All on 4 Dental Implants: A Guide To Full Set Teeth Replacement

All on 4

An advanced, cost-effective procedure that can transform your smile and allow you to eat foods you never thought you’d eat again. The Sydney Implant Institute can deliver you a new set of teeth in as little as a day.

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What is an All on 4 (AO4)?

All on 4 dental implants are an innovative and increasingly popular procedure in which an entire set of broken down, loose, painful or missing teeth is replaced with a new set of fixed teeth. The new teeth are supported by just four dental implants, which are inserted into the jaw bone.

A cost-efficient and permanent solution that provides a fixed, full-arch prosthesis. Implants are fixed and do not need to be removed

Surgery is usually completed in one day and the teeth are issued within one or 3 days

Fewer surgical appointments mean faster recovery time and fewer trips to the dentist!

Recommended by 98% of patients who see a rapid improvement in function, aesthetics, speech and self-esteem*

How does All on 4 work?

An All on 4 replaces an entire arch of teeth (upper or lower) with four dental implants and a fixed bridge. If you need the upper and lower teeth replaced, there will be eight dental implants and two bridges. Before All on 4, we used six to ten implants per arch of teeth and usually with a large amount of bone and gum grafting.

All on 4 utilises the bedrock bone in front of the sinuses in the upper jaw and in front of the dental nerves in the lower jaw. Bone grows into the implants, allowing them to be fixed and able to support teeth. The back implants are angled, which means we use the good bone in the front part of the jaws. This angulation also allows the top of the implant to align with the position of a first molar, meaning we can replace 12 teeth (first molar to first molar) with just four implants and no bone grafting.

The All on 4 technique also allows the implants to be further apart from each other. This means the implants are surrounded by more healthy bone and gum and they do not disturb the blood supply in the bone around adjacent implants.

The use of only four dental implants means the force is spread evenly along the bridge, making it stable, much like the four legs of a table. The bridge also splints the implants together, which prevents them from moving independently. This is why we can put teeth on the implants immediately in All on 4, where it usually takes three months in conventional implant treatments.

All this means: fewer implants, less cost, healthier implants, less surgery and fewer visits.

Is All on 4 right for me?

The experienced dental surgeons at The Sydney Implant Institute can conduct a thorough examination to determine the best course of treatment for you. All on 4 dental implants may be the best option for you if you are suffering from one or more of the following:

You have teeth that are breaking down, loose or painful
You have a denture that you can’t wear
You have no teeth at all
Your teeth are failing and you want your smile transformed in as little as a day.

The All on 4 technique is a full-mouth dental implant technique for the upper teeth, lower teeth or both. If there are teeth that can be saved, we often recommend a more conservative approach. We can show you all the ways we can transform your smile when you come in for your complimentary consultation.

Most people are healthy enough to undergo an All on 4 procedure at The Sydney Implant Institute. There are very few medical conditions that preclude you from being treated with an All on 4 denture implant; however, we still do a thorough medical history and check and will often involve your GP if necessary.

Age should not be a concern. We have performed All on 4 on patients as young as 24 years of age and as old as 91! If you are healthy and your teeth are in the condition to warrant it, you can be a good candidate for an All on 4 implant.

The best way to really find out is to book in for your complimentary consultation which includes;

Thorough medical and dental screening for suitability
Digital radiography and digital surgical planning
Full photographic work up
Moulds taken for study and assessment models
Tailor made treatment planning including all treatment alternatives and costs.

Dental All on 4 bridges (initial and upgrades)

Your All on 4 bridge can be made from a number of different materials. Everyone undergoing an All on 4 at The Sydney Implant Institute will initially be issued a metal-reinforced acrylic bridge.

As an All-on-4 clinic, we’re proud to have our very own in-house dental laboratory, giving us full control over the quality, precision, and aesthetics of every final result.

Our lab team works closely with our clinicians to craft beautiful, durable bridges using Phonares premium teeth and high-impact Ivocap acrylic. By managing the entire process under one roof, we ensure faster turnaround times, greater consistency, and a truly personalised outcome for every patient. Best of all, your custom bridge is included in the initial All-on-4 cost.

After three months to two years, you will usually need to change your bridge to one with a stronger material. As a rule, the more premium the bridge, the stronger the material is and therefore the thinner the bridge can be.

Acrylic and titanium

Also known as a “hybrid” bridge, this bridge utilises a custom-milled titanium substructure to support the same material and teeth the initial bridge was fabricated from. The main difference between this and the original bridge is that the strength is obtained from the titanium substructure, not the bulkiness of the acrylic.

The titanium substructure is manufactured in Sweden by Nobel Biocare and carries a 10-year warranty from the manufacturer. Our technicians then overlay the titanium with high-impact acrylic and the very aesthetic Phonares teeth.

This bridge is light, thin and aesthetic. The disadvantages are that it can still wear, as all resin/acrylic-based materials do, and that in extreme impact situations, it will not perform as well as porcelain-based materials.

Zirconia and Porcelain

Zirconia All on 4 Bridges are recognised as the best quality bridge in the industry. They are solid, long-lasting, visually appealing and function more like your natural teeth as compared to other types of bridges.

Zirconia bridges are milled from Zirconium, a super hard and durable material. Our technicians then make the bridge bespoke by cutting back the zirconium and adding layers of highly aesthetic porcelain to give the bridge the translucency and natural look of pure enamel and untouched teeth.

Zirconia porcelain bridges are a great solution for younger patients, heavy bruxers (tooth grinders) and those after the highest aesthetics modern dentistry can offer. Because this material is so strong, the bridge is thin and has the most natural look and feel.

As with all our bridges, the shape, position and colour is determined by our patient’s wishes and decided upon after a consultative process involving our patient, the technicians and our team.

All on 4 treatment process

Complementary consultation:

Digital and surgical planning
Cone beam 3D scan taken
Take impressions of your teeth
Medical history checks
Evaluate your teeth for implant placement

Second consultation:

Discuss your questions about the procedure with our team

Review of digital smile design and picture of final outcome

Full discussion surrounding treatment options and costing

Presentation of similar cases and patient journeys

Tooth colour and shape selection

Any additional radiography, photography or measurements

All on 4 dental implant procedure:

Review and discussion with the medical doctor performing your sedation. (If required)
Checking into the recovery suite where you will be based after surgery and where you will be able to secure your belongings
Final review of the procedure and the day ahead with your surgical team. Pre-op medications will be given.

You will be given the anaesthetic which will mean you will not remember anything and it will make the surgery seem as though it has taken 5 minutes.
After you are sedated you will be made numb and any remaining teeth and infection will be removed before commencing the All on 4 procedure.
During the procedure the jaw bone will then be flattened to enable the fitting surface of the bridge to be smooth. This also ensures that when you smile the junction between the All on 4 bridge and your gums cannot be seen. It also removes the dirty and infected bone that often surrounds the necks of the teeth. This process is called an alveolectomy.
Four dental implants are then placed on the upper or lower arch (or both) according to the pre-designed surgical guide. Abutments (connectors) are then fitted to the implants before the gums are sutured back over. These abutments go through the gums and connect the implants to the bridge.
Once you have woken up, the surgical guide is then attached to the abutments by titanium cylinders. This allows our team to assess the look and position of the teeth before the bridge is made.
Copings are then placed onto the abutments in order to take impressions of the implants and surrounding tissues. This is then picked up by our master technicians who spend the next 1-3 days (upper and lower bridges need closer to 3 days), creating your custom fitting bridge.
When the bridge is ready it is then screwed into the abutments and the bite is evaluated and adjusted. We are now working on the implants so there is no need for anaesthetic and the procedure is painless.
Post operative instructions are then explained to your carer and you and printed for later revision. Prescriptions, ice packs and a mouthwash are included in your take home pack.
Our team will contact you in the next two days to see how you are doing.

Post Operative Review:

At the two- week mark, we take the bridge off, remove the sutures and evaluate the healing process. The bridge is replaced, and the bite and aesthetics are checked again. The access holes for the screws are then sealed with a resin material.
Your dedicated clinician then goes through the cleaning process at length with you. You will be shown how to best maintain your All on 4 and look after your bridges.

Finally, at a six- month review, we evaluate your All on 4, the way it is wearing and how it is being cleaned. A final healing check, review of maintenance and a cleanup are done with your oral health therapist. You can also discuss upgrading your bridge and the alternatives at this appointment.

All on 4 pre-operative care

You must fast (no food or drink except a few sips of water) from midnight the night before surgery
Do not drive yourself to or from the surgery, and you must also be accompanied by someone. They will likely want to go for a walk or leave the surgery while you are in surgery and recovering. They can go home and come back before the bridge is issued if that is more convenient.
If you have any questions, write them down so you can ask the team before surgery.
Discuss your medications with your dentist, GP or sedationist prior to taking them before the procedure .
Wear comfortable, loose fitting and warm clothing.
Bring an Ipad or something to read if you’d like and a secure bag for your belongings

Addressing common myths about All on 4 denture implants

When considering All on 4, you may encounter a few myths that can cause hesitation. Let’s clear up some common misconceptions and provide clarity about this procedure.

Myth 1 — All on 4 bridges are difficult to maintain

A common concern is that fixed bridges are hard to care for. All on 4 bridges are designed with maintenance in mind. Regular brushing, proper flossing and routine dental visits will keep them in excellent condition.

Myth 2 — All on 4 isn’t as strong as natural teeth

There’s a belief that All on 4 bridges might not hold up to daily use. In reality, they are engineered for strength and stability, with materials like titanium and zirconia offering durability comparable to natural teeth.

Myth 3 — All on 4 dental implants require frequent adjustments

Unlike some other dental solutions, All on 4 implants are highly stable and do not require frequent adjustments. Routine check-ups are sufficient to ensure the implants remain functional and properly aligned.

Dispelling these myths can help you make an informed decision about All on 4 implant dentistry. If you have questions about the procedure, feel free to discuss them during your consultation with our team.

Potential risks and discomforts to consider

While the All on 4 dental implant procedure is highly effective and safe, like any dental surgery, it’s important to understand that there may be some risks and mild discomforts involved. Knowing what to expect helps you feel confident and prepared.

Common temporary side effects include minor swelling, bruising or tenderness in the jaw and gums following surgery. These are completely normal and typically subside within a few days. Your care team will provide clear post-operative instructions and medications, if needed, to manage any discomfort and support a smooth recovery.

In very rare cases, complications such as infection, bite misalignment, gum recession or implant instability may occur. However, these are unlikely when the procedure is performed by experienced dental surgeons like here at The Sydney Implant Institute. We will closely monitor your progress and address any concerns during follow-up appointments.

Our goal is to make your journey to a new smile as seamless as possible. If you have questions about potential risks, feel free to discuss them during your complimentary consultation. Transparency and your peace of mind are always our priorities.

Had All on 4 implants elsewhere and something feels off?

If you’ve had All on 4 dental implants completed elsewhere and feel that something isn’t quite right, it’s natural to have questions or seek reassurance. The Sydney Implant Institute is here to help identify and address any concerns, ensuring your implants function and feel as they should.

Signs that your All on 4 implants may need attention

Difficulty eating or speaking

If your implants feel loose or you struggle with basic functions like chewing or speaking, it might be a sign of misalignment or structural issues.

Changes in appearance

If you notice unevenness, gaps or changes in how your bridge sits, it could indicate wear or a poor initial fit.

Unusual noises or movement

Clicking sounds or movement of the bridge could suggest that the implants or connectors (abutments) need adjustment or repair.

If you’re experiencing any of these signs or just want a second opinion, reach out to us today for a consultation.

Discover if All on 4 implants fit your needs

If you think All on 4 might be the solution you’re looking for, schedule a consultation with The Sydney Implant Institute today. As Sydney’s leading All on 4 clinic, we’ll help you determine if this treatment is the right fit and guide you towards the best possible outcomes for your dental health.

For immediate guidance on common questions, explore our comprehensive FAQs.

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About Full Mouth Dental Implants