestimonialCustomer1TestimonyI've traveled twice to Bangkok for dental work through Dental Departures. After returning from my first trip, my local dentist said he had rarely seen such well done crowns (including his own).
@@homeTestimonialCustomer2Name Margy & Kevin
@@homeTestimonialCustomer2LocationBrisbane, Australia
@@homeTestimonialCustomer2TestimonyWe had a very successful trip to Thailand and are extremely happy with the work done and grateful for Dental Departures who gave us the confidence to proceed with the trip. Very highly recommended.
@@homeTestimonialCustomer3Name Sam
@@homeTestimonialCustomer3LocationPhoenix, United States
@@homeTestimonialCustomer3TestimonyI have a beautiful smile once again thanks to my referral from Dental Departures!
@@homeMetaTitleDental Tourism Experts
@@homeMetaTitleMDMedical Tourism Experts
@@homeMetaDescriptionSave 70% here on dental tourism. Compare treatment prices with over 1339 global dental clinics with 7791 reviews and 14905 photos. Get your Free Quote and Book Now.
@@homeMetaDescriptionMDSave 70% here on medical tourism. Compare treatment prices with over 1339 global medical clinics with 7791 reviews and 14905 photos. Get your Free Quote and Book Now.
@@infoBestPriceMetaTitle Best Price Guarantee
@@infoBestPriceBreadcrumbs Best price guarantee
@@infoConnectMetaTitle Connect with Dental Departures
@@infoConnectBreadcrumbs Connect with us
@@infoPrivacyMetaTitle Privacy Policy
@@insuranceMetaTitle Dental Insurance
@@insuranceDescriptionDental Departures makes it even easier to book an appointment at a global clinic with our exclusive dental insurance packages.
@@insuranceBreadcrumbs Dental Insurance
@@insuranceAuMetaTitle Australia Dental Insurance
@@insuranceAuDescriptionBook your next visit to a dentist in Australia with the safety & security with dental insurance coverage. Get your Free dental insurance quote now.
@@insuranceAuBreadcrumbs Australia
@@insuranceMxMetaTitle Mexico Dental Insurance
@@insuranceMxDescriptionBook your next visit to a dentist in Mexico with the safety & security with dental insurance coverage. Get your Free dental insurance quote now.
@@insuranceMxBreadcrumbs Mexico
@@insuranceGbMetaTitle United Kingdom Dental Insurance
@@insuranceMxDescriptionBook your next visit to a dentist in United Kingdom with the safety & security with dental insurance coverage. Get your Free dental insurance quote now.
@@insuranceGbBreadcrumbs United Kingdom
@@insuranceThMetaTitle Thailand Dental Insurance
@@insuranceThDescriptionBook your next visit to a dentist in Thailand with the safety & security with dental insurance coverage. Get your Free dental insurance quote now.
@@insuranceThBreadcrumbs Thailand
@@insuranceUsMetaTitle United States Dental Insurance
@@insuranceUsDescriptionBook your next visit to a dentist in United States with the safety & security with dental insurance coverage. Get your Free dental insurance quote now.
@@insuranceUsBreadcrumbs United States
@@newsletterSubscribeMetaTitle Subscribe Successful
@@newsletterSubscribeBreadcrumbs Subscribe
@@newsletterUnsubscribeErrors Unable to unsubscribe
@@newsletterUnsubscribeMetaTitleUnsubscribe Successful
@@newsletterUnsubscribeBreadcrumbs Unsubscribe
@@partnerSignupMetaTitle Sign Up
@@partnerSignupDescriptionFind out how DentalDepartures.com can bring more western patients to your dental clinic.
@@premiumContentMetaDescriptionLoc **treatment** in **location** - Browse listings, compare prices, read real patient reviews and book your plastic surgery appointment online.
@@premiumContentMetaDescription **treatment** - Browse listings, compare prices, read real patient reviews and book your plastic surgery appointment online.
@@pressMetaTitle Press Releases
@@pressBreadcrumbs Press
@@promotionsMetaTitleDental Treatment Promotions & Discounts Worldwide
@@promotionsMetaDescription Get the best dental treatment promotions and discounts from clinics all around the world. Save up to 70% off your dental treatments and get the best price guaranteed.
@@promotionsMetaLocationTitleDD Current promotions in
@@promotionsMetaLocationDescriptionDD Check out the current promotions we're offering in **location** to help you save even more on your dental care!
@@anytimeAnytime
@@morningMorning
@@afternoonAfternoon
@@eveningEvening
@@promotionsBreadcrumbs Promotions
@@seoLocationsMetaTitle Complete listing of Clinics
@@seoLocationsDescription A listing of every clinic location.
@@seoLocationsBreadcrumbs All locations
@@seoSitemapMetaTitle Sitemap
@@seoPopCitiesMetaTitle Most popular regions
@@seoPopCountriesMetaTitle Most popular countries
@@seoTopClinicsMetaTitle Top Clinics with Dental Departures
@@seoTopClinicsBreadcrumbs Top Clinics
@@seoTreatmentsMetaTitle Dental Procedures
@@seoTreatmentsBreadcrumbs All treatments
@@currentPromotionsTitleCurrent promotions in
@@promotionsMetaPromotionsDescriptionMDCheck out the current promotions we're offering in **location** to help you save even more on your medical care!
@@alertUploadErrorSomething is wrong. Cannot upload your photo
@@alertSubscriptionErrorForm Subscription Error
@@clinicContactFormErrorAn error occurred while submitting the form. Please try again.
@@moreCountriesMore countries
@@pageNotFoundMetaTitle404 - Page not found
@@breadcrumbPageNotFoundPage not found
@@alertCancelAppointmentAre you sure you would like to cancel your appointment?
@@clinicContactFormErrorAn error occurred while submitting the form. Please try again.
@@insuranceCountryMetaDescriptionBook your next visit to a doctor in **country** with the safety & security with medical insurance coverage. Get your Free medical insurance quote now.
@@insuranceMdMetaTitleMedical Insurance
@@insuranceCountryMetaTitle**country** Medical Insurance
@@insuranceGenericMetaDescriptionMedical Departures makes it even easier to book an appointment at a global clinic with our exclusive medical insurance packages.
@@gpcYearLocationMetaDescriptionMDThe best medical clinics and doctors in **location** of **year**. The Global Patients' Choice Awards recognizes the best reviewed clinics by our patients.Check out our award winning clinics now!
@@articlesMDMedical Articles
@@homeGenericMetaTitleMedical Tourism Experts - Best Price Guaranteed
@@homeGenericMetaDescriptionSave 70% here on medical tourism. Compare treatment prices with over 1339 global medical clinics with 7791 reviews and 14905 photos. Get your Free Quote and Book Now.