All-on-4 Dental Implants

All-on-4 refers to a full arch of teeth ("all") supported on ("on") four dental implants ("4"). It is a trademarked protocol developed by Nobel Biocare based on Dr. Paulo Malo's research. The technique uses two straight anterior implants and two tilted posterior implants to support a fixed, non-removable prosthesis of 10 to 14 teeth.

Yes, in most cases. Dr. Ostovar places the four implants and attaches a prefabricated provisional prosthesis on the same day. You leave our Beaverton office with a full set of fixed teeth. These provisional teeth are functional and aesthetic, though they will be replaced with a stronger final prosthesis after the implants integrate.

A single arch All-on-4 treatment typically ranges from $22,000 to $30,000, which includes all implants, extractions if needed, the provisional prosthesis, and the final zirconia prosthesis. Upper arches tend to cost slightly more due to bone density considerations. We provide exact pricing after your CBCT consultation.

This is exactly the patient population All-on-4 was designed for. The tilted posterior implants bypass areas of bone loss — particularly around the maxillary sinuses — by engaging denser bone further forward and at an angle. Many patients who were told they need extensive bone grafting for traditional implants are excellent All-on-4 candidates without any grafting.

All-on-4 uses four implants; All-on-6 uses six for additional support. The choice depends on bone quality and the patient's bite force. Six implants distribute load across more points, which can be advantageous in patients who clench or grind. Dr. Ostovar recommends the approach that best fits your anatomy.

The surgical phase takes approximately two to three hours per arch. Adding extractions, prosthetic fitting, and adjustments, the total appointment runs about four to six hours for a single arch. The procedure is performed under IV sedation, so the time passes quickly and you will not remember the details.

For the first three months, you follow a soft-food diet: scrambled eggs, pasta, fish, mashed potatoes, yogurt, smoothies, and similar foods. This protects the implants during the critical integration period. After the final prosthesis is placed, you can eat virtually anything — steak, raw vegetables, crusty bread, and all the foods you have been missing.

Yes. The final zirconia prosthesis includes individually shaped teeth with natural color variations and realistic gum-colored material. We digitally design the smile to complement your facial proportions, lip line, and skin tone. Patients routinely tell us that friends and family cannot tell they have implants.

The four titanium implants are designed to last a lifetime with proper care. The prosthesis (the visible teeth and gum structure) typically lasts 15 to 25 years before needing refurbishment. Zirconia prostheses tend to outlast acrylic versions. Regular maintenance appointments every six months are important for longevity.

In almost every measurable way, yes. All-on-4 restores 80 to 90 percent of natural bite force versus 20 to 30 percent with dentures. There is no slipping, no adhesive, no palate coverage, and no accelerated bone loss. The psychological benefit of permanently fixed teeth is also significant. The only advantage of dentures is lower upfront cost.

Published literature reports All-on-4 survival rates of 95 to 99 percent at the 10-year mark. Dr. Ostovar's practice outcomes align with the upper end of this range. The most common complication is not implant failure but provisional prosthesis fracture during the healing phase, which is easily repaired.

Smoking increases the risk of implant failure significantly. We require patients to stop smoking at least two weeks before surgery and strongly recommend permanent cessation. If quitting is not possible, we discuss the improved risks honestly. Some smokers proceed with All-on-4 successfully, but the risk-benefit conversation is essential.

Extractions are performed at the beginning of the same surgical appointment. Failing teeth are removed, the sockets are cleaned and grafted if needed, and the implants are placed in the best pre-planned positions. There is no need for a separate extraction appointment in most cases.

All-on-4 produces a fixed prosthesis that is permanently screwed onto the implants — only a dentist can remove it. Snap-on dentures (overdentures) are removable; you take them out nightly for cleaning. All-on-4 feels more like natural teeth, provides stronger bite force, and better preserves bone, but costs more.

Yes. We work with several third-party financing companies that offer plans with low or zero interest for qualified applicants. Monthly payments can make All-on-4 surprisingly accessible. Our treatment coordinator will review all financial options at your consultation so cost does not prevent you from getting the care you need.

All-on-4 full-arch dental implants at Aloha Dental Specialty Center cost between $20,000 and $30,000 per arch. This includes four titanium implants, temporary teeth on the day of surgery, and the final permanent prosthesis. We offer CareCredit financing with 0% interest for up to 24 months. Some dental insurance plans cover a portion of implant costs.

Yes — All-on-4 is specifically designed as a same-day teeth replacement procedure. Dr. Ostovar places four implants and attaches a temporary set of fixed teeth in a single appointment, typically lasting 2-4 hours under IV sedation. You leave our Beaverton office with functional teeth the same day. Your permanent prosthesis is fabricated over the following 3-6 months while the implants integrate with your jawbone.

All-on-4 implants are permanently fixed to your jawbone and function like natural teeth — you brush them, eat any food, and never remove them. Traditional dentures sit on top of your gums, can slip or click when eating/speaking, require adhesive, and must be removed for cleaning. All-on-4 also preserves jawbone density, while dentures accelerate bone loss over time.

Most adults missing all or most teeth on an arch are candidates. Even patients with significant bone loss may qualify because All-on-4 uses angled implants to avoid the need for bone grafting in many cases.

Most patients return to desk work within 3–5 days. Full healing of the implant-to-bone connection (osseointegration) takes 3–6 months. During this time you wear comfortable temporary teeth.