All-On-4®: Single-stage approach vs two-stage approach
Posted on: March 1, 2023
“The type of bridge your dentist offers can determine whether you need to pay for one or two sets of replacement teeth in the short term”.
If you want to replace all of your teeth with implants, or you want a more permanent and convenient alternative to removable dentures. you may have heard of All-On-4 dental implants. This ground-breaking procedure supports a full arch of replacement teeth on as few as four implants, keeping implant surgery and costs to a minimum.
Different dentists use different systems and approaches to full mouth implants, which will affect the cost and experience of your treatment. One of the most important differences to know is whether your dentist follows a one-stage or two-stage approach to replacing teeth, which depends on the type of bridge fitted.
At Perth Dental Implant Centre, our experienced dentist Dr David Norcross provides high-quality All-On-4 dental implants using a clinically-proven single-stage approach that helps our patients save time and money. Book a consultation with Dr Norcross today for an assessment and more information about restoring your smile with All-On-4 implants.
What are All-On-4 dental implants?
The All-On-4 implant system supports a full set of replacement teeth on four dental implants placed in the upper or lower jaw. This normally involves placing two implants at the front of the mouth and two at the back, in a way that avoids contact with the nerves and sinus cavity. A fixed bridge of replacement teeth can usually be attached within 3 to 5 days of surgery.
The All-On-4 implant system and surgical protocol was developed by Professor Paulo Malo for Nobel BioCare in 1998. Although widely adapted by other dental implant companies since, the trademarked technique for placing full mouth dental implants using the original All-On-4 system, is backed by clinical studies with success rates up to 98%.*
One advantage of All-On-4 implants is that they avoid or reduce the need for bone grafting to build up a small jaw due to the way the implants are placed, making full mouth dental implants a possibility for more patients. However, as certain medical conditions and lifestyle factors can impact on the success of treatments, a comprehensive assessment with Dr Norcross is necessary to determine whether All-On-4 is an option for you.
Types of All-On-4 implant treatment
If you’re considering All-On-4 implants to replace missing or damaged teeth, you should be aware that not all dentists use the same approach. The type of implants and prosthetic teeth offered can vary in quality, affecting their price, their durability and the procedure itself.
The type of bridge your dentist offers can determine whether you need to pay for one or two sets of replacement teeth in the short term. If you choose a dentist who places a conventional full-acrylic bridge after surgery, this will generally need to be replaced with a zirconia bridge within 3 to 6 months of surgery.
At Perth Dental Implant Centre, Dr Norcross uses a single-stage approach to All-On-4 teeth, placing a strong titanium-reinforced acrylic bridge after surgery, that can last for several years before needing to be replaced.
- 100% acrylic bridge (lasts an average 3 to 6 months) or;
- Cast metal-reinforced acrylic bridge (lasts an average 6 to 12 months)
The traditional approach to replacing teeth with All-On-4 implants involves placing a temporary acrylic bridge within 5 days of implants being placed. These are worn while the mouth is healing, then replaced within 3 to 6 months with a more durable option such as a zirconia bridge at additional cost.
Some dentists offer a cast metal-reinforced acrylic bridge as a stronger alternative, but in most cases, this will also need to be replaced with a zirconia bridge within a year of surgery.
The challenge with loading a full acrylic bridge onto healing dental implants is that the bridge can be prone to break. If the bridge were to break, it would put undue stresses on the implants and subsequently delay the healing process.
- Milled titanium-reinforced acrylic bridge (lasts an average 2 to 5 years or longer with good care)
A more modern approach to All-On-4 teeth replacement involves placing a precision milled titanium- acrylic bridge as the first set of teeth. High-quality acrylic is used for the teeth and pink gum areas, while the milled titanium bar inside the bridge enables it to last much longer before needing to be replaced – generally within 2 to 5 years or longer if you take good care of your new teeth and oral health.
Titanium acrylic bridges offers a more passive fit than full acrylic bridges do, meaning they promote better healing of dental implants during those crucial months of recovery after surgery.
At Perth Dental Implant Centre, our experienced dental lab technician uses titanium milling technology to manufacture titanium-reinforced acrylic bridges within 1 to 2 days of implant surgery.
You will normally be able to continue using this first set of teeth for several years without having to replace them after your mouth heals.
Watch as Dr Norcross explains our approach to All-On-4 Teeth:
How long do All-On-4 implants last?
Dental implants themselves will normally last a lifetime with good care and provided you follow your dentist’s advice to minimise the risk of implant failure, but an implant bridge will need to be replaced after a number of years due to normal wear and tear or accidental damage.
How long a bridge lasts mainly depends on the material it’s made from, as well as your oral hygiene and biting forces.
The first set of replacement teeth is attached several days after implant surgery. A full acrylic bridge will generally need to be replaced during or after the healing process, but a reinforced acrylic bridge can last for longer.
- A 100% acrylic bridge placed immediately after implants lasts 3 to 6 months on average
- A cast metal-reinforced acrylic bridge placed immediately after implants lasts 6 to 12 months
- A milled titanium-reinforced acrylic bridge placed immediately after implants can last 2 to 5 years or longer with proper care
The bridge a dentist places will depend on their approach to All-On-4 teeth and their access to lab technology.
A replacement bridge will generally last longer than the first bridge, as stronger materials such as zirconia may now be used.
- A replacement titanium-reinforced acrylic bridge can last 2 to 5 years
- A titanium-reinforced zirconia bridge can last 10 to 15 years
- A porcelain-layered zirconia bridge can last 10 to 15 years
If your replacement teeth are damaged, a dental technician may sometimes be able to repair the damage and restore the bridge rather than having to replace it.
How much does All-On-4 cost?
The cost of All-On-4 implants varies depending on the type of implants and bridge used and whether your implant dentist follows a single-stage or two-stage approach to treatment. While a higher-quality bridge costs more, it can last significantly longer than a lower-quality bridge that will normally have to be replaced within a year or less.
Single-stage treatment cost
- From $20,000 per arch
The cost of All-On-4 at Perth Dental Implant Centre starts from $20,000 per arch. This includes the cost of placing genuine Nobel BioCare dental implants using the clinically-proven All-On-4 technique and a titanium-reinforced high-impact acrylic bridge that can last 2 to 5 years on average.
Our treatment plans are inclusive of clinical radiographs (excluding 3D bone scan); 6 months of follow-up appointments; 5-year warranty* on dental implants; 5-year warranty* on titanium frame; 2-year warranty* on acrylic teeth.
*Warranty is subject to attending implant reviews, six-monthly check-ups and hygiene maintenance appointments.*Hospital and anaesthetist fees are not included and subject to individual circumstances and private health cover.
Two-stage treatment cost
- From $28,000 per arch
Two-stage treatment using All-On-4 or a similar implant system and a 100% acrylic bridge costs from $20,000 per arch initially, plus the cost of a second bridge after 3 to 6 months. This can bring the total cost of treatment to $28,000 or more in the short term.
Replacement bridge cost
- From $8,500 per arch
Your first set of All-On-4 teeth will usually need to be replaced after several months or several years, depending on the type of bridge placed by your dentist. A replacement bridge will cost from $8,500 for a titanium-reinforced acrylic bridge or from $9,000 for a longer-lasting zirconia bridge. Alternatively, for the ultimate option in aesthetics you may choose to go with a porcelain-layered bridge from $10,000.
Choosing a dentist who uses a single-stage approach will delay the need to replace your first bridge within the first 3 to 6 months after surgery.
Why choose us for All-On-4 dental implants in Perth?
Perth Dental Implant Centre is a dedicated surgical and dental implant clinic headed up by experienced implant surgeon, Dr David Norcross. We place genuine Nobel BioCare implants using the All-On-4 clinical protocol, and we will make sure you understand all of your options for restoring your smile.
All-On-4 Centre of Excellence
Perth Dental Implant Centre is one of the few dental implant clinics in Perth named an All-On-4 Centre of Excellence by Nobel BioCare. This recognises the skill and experience of our practitioners in providing a high standard of treatment using genuine All-On-4 implants.
Qualified and experienced dentist
Placing dental implants is a complex procedure that requires a skilled practitioner. Our head dentist in Perth, Dr David Norcross, has dedicated his career to restoring smiles using dental implants. Dr Norcross has completed a number of advanced courses in implant dentistry and the All-On-4 protocol specifically, so your treatment will be in safe hands. Dr Norcross’ qualifications and training include:
- Bachelor of Dental Surgery, University of Leeds, BchD (Leeds)
- Advanced Restorative Dentistry Course, North of England Academy
- Implant Dentistry Course, British Academy of Dental Implantology
- Master Clinician in Implant Dentistry Program, University of California Los Angeles (UCLA) and Global Institute for Dental Education (gIDE)
- Certificate of Residency, Cadaver Course | All-on-4® Surgical Protocol – From Standard to Zygoma Cases, MALO Clinic Education, Portugal
High quality implant bridges
The quality of full mouth dental bridges can vary by clinic depending on the expertise of the dental technicians and the systems they use. Our implant bridges are custom designed by experienced Perth dental technician Patrick Barrett-Lennard using advanced titanium milling technology. This allows us to place titanium-reinforced All-On-4 bridges within 3 to 5 days of implant surgery.
Book a consultation
If you’re considering All-On-4 dental implants to replace missing or badly damaged teeth, book a consultation with Dr Norcross at Perth Dental Implant Centre for personalised advice and an accurate quote. We have two convenient locations in Perth at Kelmscott and East Victoria Park.
Contact 1300 108 133 to book at our Kelmscott or East Vic Park clinic, so our friendly staff can arrange an initial appointment with Dr Norcross at a time that’s good for you. You can also contact Dr Norcross directly to find out more about your treatment options for restoring the appearance and function of your smile.
The total cost of All-On-4 treatment includes a number of fixed and variable expenses. This includes the cost of dental implants and replacement teeth (first and subsequent sets), implant surgery (digitally-guided or free-hand), diagnostic fees and other services or procedures that may be needed, such as sedation. There are also ongoing maintenance costs to consider, such as professional cleaning, bridge repairs and replacements when needed.
How often you need to replace your implant bridge depends on your oral hygiene, biting forces and your dentist’s approach to All-On-4 teeth.