What Is All-on-4?
All-on-4 is a full-arch tooth replacement technique that uses four strategically positioned dental implants to support a complete, fixed set of upper or lower teeth. Instead of replacing each missing tooth individually, the implants support a full-arch prosthesis.
All-on-4 may be suitable for patients who have lost most or all of their teeth in an arch, or who currently wear removable dentures and are looking for a more stable, fixed alternative.
The implants are positioned and angled to make the best use of the available bone in the jaw. In some cases, this approach may reduce the need for extensive bone grafting, particularly for patients who have experienced bone loss. However, suitability depends on each patient’s individual bone structure and clinical condition.
All-on-4 is one full-arch technique within the broader area of dental implant treatment. Whether it is suitable depends on the amount of available bone, your oral health and your treatment goals, which your dentist will assess before proposing a plan.
Potential Features and Considerations of All-on-4
- Fewer implants — A complete arch can be supported by four strategically positioned implants, rather than placing an implant for every missing tooth.
- Fixed teeth — Unlike removable dentures, the prosthesis is designed to remain securely in place and does not need to be removed for daily cleaning.
- May reduce the need for bone grafting — The strategic positioning of the implants can make use of available bone and may reduce the need for extensive grafting in suitable cases.
- Potentially shorter treatment process — In suitable cases, a temporary fixed prosthesis may be fitted on the same day as implant surgery, allowing you to leave the clinic with fixed teeth while your implants heal.
- Stability and chewing function — Fixed implant-supported teeth can provide greater stability than conventional removable dentures, which may help improve chewing ability and confidence.
All-on-4 Dental Implants - Full Arch Teeth Replacment
All-on-4 is one approach to supporting a full arch of replacement teeth using dental implants. Suitability depends on clinical examination, bone condition, oral health and other individual factors. In selected patients, a full-arch prosthesis may be supported by several dental implants. The number and position of implants depend on bone condition, anatomy, bite forces and the proposed prosthesis. Typically, full arch reconstruction of edentulous ridges requires five to 10 dental implants; however, some patients considering a fixed implant-supported prosthesis and in selected cases, tilted or strategically positioned implants may be considered where grafting is unsuitable or not preferred.
This approach is not appropriate for every patient. These situations could pivot the treatment plan toward the All-on-4 protocol.
Provisional teeth may sometimes be placed soon after implant surgery when clinical stability and other conditions permit. Immediate loading is not suitable in every case.
Treatment aims may include support for chewing, speech and appearance. Outcomes vary and adaptation is required.
A provisional prosthesis may be fitted on the day of surgery or later in selected cases. This depends on implant stability, bone condition and the treatment plan.
When treating edentulous cases, removable options represent a more straightforward approach, whereas a fixed option with 4 or more implants (straight or tilted) represents a more advanced approach.
The new Straumann Pro Arch for fixed edentulous restorations combines several treatment steps. From planning and implant placement to the final restoration, the entire treatment is seamless for the patient.
- 2D conventional implant prosthetic planning based on (CB) CT scanning or x-rays
- Three-dimensional imaging may assist diagnosis and implant planning where clinically indicated. Imaging does not eliminate surgical or prosthetic risks.
- Roxolid material with mechanical properties
- SLActive surface designed to deliver increased predictability in stability critical protocols
- Straumann Planning Giode to support tilted implant placement
- Internal CrossFit® implant-to-abutment connection for long-term stability
- Abutments with a low-profile design, additional abutment angulations and universal abutment connector
- Abutment portfolio allows
- Immediate temporization to deliver teeth within a good primary stability is achieved
- High-end final restorations with the option for custom-milled hybrid and wrap-around designs
Am I a Candidate for All-on-4?
All-on-4 is generally suitable for patients who:
- Are missing most or all of their teeth in the upper or lower jaw
- Currently wear a full or partial removable denture and are considering a fixed alternative
- Have experienced bone loss and may benefit from an implant approach that makes use of the available bone
- Are in suitable general health for implant treatment
- Do not have untreated gum disease or other oral health conditions that could affect treatment
Suitability cannot be determined based on these factors alone. An individual assessment is required, including a clinical examination and appropriate dental imaging, such as a CT scan, to evaluate your bone structure, oral health and overall suitability for treatment.
Book a consultation with our dentist to find out whether All-on-4 may be suitable for you.
Treatment Timeline
One of the potential advantages of All-on-4 is that, in suitable cases, a temporary fixed prosthesis may be fitted on the same day. A typical treatment journey may include:
- Consultation & planning — Your dentist will assess your oral health, conduct the necessary examinations and imaging, and develop a personalised treatment plan.
- Surgery day — The four implants are placed, and where clinically appropriate, a temporary fixed prosthesis may be fitted on the same day.
- Healing period — The implants gradually integrate with the jawbone through a process known as osseointegration. This typically takes several months.
- Final prosthesis — Once healing and implant integration are complete, the temporary teeth are replaced with a custom-made final fixed prosthesis.
The treatment timeline varies from patient to patient. Your dentist will explain the expected timeline and each stage of treatment during your consultation.
Cost of All-on-4 Dental Implants in Singapore
The cost of All-on-4 treatment varies depending on several factors, including the complexity of your case, the number of implants required, the type of prosthesis selected, and whether additional procedures such as tooth extractions or bone grafting are needed.
Exact pricing can only be determined after an individual consultation and assessment with our dentist.
Some components of implant treatment may be Medisave claimable, subject to the procedure performed and applicable CPF/MediSave guidelines. Please refer to our Medisave Accreditation page for more information or speak with our dental team about your eligibility.
A Dental Clinic is a MediSave-accredited and CHAS dental clinic Singapore and eligible patients may use MediSave or the Community Health Assist Scheme (CHAS) toward the cost of qualifying procedures. See our financial policy for details.
Risks and Considerations
As with any surgical procedure, All-on-4 implant treatment carries potential risks and complications. These may include infection, implant failure, inflammation or gum disease around the implants (peri-implantitis), and other surgical or prosthetic complications.
Certain factors may increase the risk of complications, including smoking, poorly controlled diabetes, inadequate oral hygiene and insufficient bone volume or quality.
Your dentist will review your medical and dental history, assess your oral health and discuss the potential risks and benefits of treatment before recommending an appropriate treatment approach.
All-on-4 vs. Other Options
|
All-on-4 |
Traditional Multiple Implants |
Removable Denture |
|
|
Implants needed for a full arch |
Typically 4 |
May require multiple implants, depending on the treatment plan |
None |
|
Fixed or removable |
Fixed |
Usually fixed |
Removable |
|
Bone grafting |
May be reduced or avoided in suitable cases |
May be required depending on bone volume |
Not required for denture placement |
|
Temporary teeth on the day of surgery |
May be possible in suitable cases |
Depends on the treatment plan |
Not applicable |
All on 4 dental implants CARE AND MAINTENANCE
For long-term success and proper fit of the fixed prosthesis, thorough patient instruction, and periodic check-ups are recommended. It may be necessary to exchange the Occlusal Screws at each check-up visit.
During patient visits, you should carefully examine the:
As with any surgical procedure, All-on-4 implant treatment carries potential risks and complications. These may include infection, implant failure, inflammation or gum disease around the implants (peri-implantitis), and other surgical or prosthetic complications.
Certain factors may increase the risk of complications, including smoking, poorly controlled diabetes, inadequate oral hygiene and insufficient bone volume or quality.
Your dentist will review your medical and dental history, assess your oral health and discuss the potential risks and benefits of treatment before recommending an appropriate treatment approach.
- Condition of peri-implant tissues with regard to diseases: ‒ Plaque and calculus, bleeding, recession, bone loss, radiographs
- Superstructure: ‒ Occlusal fit and articulation, proper fit of the fixed bridge, wear of occlusal surface, retention, attachment loosening, abutment status
- Function of the prosthesis.
For proper care at home, instruct the patient to clean the space between gingiva and fixed bridges, especially around the implants on a regular basis. Dental floss, super dental floss or interdental brushes are recommended.
Frequently Asked Questions
How long do All-on-4 implants last?
All-on-4 implants are designed as a long-term tooth replacement solution. Their longevity depends on factors such as oral hygiene, general health, lifestyle, regular dental care and maintenance of the implant-supported prosthesis. Your dentist can provide more personalised guidance based on your individual circumstances.
Is All-on-4 surgery painful?
The procedure is performed under local anaesthesia, with sedation options available in suitable cases. You may experience some discomfort, swelling or soreness following surgery, which can usually be managed with medication and appropriate post-operative care. Your dentist will explain what to expect before treatment.
Can I eat normally after All-on-4?
You will generally need to follow a softer diet during the initial healing period. Your dentist will advise you on what foods to eat and when you can gradually return to a more normal diet.
What’s the difference between All-on-4 and a removable denture?
All-on-4 uses dental implants to support a fixed full-arch prosthesis, whereas a conventional denture is removable. Implant-supported teeth can provide greater stability and may improve chewing function compared with traditional removable dentures. Your dentist can help you understand which option is more appropriate for your needs.
Is All-on-4 covered by Medisave?
Certain surgical components of dental implant treatment may be Medisave claimable, subject to the procedure performed and applicable CPF/MediSave guidelines. Eligibility and claim limits depend on the individual treatment. Please refer to our Medisave Accreditation page or speak with our dental team for more information.