Losing most or all of your teeth can feel overwhelming, but modern dental technology offers solutions that may restore your smile in less time than you think. All-on-4 or All-on-X dental implants use four or more strategically placed implants to support a full arch of replacement teeth, giving you a complete smile that looks natural and functions like your own teeth.
We provide All-on-4 treatment at our Durham practice, helping patients regain confidence and improve their quality of life. Our approach focuses on delivering results you can count on with clear communication about what to expect throughout your treatment journey.
All-on-4 is a full arch restoration technique that replaces an entire upper or lower set of teeth using four dental implants. You may also see it referred to as All-on-X or AOX, as some (but not all) cases benefit from more than four implants. Unlike traditional dentures that rest on your gums, All-on-4 implants anchor directly into the bone of your upper or lower jaw, creating a stable foundation for your new teeth.
The implants are positioned at precise angles to maximize contact with your existing bone. The back implants are typically placed at a 30- to 45-degree angle, which allows us to avoid areas where bone loss commonly occurs and reduces the need for bone grafting procedures. This strategic placement is what makes the All-on-4 method different from other implant approaches.
Your new teeth attach to these implants through a custom-designed prosthetic arch. The prosthetic is engineered to distribute biting forces evenly across all the implants, which helps protect both the implants and your remaining bone structure. This design creates a restoration that can handle normal eating and speaking activities.
All-on-4 uses a time-tested protocol that strategically places four implants to support your full arch restoration. This established approach has been refined over decades, with two implants placed in the front of your jaw and two angled in the back to maximize contact with available bone and provide stable, reliable support.
The All-on-4 technique often allows treatment to proceed without extensive bone grafting procedures, even for patients with some bone loss. The strategic angled placement of the posterior implants takes advantage of your existing bone structure, potentially reducing treatment time and complexity while still delivering a secure, functional restoration.
Most patients receive a temporary set of teeth on the same day as their implant surgery, allowing you to leave with a functional smile immediately. This instant loading approach means you won't need to go without teeth during the healing process, letting you return to work and social activities with confidence while your implants integrate with your bone.
Dr. Long conducts a thorough examination using advanced 3D imaging to assess your bone density, oral health, and overall treatment needs. This detailed evaluation determines whether the All-on-4 protocol is appropriate for your specific anatomy and helps identify the optimal implant positions for your case.
Using digital technology, we create a detailed surgical plan that maps the exact placement of your four implants. Two implants will be positioned vertically in the front of your jaw, while two are angled strategically in the back to maximize bone contact and provide stable support for your full arch restoration.
During a single surgical appointment, any remaining teeth are removed and your four implants are placed according to the predetermined plan. The angled posterior implants allow us to avoid areas of bone loss and take advantage of your strongest available bone, creating a solid foundation for your new teeth.
In most cases, a temporary full arch of teeth is attached to your implants the same day as surgery. This provisional restoration allows you to leave our office with a functional smile while your implants heal and integrate with your bone over the following months.
After the healing period is complete, typically three to six months later, your permanent custom-crafted teeth are fabricated and attached. These final restorations are designed for optimal aesthetics, comfort, and long-term durability, giving you a beautiful, functional smile you can count on for years to come.
The All-on-4 protocol offers several advantages for patients who need full arch restoration. The treatment uses fewer implants than tooth by tooth replacement and splints the implants together, which allows us to immediately restore the patient’s function and esthetics. Many patients can go home with new teeth the same day as the surgery. Most appreciate this streamlined approach.
The strategic angling of the implants frequently eliminates the need for bone grafting, even in patients with moderate and even severe bone loss. This can reduce both treatment time and overall costs compared to procedures that require grafting before implant placement.
All-on-4 restorations are fixed in place, meaning you don’t remove them like traditional dentures. You can eat the foods you enjoy without worrying about slipping or adhesives. The stability of implant-supported teeth also helps preserve your facial structure by stimulating the jawbone, which may prevent the sunken appearance that sometimes develops with traditional dentures.
Your All-on-4 journey begins with a comprehensive evaluation. We assess your oral health, take detailed imaging of your jaws, and discuss your goals for treatment. This information helps us create a treatment plan tailored to your specific needs.
On the day of your procedure, we place the implants into the bone using advanced techniques and technology. If you have remaining teeth in the treatment area, we remove them during the same appointment. Most patients receive temporary teeth on the same day, allowing you to leave our office with a beautiful and functional smile.
The initial healing period typically lasts several months as your implants integrate with your jawbone through a natural process called osseointegration. During this time, you wear your temporary restoration, eat soft foods (think ground beef or crockpot meals) and follow our care instructions. Once healing is complete, we replace the temporary teeth with your permanent prosthetic, which is custom-crafted to match your desired appearance and function.
All-on-4 may be suitable if you’re missing most or all of your teeth in one or both arches, or if your remaining teeth are severely damaged and need extraction. The treatment works well for patients who want a fixed solution rather than removable dentures.
You don’t need perfect bone density to qualify for All-on-4. The angled implant placement technique often works for patients with moderate bone loss who might not be candidates for traditional implant approaches without grafting. However, certain health conditions can affect healing and implant success, so we carefully evaluate your medical history during your consultation.
Your commitment to the process matters. Successful All-on-4 treatment requires following post-operative care instructions, attending follow-up appointments, and maintaining good oral hygiene habits once your permanent teeth are in place.
All-on-4 implants require daily care similar to natural teeth, but with some specific considerations. You’ll brush your teeth twice daily and use special flossing tools and water flossers to clean around the implants and under the prosthetic. We provide detailed instructions on proper cleaning techniques during your treatment.
Regular dental visits are important for long-term success. We monitor your implants, check the prosthetic for wear, and perform professional cleanings to remove buildup that home care might miss. These appointments help us catch and address any concerns early.
Protecting your investment means avoiding habits that could damage your restoration. While All-on-4 teeth can handle normal chewing forces, extremely hard foods or using your teeth as tools can cause problems. We discuss specific recommendations based on your restoration design and lifestyle.
We understand that choosing full arch restoration is a significant decision. Our Durham practice focuses on helping patients achieve functional, confident smiles through proven implant techniques. We take time to answer your questions, explain your options, and ensure you understand what to expect before, during, and after treatment.
Dr. Long brings extensive training in implant dentistry to every procedure, using modern technology and techniques to deliver results. Our goal is to make your experience as comfortable and straightforward as possible while providing the personalized attention you deserve. Schedule your consultation today to learn whether All-on-4 is right for your needs.
Find answers to common questions about our practice and services
All-on-4 implants are permanently anchored in your jawbone, eliminating the slipping, clicking, and movement associated with traditional dentures. Unlike removable dentures that rest on your gums, All-on-4 provides a fixed solution that stays securely in place while you eat, speak, and smile. The implants also stimulate your jawbone like natural tooth roots, preventing the bone loss and facial changes that occur with conventional dentures. You’ll regain nearly full chewing power and won’t need adhesives or nightly removal.
With proper care and maintenance, All-on-4 implants can last for many years, often decades. The titanium implants themselves can integrate permanently with your jawbone, while the prosthetic teeth attached to them may need replacement or adjustment over time due to normal wear. Your commitment to daily oral hygiene and regular professional maintenance visits significantly impacts longevity. During your consultation, we discuss realistic expectations based on your specific health factors and lifestyle habits.
Most patients report that the All-on-4 procedure is less uncomfortable than they anticipated. We provide appropriate anesthesia and sedation options to keep you comfortable throughout the surgery. After the procedure, you may experience some swelling and discomfort, which is typically manageable with prescribed medications and ice packs. Many patients return to normal activities within a few days. We provide detailed post-operative instructions and remain available to address any concerns during your recovery period.
Yes, All-on-4 implants restore most of your natural chewing ability, allowing you to enjoy a varied diet. During the initial healing phase, you’ll need to follow a soft food diet while your implants integrate with your bone. Once healing is complete and your final restoration is placed, you can eat most foods confidently, including items that may have been difficult with traditional dentures. We recommend avoiding extremely hard foods like ice or hard candies to protect your restoration, but you’ll be able to enjoy steaks, fresh vegetables, and other nutritious foods.
Age alone doesn’t disqualify you from All-on-4 treatment. What matters more is your overall health and bone structure. Many patients in their 70s, 80s, and beyond successfully receive All-on-4 implants and enjoy improved quality of life. During your evaluation, we assess factors like bone density, healing capacity, and any medical conditions that might affect treatment success. As long as you’re healthy enough for a routine dental extraction, you may be a good candidate for All-on-4 regardless of your age.
The cost of All-on-4 treatment varies based on your specific needs, the materials selected for your final restoration, and any additional procedures required. While All-on-4 represents a significant investment, it often costs considerably less than placing individual implants for each missing tooth. We offer multiple financing options through Care Credit, Cherry, and Alpheon to make treatment accessible, with plans available for various credit situations. During your consultation, we provide a detailed treatment plan with transparent pricing and discuss payment options that work for your budget.
