All on four dental implants
Tafur Dental Clinic.
All on 4 for full-arch rehabilitation, we place four implants: two straight in the front and two posterior implants tilted up to ~45° to make the most of the available bone while avoiding anatomical structures (sinus/nerve). With sufficient primary stability, we can fit a fixed temporary bridge the same day—so patients leave with teeth while the implants integrate. This concept is well documented with strong clinical outcomes.
Finance available.
What is All-on-4?
All-on-4 is a full-arch dental implant treatment for patients who have lost most or all of their teeth, or whose remaining teeth can no longer be predictably maintained.
Four implants are positioned strategically in the jaw to support a fixed bridge. The rear implants are often angled to make better use of the available bone and to help avoid important anatomical structures.
Where the implants achieve sufficient initial stability, a fixed provisional bridge can be fitted during the immediate treatment phase while the implants heal.
Learn more about dental implants in Gibraltar →What is involved in an All-on-4 treatment?
All-on-4 is not simply four implants. It combines surgical, restorative and maintenance stages to rebuild a complete dental arch.
Planning and assessment
We assess the remaining teeth, gums, bite and bone available before deciding whether All-on-4 is appropriate.
Four dental implants
Four strategically positioned implants are used to support a fixed restoration across the complete arch.
Fixed provisional teeth
When sufficient implant stability is achieved, a fixed provisional restoration can be provided during the initial healing period.
Healing and review
The implants are monitored while they integrate with the bone, and the gums and bite are reviewed during healing.
Final zirconia teeth
Once healing is satisfactory, the provisional restoration is replaced with the definitive fixed zirconia restoration.
Long-term maintenance
Regular professional hygiene and implant reviews help maintain the gums, bridge and implants over time.
Provisional teeth and final zirconia teeth are different stages
The first fixed restoration allows patients to have teeth during the healing period. The definitive restoration is completed after the implants have integrated and the tissues are stable.
Fixed provisional restoration
The provisional bridge is used while the implants heal and integrate with the bone.
It restores function and appearance during this period and allows the bite and soft tissues to be reviewed before the definitive restoration is completed.
Definitive zirconia restoration
Once implant integration and healing are satisfactory, the provisional restoration is replaced with the definitive fixed zirconia prosthesis.
The final restoration is designed around the established bite, function and appearance after the healing phase.
Can I have All-on-4 if I have bone loss?
One of the advantages of the All-on-4 concept is that implant positioning can sometimes make efficient use of the bone that remains.
However, All-on-4 does not mean that additional bone treatment is never required. Bone volume and anatomy still need to be assessed before treatment.
In the upper jaw, some patients may require bone regeneration or sinus elevation. Other implant techniques may also be considered where bone loss is more advanced.
Sinus lift & bone graftingWhat happens during All-on-4 treatment?
Assessment and diagnosis
The teeth, gums, bite and available bone are assessed and the available treatment options are discussed.
Treatment planning
Implant positions, the condition of any remaining teeth, available bone and the planned restoration are considered together.
Implant surgery
Four implants are placed in strategic positions in the jaw. Any additional treatment required depends on the individual clinical plan.
Fixed provisional teeth
If the implants achieve the stability required for immediate loading, a fixed provisional restoration can be fitted during the initial treatment phase.
Healing and integration
The provisional restoration is used while the implants integrate with the bone. Reviews are carried out during this stage.
Final zirconia teeth
Once healing is satisfactory, the definitive fixed zirconia restoration is completed and fitted.
See how immediate-load implant treatment works
This video shows the concept of immediate implant loading and the use of a fixed provisional restoration during the healing phase when implant stability allows.
How much does All-on-4 treatment cost?
The total cost depends on the clinical condition of the mouth and the treatment needed to complete a full-arch rehabilitation.
Factors can include the condition of remaining teeth, bone availability, whether additional surgical treatment is needed and the final restorative plan.
After assessment, we provide a personalised quotation explaining the recommended treatment stages.
What affects the cost of dental implants? →All-on-4 compared with other ways of replacing teeth
All-on-4 is not automatically the right option for every patient. The best solution depends on the number of missing teeth, bone availability and whether a fixed or removable restoration is preferred.
| Treatment | Type | May suit patients who... |
|---|---|---|
| All-on-4 | Fixed full-arch restoration | Need to replace most or all teeth in one arch and want a fixed implant-supported solution. |
| Implant overdenture | Removable implant-supported restoration | Want better denture stability while retaining a removable prosthesis. |
| Implant bridge | Fixed implant-supported bridge | Need to replace several missing teeth rather than a complete dental arch. |
| Dentures | Removable restoration | Prefer or require a conventional removable solution. |
Looking after All-on-4 implants
A fixed implant bridge still needs daily cleaning and professional maintenance.
Cleaning around and underneath the bridge is especially important because plaque accumulation can affect the gums and tissues surrounding the implants.
- Clean around the bridge every day
- Clean underneath the fixed restoration
- Attend professional hygiene appointments
- Have routine implant reviews
- Contact the clinic if something feels loose or unusual
Want to understand All-on-4 in more detail?
Our comprehensive All-on-4 guide explains the treatment in greater depth, including how the implant concept works and what patients can expect from full-arch rehabilitation.
Read the comprehensive All-on-4 guideQuestions about All-on-4 dental implants
Will I have fixed teeth during the healing period?
Where the implants achieve sufficient initial stability, a fixed provisional restoration can be fitted during the healing phase. The final decision depends on the stability achieved during surgery.
When are the final teeth fitted?
The provisional restoration is worn while the implants integrate. Once healing is satisfactory, the definitive zirconia restoration can be completed. The exact timing depends on the individual healing process.
Can All-on-4 be used if I have very little bone?
Sometimes. The implant positions can help make efficient use of available bone, but every case is different. Some patients may still require bone regeneration, sinus elevation or another implant approach.
Can both upper and lower arches be treated?
Yes, both arches can be considered for full-arch rehabilitation. Whether both should be treated during the same treatment phase depends on the clinical situation and treatment plan.
Are All-on-4 teeth removable?
The All-on-4 restoration is fixed to the implants and is not removed by the patient during normal daily use.
Is All-on-4 the same as an implant overdenture?
No. All-on-4 is designed as a fixed full-arch restoration. An implant overdenture is retained or supported by implants but remains removable by the patient.
How much does All-on-4 cost?
The cost depends on the clinical condition, the treatment required before implant placement and the individual restorative plan. A personalised quotation is provided after assessment.
Considering fixed full-arch teeth?
An assessment can determine whether All-on-4 is appropriate for your teeth, bone and long-term treatment goals.