What Is the All-on-Four Technique? Advantages and Costs

All-on-Four is an advanced approach for fully edentulous patients (or those requiring extractions), placing four implants per arch and delivering a same-day provisional fixed prosthesis. It often avoids major grafting even in posterior bone loss.

How It Is Performed

1. Planning: CBCT identifies optimal bone.
2. Surgery: Two anterior implants are placed upright (~90°) and two posterior implants at an angle (~45°) to bypass resorbed areas and increase contact.
3. Immediate Loading: A provisional fixed bridge is screwed in the same day in many cases.
4. Definitive Prosthesis: After 3–6 months of healing, the definitive hybrid or zirconia bridge is delivered.

Advantages

• Speed & Comfort: Leave with fixed teeth the day of surgery.
• Less Surgery: Minimizes need for sinus lift/large grafts.
• Lower Cost: Four implants instead of six to eight per arch.
• Function: No palatal coverage; better chewing and taste.

Cost Drivers

1. Implant brand
2. Surgical complexity
3. Provisional prosthesis
4. Final prosthesis material (hybrid vs. zirconia)

Overall, it is often a cost-effective full-arch solution with the comfort of a fixed restoration.