All-on-4 Dental Implants
All-on-4 replaces an entire arch of missing or failing teeth with a fixed bridge supported by four dental implants. The two back implants are angled to use the denser bone that most people still have, which is why many patients who were told they needed bone grafting can be treated without it. At S&L Dental in Paradise Valley, Dr. David Ngo plans each case from a 3D scan, and most patients leave the surgical visit with a fixed temporary set of teeth the same day. You can see a completed case in our before and after gallery.
Who All-on-4 Is For
Patients who have lost most or all of the teeth in one arch, whose remaining teeth are failing from decay or gum disease, or who struggle with a loose denture. Because the implants are angled into stronger bone, it also suits many people with moderate bone loss. Uncontrolled diabetes, heavy smoking and some medications affect healing and are reviewed at the consultation.
All-on-4 Versus a Denture
A denture rests on the gums, moves when you chew and has to come out at night. All-on-4 teeth are screwed to the implants, stay in place, restore most of your natural biting force and keep the jawbone from shrinking the way it does under a denture. The trade-off is cost and a surgical procedure, which is why we also offer implant-retained dentures as a middle option.
The All-on-4 Process at S&L Dental
- Consultation and 3D scan. A CBCT scan shows bone volume and nerve position so implant positions are planned before surgery, not during it.
- Surgery day. Any failing teeth are removed, four implants are placed per arch, and a fixed temporary bridge is attached the same day in most cases. Sedation is available.
- Healing. Three to six months on a softer diet while the implants fuse to bone. The temporary bridge stays in place throughout.
- Final teeth. A stronger permanent bridge is made from new impressions, with the shape and shade refined based on how you have lived with the temporary.
- Maintenance. Cleanings and a check of the bridge screws every six months. The bridge is removable by us for cleaning when needed.
Cost and Financing
All-on-4 is priced per arch and includes extractions, the implants, the same-day temporary bridge and the final bridge. The total depends on the bridge material (acrylic on titanium versus zirconia) and whether any grafting is needed. You receive a written, itemized quote after the scan. Dental insurance often contributes to the extractions and sometimes toward the implants; we offer third-party financing for the balance.
All-on-4 Questions
Do I really get teeth the same day?
In most cases, yes. A fixed temporary bridge is attached to the implants on the day of surgery. If the implants are not stable enough at placement, we use a temporary denture for a few weeks instead, which the scan usually predicts in advance.
Is it painful?
The surgery is done under local anesthetic with sedation available. Expect swelling and soreness for a week or so, managed with over-the-counter medication for most patients.
How long do All-on-4 implants last?
Long-term studies report implant survival above 94% at ten years. The bridge itself is expected to be refurbished or replaced after roughly 10 to 15 years of wear.
Can I eat normally?
A soft diet for the first few months while the implants heal, then most foods once the final bridge is fitted. Very hard or sticky foods are best avoided to protect the bridge.
What if I have bone loss?
The angled rear implants are designed to use the bone most people retain. Severe upper-jaw bone loss may call for zygomatic implants or grafting, which the 3D scan will show.