The Science Behind All-on-4® Implants: Why They’re So Effective

If you need to replace all of your upper or lower teeth, or you want to upgrade dentures with a longer-term solution, All-on-4® dental implants are the industry-leading solution for full arch replacement. These implants are quick to place and designed to suit a wide range of patients, even those with smaller or less dense jawbones.

If you’re interested in All-on-4® for teeth replacement, learn more about how this treatment works and why All-on-4® dental implants are effective for people who may not be candidates for standard dental implants.

Talk to our experienced dentists in Perth, get in touch with Perth Dental Implant Centre today.

What is the All-on-4® concept?

The All-on-4® technique was developed in the late 1990s by Dr Paulo Malo in collaboration with Nobel Biocare. Their goal was to design an implant system capable of restoring a full arch of teeth in patients who had insufficient jawbone density for conventional dental implants.

The name All-on-4® refers to the use of four dental implants that are strategically placed to offer support for a full bridge of replacement teeth without the need for bone grafting. All-on-4® implant bridges use the latest techniques in prosthetic design to create natural-looking, long-lasting teeth.

The All-on-4® treatment protocol is recognised as the preferred method for full arch replacement, and is backed by a growing body of clinical studies showing its efficiency and long-term success.

How All-on-4® implants work

Like other dental implants, All-on-4® implants are surgically placed in the jaw to support a bridge of replacement teeth. However, there are some significant differences.

Distributing bite forces

Whereas standard dental implants support one or several teeth, All-on-4® implants are strategically placed in the jawbone to support a full arch of upper or lower teeth. Two implants are placed at the front of the mouth and two at the back, distributing bite forces evenly to achieve stability without the need for additional implants in most cases.

Angled implant placement

While conventional implants are placed vertically in the jaw, All-on-4® posterior (back) implants are angled at 45 degrees. This maximises contact with denser bone in the anterior (front) jaw, holding the implants firmly in place even if the jaw below is soft or deteriorated and avoiding the need for bone grafting in most cases.

Teeth within 24 hours

Traditionally, full mouth dental implant treatment involved two separate surgeries. During the first procedure, dental implants were placed and left to heal for several months while they fused with the jawbone. Throughout this healing period, patients typically wore a full denture.

Once the implants had integrated with the bone, a second surgery was required to expose the implants beneath the gums, attach the abutments, and take impressions for the fabrication of the final prosthetic teeth, which were later secured to the implants.

A major advantage of modern full mouth dental implant treatment using the All-on-4 approach is that replacement teeth are typically attached within 24 hours of surgery. At this stage, the jawbone remains rigid enough to support a fixed bridge on the implants.

Around seven days after implant placement, the bone begins to soften as part of the natural 3–6 month healing process. For this reason, temporary teeth are attached before this stage begins.

Another key advantage of the All-on-4 approach is that patients generally do not need to wear a removable temporary denture while their implants heal.

Why All-on-4® dental implants are effective

All-on-4® implants have been used successfully for more than 25 years, helping people of all ages to restore their smiles and avoid some of the possible risks involved with other implant systems and dentures.

Minimal surgical intervention

All-on-4® implants are placed in the jaw in a single surgery. All-on-4® reduces the need for additional procedures such as bone grafts or sinus lifts in most cases, which may be needed before conventional implants can be placed for people with poor jawbone quality.

High success rates

All-on-4® treatment is supported by decades of clinical research demonstrating its long-term success and patient satisfaction. A 10-year study found that All-on-4® implants in the lower jaw had a 98% success rate*, which is higher than the average for dental implants. The success of implant treatments also depends on them being provided by a suitably qualified and experienced dental surgeon.

*Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4® implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011 Mar;142(3):310-20. doi: 10.14219/jada.archive.2011.0170. PMID: 21357865.

Improved aesthetics and function

Replacement bridges are designed by a skilled dental technician to suit your individual facial proportions, made from high-quality and durable zirconia.

Once fitted, your new teeth will look and function as close to natural teeth as possible, allowing you to eat, speak and smile with more confidence than alternatives such as removable dentures.

Consider the cost

All-on-4® implants are a lifelong investment, and comparable to the cost of similar surgeries. The main difference being that Medicare won't cover dental expenses.

For more details about our All-on-4® solutions or to schedule an appointment with our team, call 1300 108 133.

Advantages of Full arch dental implants over conventional implants and dentures

All-on-4®’s innovative technique and protocol can make it an attractive solution over other implant systems or conventional dentures for people who have severely damaged or multiple missing teeth. Some of its benefits are:

• Eligibility: All-on-4® may be an option even if you have moderate to severe bone loss, without the need for bone grafting.
• Shorter treatment and recovery time: Your implant bridge is tried in within three days of All-on-4® surgery, and then fitted within five days of surgery.
• Permanent teeth replacement: All-on-4® bridges are fixed and non-removable, unlike conventional dentures.
• Long-term durability: All-on-4® implants are made from titanium and can last a lifetime. Implant bridges incorporating titanium can also last many years before they need to be replaced.

In complex cases, we use advanced full arch techniques to achieve a more predictable outcome. These may include placing additional implants, or longer implants known as pterygoid or zygomatic implants for increased stability.

Clinical evidence supporting an All-on-4® approach

All-on-4® implants have been subject to many clinical trials that consistently show their reliability and effectiveness in both the short and long term.

A study of 126 patients with All-on-4® implants found a 98.2% survival rate for implants and 94.4% survival rate for restorations after 1 year.*

A longer-term study found a 98% success rate for All-on-4® implants after 5 years and 95% success rate with up to 10 years of follow-up care, with restorations having a 99% success rate over the same period.**

All-on-4® implants are less prone to complications than other implant systems due to their simplified surgical process.

*Korsch, M., Walther, W., Hannig, M. et al. Evaluation of the surgical and prosthetic success of All-on-4® restorations: a retrospective cohort study of provisional vs. definitive immediate restorations. Int J Implant Dent 7, 48 (2021). https://doi.org/10.1186/s40729-021-00330-1

** Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4® implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011 Mar;142(3):310-20. doi: 10.14219/jada.archive.2011.0170. PMID: 21357865.

How much does All-on-4® cost?

The cost of All-on-4® treatment varies from case to case, but at Perth Dental Implant Centre, we have tailored three packages for immediate function, long-term function and complex cases. Prices start from $17,250 per arch.

Finance options

To help you manage treatment costs, we offer payment plans from trusted providers including Zip Money, Humm payments and Pretty Penny Finance.

Why choose us for full mouth dental implants (All-on-4®)?

If you’re considering full arch teeth replacement, our dentists are highly experienced in using the All-on-4® surgical protocol as well as advanced full arch techniques for complex cases.

We will discuss all of your treatment options for restoring your smile and tailor a plan to your individual needs, so you can make a fully informed decision about what’s right for you.

Our experience

Dr David Norcross has completed advanced training in the All-on-4 protocol at the Malo Clinic in Melbourne, Portugal and Brazil, including training in the use of longer pterygoid implants. Dr Norcross has provided successful All-on-4 treatments for patients with varying clinical needs at our Perth clinic and regularly trains and consults with other dentists requiring surgical assistance in complex full arch cases.

Dr David O’Dowling has focused exclusively on dental implants since 2020 and holds a Master of Science in Oral Implantology from Goethe Dental School in Frankfurt. He has experience in implant surgery and prosthetics across Ireland, Queensland and Perth, with a particular interest in full arch rehabilitation, digital workflows and advanced implant procedures. Dr O’Dowling also mentors dentists and regularly guest-speaks at industry events.

All-on-4® Centre of Excellence

Perth Dental Implant Centre is one of a handful of Australian dental clinic that’s recognised as an All-on-4® Centre of Excellence by Nobel Biocare. This demonstrates our team’s expertise and trust in providing full arch dental implant treating using the All-on-4® surgical approach.

Before and after videos

Check out our before and after patient stories to see how we have helped people restore their smiles.

Book a consultation for full arch dental implants (All-on-4®) in Perth

To speak to our dedicated treatment coordinator about All-on-4® dental implants or other options for full arch replacement, book a consultation in Applecross today. Call 1300 108 133.

References

1. Korsch, M., Walther, W., Hannig, M. et al. Evaluation of the surgical and prosthetic success of All-on-4 restorations: a retrospective cohort study of provisional vs. definitive immediate restorations. Int J Implant Dent 7, 48 (2021). https://doi.org/10.1186/s40729-021-00330-1
2. Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011 Mar;142(3):310-20. doi: 10.14219/jada.archive.2011.0170. PMID: 21357865.