What is All-on-4™ ?
Let’s dispense with the fancy words and terminology, it is now possible to insert a series of grade 4 or grade 5 titanium screws into the jawbone and have them bond with human bone. If this isn’t a miracle, I don’t know what is! Whatever terminology we assign to this treatment, be it “full mouth implants“, “full arch dental implants”, “All on 4”, or “All on 6”, the concept remains the same. A bridge of spectacular pearly whites is effectively anchored to these implants.
While the term “All-on-4™” was trademarked by Nobel Biocare, it’s essential to note that other reputable implant brands can equally champion this restorative concept. As a practitioner, my allegiance lies not with a particular brand, but with reliability and exceptional implant company support of the final result. Depending on patients’ individual needs, I select the appropriate design and brand of implants, providing them with a bigger range of implant brand options.
There are significant advantages to the newer techniques, which utilise 4-6 implants to replace all upper or lower teeth. Conventional full-arch dental implants often use 8 or more implants to replace a full arch of teeth, increasing the cost of treatment, and often requiring more invasive bone grafts and sinus lifts. The time spent on the treatment with conventional methods can be in the order of two years. Our expertise in All on Four and similar implant dentistry in Melbourne, Australia ensures lasting solutions for missing teeth, improving oral health and quality of life.
Modern techniques only require four implants, each arranged in a specific 45-degree manner so that the maxillary sinuses are often avoided, negating the need for sinus augmentation and bone regeneration to compensate for the lack of jawbone. Thus, reducing treatment time and cost.
All-on-4™ dental implants offer some distinct advantages over conventional implants:
- Only four implants are needed to support all upper or lower teeth
- Reduces the need for bone grafting to regenerate lost bone
- It’s a less invasive procedure
- Reduces healing and recovery time
- It’s a much quicker procedure
- Doesn’t require the same volume of bone if your teeth have been missing for a while
- You receive your new fixed teeth in as little as 24 hours after surgery
- Opens up the possibility of implants for previously unsuitable patients
- Great alternative for long-time denture wearers
BEFORE & AFTERS
MELBOURNE’S LEADING COSMETIC DENTAL CENTRE
Patient: Joanne
Condition: Joanne came in to see us for honest advice on what to do with her teeth. During COVID, a few of her teeth broke. She recalled that her teeth started deteriorating after her pregnancy, and she subsequently lost more teeth. She got by with dentures for some years but now was the time to so something as she is a business owner and couldn’t go around with lower teeth in such a condition. Joanne was on a mission to quit smoking, and with much needed support from her husband she embarked on the journey of full mouth dental implants.
Procedure: Six implants in the upper jaw and six in the lower jaw. Initially we made Joanne titanium reinforced acrylic teeth but following some further discussions, they were upgraded to zirconia bridges for strength, as Joanne grinds her teeth at night. She also wears a night guars (occlusal splint) to protect them.
Patient: Sotirios
Condition: Sotirios presented with multiple missing teeth in the upper jaw. He only had a few teeth remaining and wanted to replace them all with fixed implants, he knew his remaining teeth couldn’t be salvaged. A family friend had All-on-4 implant surgery a few years prior and mentioned how happy he was with the result. This was all the encouragement Sotirios needed, he was determined in proceeding with All-on-4 implants.
Procedure: Under General anaesthesia, Sotirios had his top teeth removed and replaced with 4 implants. They anchored well on the day so he was able to return the following day for his new but temporary upper bridge. The new teeth in 1 day made an enormous difference to his smile. Although he had to eat soft foods for five months until implants fully integrated, time passed very quickly, and Sotirios was now able to enjoy all sorts of food with his new upper titanium reinforced acrylic teeth. In the lower jaw, Sortirios decided to have his teeth whitened and have a partial removable denture.
Patient: Lan
Condition: Lan told us that she has been suffering from gum disease since she was 18. Her teeth were unstable and wobbly, and she noticed that they started to move forward in her mouth. She has lost a few teeth at a young age, and now wanted to improve their condition.
Procedure: After considering the option of maintaining some of the teeth and replacing others, versus replacing them all, Lan opted to replace all of the teeth with implants. Upper and lower immediate full arch All on 6 implants were done, which also required sinus lift grafting in the upper jaws. Even though Lan grinds her teeth at night, she decided to go for titanium reinforced acrylic teeth, and to wear a protective, grinding splint at night.
Google Reviews
Mark Norris2023-09-11Trustindex verifies that the original source of the review is Google. Dr Helen has always provided the highest quality dental care, coupled with her honesty and attention to detail I would highly recommend her to anyone requiring dental work A B2023-09-05Trustindex verifies that the original source of the review is Google. Dr Helen is lovely, professional and knowledgeable RK2023-08-28Trustindex verifies that the original source of the review is Google. A big thank you to Dr Helen and her team at Dr Helens Dental & Implant Studio for the great dental service provided involving my dental bone grafting and tooth implant. I'm very pleased with the whole process from the initial informative consultation to walking out with a naturally appearing tooth implant many months later. Dr Helen’s thoroughness and professionalism in her work ultimately resulted in a positive journey for me and I am recommending Dr Helens Dental & Implant Studio for anyone requiring dental services. Joanne Sinclair2023-08-24Trustindex verifies that the original source of the review is Google. MY IMPLANT JOURNEY I have decided to share my implant journey hoping to help others in the decision-making process on dental implants. We all have a different story but here is mine. I had tried to maintain my own teeth but was at a point where I had lost a few and had multiple that had been repaired. The day came when I was eating and heard the dreaded crunch!! A front visible tooth had broken and fell out. That sinking hollow feeling was instant. I decided to look into full mouth implants, but where do I start? Like most people Google. The gravity of this decision was overwhelming not only the financial but fear if not done right what then? All my teeth would have been removed. I needed to have confidence that I was going to have the best chance of a successful treatment. I decided for me a local dentist was the right choice. I felt I needed a personal approachable service. I came across Dr Helens website after looking into her training and experience I began reading her articles. It was evident to me that she cared for her patients and understood that everyone’s expectations and limitations were different. I booked a consultation to discuss my options and a treatment plan. Dr Helen was compassionate to my fear of the process and importantly listened to me explain the impact my tooth deterioration was having on my everyday life. After examination I was given treatment options. One key difference I noted was Dr Helens treatment plan included 2 sets of bridges. The 1st temporary bridges 3-5 days post-surgery, then 5 months later once my jaw had healed, I would receive another full set of bridges. Dr Helen was happy to discuss and answer any questions I had. I felt she understood the enormity of the decision and didn’t rush me in any way. The outcome of this initial consultation was: 1. Treatment options given 2. Advised scan was needed to address variables such as bone density. 3. Advised of possible complications and how these would be addressed. 4. Provided with estimation of costs and referral for scan. The procedure required a general anesthetic, fortunately this is done at Dr Helens practice. The anesthetist contacted me and provided all relevant information. On the day of surgery, it was reassuring to walk in and know my surroundings and everyone. It was the usual friendly greeting I had come to know from Dr Helen and her staff. Dr Helen made sure I was ok and again gave me the opportunity to ask any questions. I went home that night with medications and reassurance to contact the practice If I had any questions or concerns. Post surgery I was never in pain or discomfort. Five days later I returned to have my temporary bridges fitted. I now had a smile I had not had for many years. It affected everything. I was happy all the time. I had my confidence back. I think because my dental problems were a gradual decline, I knew it was impacting my wellbeing but had underestimated just how much. Five months later with my jaw healed and my implants fused it was time for my final bridges. 1st was a trial fitting giving Dr Helen and myself the opportunity to discuss and request any adjustments to the laboratory. Final fitting. My temporary bridges were removed, and the final bridges screwed in place. I didn’t think there could be much improvement. I was very happy with my temporary bridges however the fit was amazing. They feel like my natural teeth. Being at the end of this journey I now understand the importance of 2 sets of bridges. Yes, I was happy with my temporary bridges, but my final bridges fit and feel amazing. I have no hesitation in recommending Dr Helen for your dental needs. She is genuine, kind, compassionate, non-judgmental and very approachable. I feel I was given detailed honest information on available options for my dental needs and the opportunity to discuss and make informed decisions on my treatment. I am extremely grateful to Dr Helen. PL2023-08-20Trustindex verifies that the original source of the review is Google. I don't have a lot to add to the very positive reviews other than say my experience with Dr Helen has been excellent. This was for some complex work . The clinic is popular so an appt can take some time, though the staff have fitted me when an emergency occured. Irina Gavrish2023-08-07Trustindex verifies that the original source of the review is Google. I don't have the words to describe what a life changing experience having implants is. It's like being given a second chance in life. I lost all my teeth due to my fear of dentists. I would avoid going to a dentist until another tooth had to come out. Eventually I had almost none left. I tried to wear full dentures but I just couldn't eat with them as they rubbed and moved so much. I contemplated implants for so long but because of my fear, I just couldn't make the first step. When I met Dr Helen she put my mind at ease. She reassured me with honesty and explained what to expect. I felt comfortable and cared for. So I did go ahead with all on 4 implants. It wasn't easy but I don't regret my decision for a moment as I can now eat like I used to many years ago, and don't have to cover my mouth anymore. I can't say enough how well Dr Helen and her team looked after me. She is so approachable but professional. I had many questions and concerns and she made sure they were all attended too. She was available whenever I needed help, even after hours. I've been to many dentists in my life, and sadly I developed a phobia as a result, which was hard to shake, but this place is not like other dentists. Dr Helen really cares about her patients. You are not just a number. Unlike my previous experiences, she went well and truly out of her way to make sure I was comfortable. Her expertise and honesty paid off in the end as I followed her advice, and I couldn't be happier. I can't thank Dr Helen and her lovely team enough. My new smile has trully changed my life. Aurelija Navakas2023-07-26Trustindex verifies that the original source of the review is Google. I would highly recommend Dr. Helen for cosmetic dentistry. Dr. Helen is a talented dental specialist with a genuine concern for her patients. I had an open discussion with Dr. Helen regarding my treatment, she gave me honest answers about what can & can't be achieved with the goal of achieving the best outcome for her patients. Her workmanship not only achieved but exceeded my expectations. I always dreamt since I was a child to have a perfect smile; Thank you Dr. Helen for making my dreams come true! Danielle Goonetilleke2023-07-26Trustindex verifies that the original source of the review is Google. Really pleased with my first visit - all questions answered and super friendly. Thank you for your help.
What are Teeth in 3 days or Teeth in 1 day?
These are catchy terms that all mean the same thing. Basically, from the time your natural teeth are removed to the time when new temporary prosthetic teeth are attached to implants, is anywhere from one to three days. Depending on how quickly your dentist and technician can deliver them to you.
What are immediate full-mouth implants?
Besides a good marketing ploy, they’re the same as teeth in 1 day, the same as teeth in 3 days, or All-on-4™ dental implants, or any other term that’s commonly used to describe immediate full mouth dental implants. The difference is in the terminology and not the product.
Essentially, the difference between immediate and conventional implants is that immediate implants are inserted on the same day as teeth are removed. Whereas conventional restorative methods allow for considerable intervals between teeth removal, implant placement, and the final fixed teeth. Sometimes the difference can be up to a few years. That’s quite significant, and that’s why immediate full-mouth implants have gained popularity in recent years.
What Brand is Best for All-on-4™?
All on 4™ technique was initially pioneered by a Portuguese dentist by the name of Paulo Malo and the term All on 4™ was subsequently trademarked by a Swiss implant company called Nobel Biocare. Again, for complete transparency, I am not promoting any particular brand of implants here, my purpose is to shed some light on otherwise confusing language.
Nobel Biocare (All-on-4™) implants are great and there has been significant research published on the success of this concept. However, as mentioned earlier, any implant brand can be used, providing it satisfies the requirements of being a successful, well-researched implant that offers the flexibility and versatility of parts.
In Australia, the implant system has to be TGA (Therapeutic Goods Administration) approved and parts need to be freely available should the need for repairs or replacements arise. These days, there are many systems that meet these requirements. Such as Nobel Biocare, MIS, Biohorizon, Straumann, Neodent, TRI and many more. I tell my patients that Nobel Biocare was the original and is still a great choice but isn’t the only option anymore. So, if I were you, I wouldn’t get too bogged down with what system the surgeon uses, trust them to use the system he or she is comfortable with to achieve the best outcome for you.
What is All on 6?
The same as All-on-4™ but on six implants, simple. I could end it there but there is a bit more to it than that. Four implants are the absolute minimum to support a full arch implant restoration. However, if one implant fails, the whole structure comes crashing down like Humpty Dumpty off the brick wall. This is because three implants aren’t adequate to support a fixed implant bridge.
However, if you have six implants, and one or even two don’t integrate or perhaps they develop a problem down the track, your teeth restoration can still be adapted without too much trouble. More implants mean more support and more security for the long-term prognosis of your implants.
Are you suitable for All-on-4™?
If you’re a living, breathing person, who has lost all or most of your teeth to decay (caries) grinding (nocturnal bruxism), or your teeth are waving in the breeze due to periodontitis (gum disease), and you are fed up with failing, damaged, and missing teeth, you’re probably a candidate. Provided you are committed to turning over a new leaf and caring for your new implants daily at home.
- You are fed up with your dentures which rub your gums, cause discomfort, and move when you eat or speak
- Your teeth are failing due to significant wear, decay, or periodontitis, causing you significant pain and discomfort, affecting your confidence, how you look and your ability to eat
- You’ve been unable to replace your teeth due to conventional implant methods, insufficient bone or high-cost
Why are some people not suitable even for All-on-4™?
Even if you are sick of your teeth, and are ready to replace them, there are very important questions that need to be asked before considering this treatment:
Can your teeth be saved? If your dentist recommends a quicker, cheaper, and more effective treatment option for you, it’s in your best interest to listen. There is nothing better than your natural teeth. We understand that you might’ve lost all faith in them and they’ve given you trouble over the years, but if there is a good chance that we can save them, take that chance. We are happy to educate you and show you how to look after them and maintain them at home. Keeping your natural teeth is always a better option than replacing them.
Do you smoke? Smoking reduces blood oxygen supply and impairs healing, hence why people who smoke have lower success rates. Both in the initial phase of healing, as well as over the long term. We encourage our patients to quit smoking permanently. This increases your chances of a good outcome. Understandably this is easier said than done. However, we can discuss strategies to assist you and prescribe medications you can take to help you quit. If you’re not ready to quit, doesn’t necessarily mean that you can’t have implants, it just pays to be aware of reduced surgical and long-term success rates.
Is your diabetes uncontrolled? Uncontrolled diabetes can also impede healing and result in a higher risk of implant failure. Diabetes potentially renders people more susceptible to infections and vascular diseases. It’s not all doom and gloom, if you work with your medical practitioner to get your diabetes under control first, you would be perfectly suitable to have dental implants.
Do you have high blood pressure? Hypertension is one of the most common conditions in Western countries. With the help of healthy whole food plant-based nutrition, antihypertensive medications, and adrenaline-free local anaesthetics, blood pressure can be stabilised, ensuring that it’s safe for you to undergo implant surgery.
Are you under the age of 25? Some rare genetic conditions can result in young adults missing their natural teeth. You would need to wait until you’re over 25 to have all your teeth replaced with implants.
Do you have a systemic disease? Certain systemic conditions such as Leukaemia, radiotherapy, and chemotherapy can impede healing, so it’s not advisable to have oral surgery until you’ve recovered.
What if you have osteoporosis? This is one of the common questions that patients ask. Interestingly, jawbone isn’t as likely to succumb to osteoporosis as weight-bearing bone, so most people with osteoporosis can still undergo implant surgery. There is one caveat – you must not be taking medications that inhibit bone turnover. If you do, it is important to consult with your medical doctor to assess your suitability for implant surgery.
Are you taking medications for osteoporosis? Some medications such as bisphosphonates slow down bone healing and would require careful consideration before committing to implants.
Do you have periodontal disease? Advanced gum disease is one of the most common reasons people lose their teeth and require full mouth implants. Patients often get concerned that their new implants will also be affected by this condition. This is both true and false. In assessing your risk it’s important to understand that periodontal disease is not only treatable in the first place but it’s also preventable. Few people can believe this fact when they are facing the prospect of having to lose all their teeth. Nevertheless, this is true, and if your dentist treats it in time, coupled with meticulous home care, periodontitis can usually be treated.
Implants can develop a similar condition called peri-implantitis. Whereby bony support is similarly lost around your implants to what would happen to a natural tooth with gum disease (periodontitis). It’s still not well understood and thus has limited treatment options, although this area of science is evolving. Both the skill of the surgeon as well as meticulous home care of your implants can minimise the risk of this condition. In other words, with appropriate care, you would be a great candidate for implants.
Have you been told you don’t have enough bone even for All on 4? For some candidates who don’t have adequate bone and require sinus lifts and bone grafting to even place implants, full arch immediate implants aren’t the best approach. A delayed or staged approach is more appropriate, which means that you get the same result but over a longer period. Teeth are removed first, followed by bone grafting, which is followed by the placement of implants. With at least a few months between each stage, you can appreciate that this process would take longer than if bone grafting was not required. This is not a contraindication as such, just a variation to the immediate approach. If a dentist determines that there is not enough bone in your mouth to anchor implants. Bone grafting could be considered before implants are placed.
What is the process?
Ok, so to sum it up, here are the steps at our practice:
1
Consultation
We begin with an initial consultation to discuss your concerns and identify the time frame and treatment options. This is an extended consultation so you will have an opportunity to ask plenty of questions. Dr Helen will begin her investigative process by examining your mouth and assessing your current situation, overall health, and suitability for full mouth implants.
2
SUITABILITY SCAN
Proceed with a scan (Cone Beam CT) to assess the volume and density of your jawbone and suitability for full mouth implants
3
PLANNING
Arrange a series of appointments where we take photographs, 3-D scans and impressions of your mouth as well as the preparation of your immediate teeth
4
SURGERY
A qualified anaesthetist will administer general anaesthesia. You will have a relaxing day asleep while we work away removing your remaining teeth, inserting new implants, and taking measurements for your new teeth. The amazing thing about immediate implants is that this will all be done in one day while you are asleep.
5
NEW TEETH
Voila! You will go home overnight and return the following day for your new but temporary teeth. This is exciting! Very exciting for all of us. We attach an acrylic bridge to your new implants and now you can go home smiling.
6
Recovery
The mouth heals surprisingly quickly and provided you follow our instructions and take your medications, it usually happens uneventfully. We will give you clear instructions on what to do and not to do after your surgery as well as how to care for your new implants. It will take five to six months for your jawbone to grow around your implants, so particular care should be taken to eat soft foods and not apply undue pressure on them.
7
Suture (stitches) removal
You return in two weeks to have your sutures removed.
You will need to see us on a monthly bases for quick reviews to make sure the healing process is proceeding well
8
New bridge
In about five months, provided your implants have integrated with the jawbone, it’s time to make you a new, final bridge. Again, we’ll see you several times to take measurements and try your new teeth in to make sure they fit and suit your face and you are happy with them.
9
Maintenance and care
Please care for your implants and your new teeth like you would for your most precious possession and visit your friends at the dental office once every six months for check ups and cleans.
1
Consultation
We begin with an initial consultation to discuss your concerns and identify the time frame and treatment options. This is an extended consultation so you will have an opportunity to ask plenty of questions. Dr Helen will begin her investigative process by examining your mouth and assessing your current situation, overall health, and suitability for full mouth implants.
2
SUITABILITY SCAN
Proceed with a scan (Cone Beam CT) to assess the volume and density of your jawbone and suitability for full mouth implants.
3
Planning
Arrange a series of appointments where we take photographs, 3-D scans and impressions of your mouth as well as the preparation of your immediate teeth
4
Surgery
A qualified anaesthetist will administer general anaesthesia. You will have a relaxing day asleep while we work away removing your remaining teeth, inserting new implants, and taking measurements for your new teeth. The amazing thing about immediate implants is that this will all be done in one day while you are asleep.
5
New teeth
Voila! You will go home overnight and return the following day for your new but temporary teeth. This is exciting! Very exciting for all of us. We attach an acrylic bridge to your new implants and now you can go home smiling.
6
Recovery
The mouth heals surprisingly quickly and provided you follow our instructions and take your medications, it usually happens uneventfully. We will give you clear instructions on what to do and not to do after your surgery as well as how to care for your new implants. It will take five to six months for your jawbone to grow around your implants, so particular care should be taken to eat soft foods and not apply undue pressure on them.
7
Suture (stitches) removal
You return in two weeks to have your sutures removed.
You will need to see us on a monthly bases for quick reviews to make sure the healing process is proceeding well.
8
New bridge
In about five months, provided your implants have integrated with the jawbone, it’s time to make you a new, final bridge. Again, we’ll see you several times to take measurements and try your new teeth in to make sure they fit and suit your face and you are happy with them.
9
Maintenance and care
Please care for your implants and your new teeth like you would for your most precious possession and visit your friends at the dental office once every six months for check ups and cleans.
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Sharon’s journey at Dr Helen’s Dental & Implant Studio
How long before I can go back to work after implant surgery?
How does a dentist choose a dental implant?
I’ve been told I can’t have implants; is that true?
Will implants help me chew?
Pros and Cons of Dental Implants
Should I get cemented or screw-retained dental implants?
What does a dental implant feel like?
How do I maintain my implants following surgery?
Is everyone suitable to undergo implant surgery?
How much recovery time is required after implant surgery?
When should I consider dental implants?
What is the difference between implants and dentures?
Is it painful?
Surprisingly, pain is a rare complaint we get. Patients don’t usually call us at night in pain wondering how to fall asleep. So, what’s our secret? Medications! We are so spoilt with modern medicine. A combination of non-steroidal anti-inflammatories, short-term corticosteroids, and antibiotics work a treat. These medications keep people comfortable and sleeping well at night. They’re not so good that you would want to come back for more… but almost.
The most common demographic of people we see who require full mouth implants are people who have a dental phobia. They are often terrified to even sit in the dental chair at the beginning, but by the end of the process, they jokingly tell me that they’ve been cured of their fear. Really? Does surgery cure fear? Well, that’s what my patients tell me.
Is it painful?
Surprisingly, pain is a rare complaint we get. Patients don’t usually call us at night in pain wondering how to fall asleep. So, what’s our secret? Medications! We are so spoilt with modern medicine. A combination of non-steroidal anti-inflammatories, short-term corticosteroids, and antibiotics work a treat. These medications keep people comfortable and sleeping well at night. They’re not so good that you would want to come back for more… but almost.
The most common demographic of people we see who require full mouth implants are people who have a dental phobia. They are often terrified to even sit in the dental chair at the beginning, but by the end of the process, they jokingly tell me that they’ve been cured of their fear. Really? Does surgery cure fear? Well, that’s what my patients tell me.
Can anything go wrong
All-on-4™ implant surgery has a very high success rate. However, any surgical procedure carries risks and complications. Both the skill of the surgeon as well as meticulous home care (of your implants) can minimise the risk of this condition.
Minor and common postoperative complications include:
- Swelling, bleeding, slight pain, and bruising of the face – with the help of medications, people are often surprised by the minimal amount of discomfort they experience after surgery.
- Infection –would be very common if it wasn’t for the antibiotics we prescribe. They minimise the chance of any post-operative infections. However, with the emergence of superbugs, this complication remains a possibility and needs to be managed by your surgeon. You will also be advised to rinse your mouth with chlorhexidine mouth rinse for two weeks after surgery.
- In the upper jaw, unless you are having zygomatic implants, there aren’t any nerves in the vicinity so there is no risk of nerve damage). However, the sinuses, which are air-filled cavities in your face, are nearby. An implant can sometimes penetrate this sinus space. This often doesn’t cause any long-term complications but on a rare occasion can cause sinus infections, in which case a follow-up procedure might be required to alleviate this situation, or you might even be referred to an ENT specialist.
- Other less serious complications of the prosthesis, which are more like maintenance issues rather than complications can include fractures of the teeth and components, which are usually repaired or replaced.
More serious complications:
- Implants not integrating – upsetting to all of us, but it’s not the end of the world – your surgeon will have to decide whether to remove the implant and start again or if it can be saved. This complication can prolong the length of the treatment as well as possibly increase the cost.
- In the lower jaw, there is a nerve, namely the “Inferior Alveolar Nerve”, that’s responsible for supplying sensation to the lower lip, the chin, and the teeth. There is one on each side of the jaw. Occasionally through grafting or implant placement, this nerve is temporarily or permanently affected, resulting in altered sensation in the lip and chin on the corresponding side of the face. Often this sensation can resolve as the nerve heals but sometimes this sensation could persist.
- Delayed problems with implants can arise too, especially if you are a smoker or have uncontrolled diabetes or you’re on bisphosphonate drugs.
How should you choose a surgeon for full-mouth implants?
It’s really important to pick a skilled, experienced dentist but it’s also important that he or she is kind, compassionate, and cares about the outcome, because what better joy is there for a surgeon than to see new life injected into their patient? You want your surgeon to hold their breath when they are doing it. No matter how experienced, they need to be transparent, honest and be invested wholeheartedly. A recommendation from a friend is worth gold but if you don’t know anyone who’s had this done, perhaps meet a few surgeons to see how comfortable you feel with them. Your gut feeling will tell you who to go with.
Surgery is not a walk in the park. When you undergo surgery, please remember this. Hopefully, you will be one of 9 in 10 for whom it all goes well rather than 1 in 10 whose implants develop complications. It’s not all up to the surgeon but many factors are.
Cost of Full mouth/All-on-4™ Dental implants
The average price of full arch dental implants in Australia is $23,000 – $30,000 per arch.
You only get two chances in life when it comes to your teeth. The first set is the one that you were born with, which came for free, and the second set will be your last chance and it will cost you. A lot. Most likely you will not get a third chance. So full dentures might be the only option left. Implants are not easily replaceable, as they leave such a deficit when removed. So, it’s crucial to understand that your best chance is getting them done right the first time.
While all licensed dentists appear to have all the necessary qualifications, there are several factors to consider:
- Dentist’s level of education and experience in executing the procedure to a high degree of accuracy and precision, as well as in managing any complications that may arise.
- Durability of the materials used. High-quality craftsmanship and materials will ensure longevity and save you frustration and money in the long run. You know yourself “You get what you pay for”, and it’s no different with implants. Remember, most people will only get one chance when it comes to implants.
- Every person who is involved in the design, construction, and installation of your new teeth needs to be an expert. Experts constantly keep abreast of new research and technology. They have done the procedure many times and they know what’s involved and how much it costs to provide the service at a standard that keeps you happy and also offers you post-operative care in case of complications. After all, their reputation is at stake. Thus, they want to be fairly remunerated for their effort and will provide the service at a fee that reflects real costs.
How can you afford All-on-4™ dental implants?
- Pay in increments over the 6-month duration of the treatment
- You can take out a payment plan that’s specifically designed for medical treatments. This is good if you need dental implants now but happy to pay them off for 24 months. Whilst this option allows you to have the treatment that you need now, it will come with interest. I advise my patients to explore all options. Perhaps a bank can offer a better deal.
- You might be able to access a proportion of your superannuation on compassionate grounds. You would need to make an application with the ATO, and if you suffer from acute or chronic pain your GP or your dentist can help you through this process. You can learn more about this by heading to the ATO website https://bit.ly/3ahM5O3
What is the Success Rate of All-on-4?
You’ll often hear that All-on-4 dental implants have a 90–95% success rate over 10 years. That sounds impressive—and it’s not wrong—but let’s pause for a moment and ask: Success of what, exactly?
Is it the success of the implants integrating with the bone?
Is it the success of the implants still being in place years later?
Is it the success of the acrylic teeth not chipping or breaking?
Or is it the success of you still loving the look and feel of your smile ten years down the track?
The truth is, success means different things to different people. And those tidy statistics don’t always capture the whole picture.
In real life, success is multi-layered. Yes, most implants integrate well and last, especially when they’re placed properly and well cared for. But let’s be realistic: implants don’t succeed 100% of the time. Sometimes the body doesn’t take to them. Sometimes things shift. Sometimes lifestyle factors, general health, or even plain old bad luck get in the way.
If you want a simple answer: All-on-4 can be highly successful, but only when all the right pieces come together—good planning, surgical skill, healthy bone and gums, good hygiene, regular maintenance, and your commitment to looking after them.
And one more thing: Your natural teeth still have the best success rate of all. Implants are a brilliant solution when teeth can’t be saved, but they’re not a perfect swap. They’re prosthetics—sophisticated, life-changing, but still prosthetics.
The truth is: implants are predictable, durable, and often life-enhancing… but they’re not foolproof. If we work together—me doing the planning and the surgery, and you doing the maintenance—we give them the best chance to last.
What Is the Cost of Full Mouth Dental Implants?
Let’s not beat around the bush—full mouth dental implants are expensive. In Australia, the average price for full arch dental implants is between $25,000 and $30,000 per arch. It’s not a small number, and the temptation to seek cheaper options—locally or overseas—is common.
And sure, cheap can be good. A discounted apple at the supermarket might still be perfectly edible with a bruise cut off. A box of tissues on special? No worries. But teeth are not the place to cut corners.
Dental implants aren’t just about appearance—they restore function, health, and quality of life. But they also come with one shot at getting it right. Implants that fail due to poor planning, substandard materials, or rushed treatment can lead to serious long-term damage. Bone loss, poorly positioned implants, broken prosthetics—all of these are much harder (and far more expensive) to fix the second time around. In some cases, a second chance may not even be possible.
That’s why “cheap implants” can be far more costly in the long run.
Why Is It So Expensive?
High-quality full arch implants include more than just the surgery. The cost typically covers:
- Premium, TGA-approved implant systems
- Digital scanning and treatment planning
- Bone grafting or preparatory procedures, if needed
- Temporary and final teeth
- Post-op care and maintenance
This process is complex and usually staged over several months to ensure long-term stability and success.
Can You Find Cheaper Options?
Yes—but with cheaper options come compromises. Often, it’s the materials, the planning process, or the level of care that’s reduced. In some overseas clinics, treatment is rushed to fit a holiday schedule, with little thought given to long-term outcomes or aftercare once the patient returns home. If problems arise, support may be limited or non-existent.
Teeth are not like supermarket items—they’re essential tools for everyday life. Full mouth dental implants are a once-in-a-lifetime procedure for many patients, and getting it right matters. When done properly, they can restore comfort, confidence, and function for years to come.
Good dental advice is always worth seeking. And while implants are never cheap, they should always be done safely, thoughtfully, and with your future in mind.
What is the Warranty on All-on-4?
It’s a common question. All-on-4 dental implants are a big investment, both financially and emotionally. And because they’re not cheap, it’s only natural to ask: Are they guaranteed?
We’ve been conditioned to think that if something costs a lot, it should last forever. And in many ways, dental implants are an incredible leap forward in medical technology. Every time I place them, I’m still amazed that we have the ability to give people fixed teeth that feel and function almost like their own. We haven’t quite mastered bionic arms and legs yet—but teeth? We are close.
Now, about that guarantee.
Here’s the honest truth: No one can guarantee dental implants in the same way that no one can guarantee the outcome of any medical procedure. We often tell my patients, “We can guarantee that we will plan your treatment with care, perform it with precision, and do everything to help it succeed. But you have to guarantee that you’ll care for them like they are your own.”
The success of All-on-4 depends on more than just surgical skill or fancy materials. It relies on:
- The right treatment plan
- The health of the person receiving it
- Good maintenance at home
- Regular check-ups
- And yes, a little bit of luck too
If you’re after a number or policy, yes—we do offer a limited warranty, provided you attend your review appointments and follow our care instructions. But more importantly, we work closely with you to make sure you understand what’s involved—so we build something that not only lasts, but also works beautifully for your lifestyle.
Here’s a quote worth saving as your wallpaper:
“Success is determined by correct treatment planning, skill of the surgeon, health of the candidate, good home maintenance, and chance.”
If we can tick most of those boxes, we’re in a very good place.
Is It Worth Upgrading to a Zirconia Bridge?
All-on-4 dental zirconia bridge can offer significant benefits in terms of strength, aesthetics, and long-term value.
- Unmatched Strength & Durability
Zirconia is one of the strongest materials used in dentistry, making it highly resistant to chipping, cracking, and wear—far superior to traditional acrylic or composite bridges. - Superior Aesthetics & Natural Appearance
Zirconia bridges provide a more lifelike, natural-looking smile, mimicking real teeth better than acrylic options. The material also offers improved translucency and shading, making it an ideal choice. - Stain & Odour Resistance
Unlike acrylic, zirconia is stain and odour-resistant, meaning your All-on-4 dental implants will stay whiter for longer. - Long-Term Investment
While zirconia All-on-4 bridges may have a higher initial cost, they require less maintenance and are longer-lasting, making them a cost-effective choice in the long run.
Who Should Consider Upgrading to a Zirconia All-on-4 Bridge?
- Patients currently wearing an acrylic All-on-4 bridgeare experiencing chipping
- Those looking for a more natural and aesthetically pleasing smile.
- Individuals who want a long-lasting, durable solutionfor their All-on-4 dental implants.
What are the disadvantages?
– A zirconia bridge is a more costly upgrade. It will set you back approximately $1500 – $3000 per arch
– It is not repairable if it breaks, and the zirconia part of the bridge needs to be replaced completely, which costs more than acrylic repairs
– Zirconia bridges make a louder sound when you eat
What Will My Teeth Look Like with All-on-4?
With All-on-4 dental implants, you have control over your final smile. These teeth are custom-made to suit your preferences, so bringing photos of smiles you like can help guide the process.
Temporary Teeth After All-on-4 Surgery
Immediately after your All-on-4 implant surgery, you will receive temporary teeth, which you’ll wear for three to five months while your implants heal. These temporary teeth serve an important function, but may not look exactly as you envisioned. This is because there is some guesswork involved in their design.
However, they act as a trial run for your final teeth, allowing you to work with your dentist to refine the shape, colour, and fit before your permanent set is made.
Your Final All-on-4 Teeth
Your permanent teeth will be more natural-looking in both shape and colour, designed to closely match your ideal smile. Before they are manufactured, you will go through one or multiple trials to ensure they meet your expectations.
Be sure to provide clear feedback during this phase—your dentist will guide you on what’s possible to achieve your best smile with All-on-4 implants.
What is a 3D Mockup for All-on-4?
A 3D mockup is a digital preview of your future All-on-4 smile, created using advanced imaging technology. This allows you to visualise your results before they are made and provide feedback to ensure they align with your expectations.
However, it’s important to remember that a digital mockup is a guide. The way it appears on-screen may look different once translated into your mouth, as real-life factors like lighting, facial structure, and proportions can affect the final outcome.
Can All-on-4 Bridges Break?
Yes, All-on-4 bridges, particularly the temporary acrylic prosthesis, can sometimes break. However, this is a known and manageable complication.
Why Do Temporary All-on-4 Bridges Break?
Temporary acrylic prostheses are made from softer materials than permanent options like zirconia or porcelain-fused-to-metal. Breakage is more likely due to:
- Bruxism (teeth grinding or clenching) can lead to fractures and even implant failure.
- High occlusal (bite) forces, as a misaligned bite, can put uneven pressure on the prosthesis.
- Inadequate lab work can result in structural weaknesses.
- Dietary habits, since hard or chewy foods, can increase the risk of damage.
How to Prevent All-on-4 Bridge Breakage
- Follow a soft food diet during the healing phase to protect the temporary prosthesis.
- Wear an occlusal splint (night guard) if your dentist tells you that you grind or clench your teeth at night
Do Permanent All-on-4 Bridges Break?
While zirconia or porcelain-fused-to-metal bridges are much more durable than acrylic, excessive biting forces, accidents, or misalignment can still cause fractures.
If you experience any issues with your All-on-4 bridge, consult your dentist, as early breakage can be a warning sign of excessive bite force that may need correction.
Can All-on-4 Still Be Maintained if I Move Overseas?
Yes, All-on-4 implants can still be maintained if you move overseas. While different countries may have variations in implant brands and availability, skilled implant dentists can generally provide ongoing care and support.
Compatibility and Availability of Parts
Many implant systems, even those from international manufacturers, share standard sizes and connections. This means that a qualified implant dentist in your new country may be able to find compatible components if needed. However, if your implants are from a specific brand that is not widely available in your new location, it’s a good idea to check with the manufacturer or distributor before moving. If necessary, purchasing extra components, such as screws, from your local supplier can help prevent future issues.
Emergency Repairs
If you experience a problem, such as a broken acrylic bridge, many implant specialists and prosthodontists can still assist with repairs, regardless of the implant brand. Acrylic bridges can typically be repaired or replaced without needing the original implant components.
Ongoing Maintenance and Follow-Up Care
Routine check-ups, cleanings, and minor adjustments can be performed by most implant specialists. To ensure continuity of care, consider bringing a copy of your treatment records, including details about the implant brand, model, and any specific instructions from your current dentist. This information will help your new provider maintain your All-on-4 implants effectively.
Finding an Implant Specialist in Your New Country
Once you’ve relocated, finding an experienced implant dentist or prosthodontist is key. Sharing all relevant details about your All-on-4 treatment will help them provide the best possible care.
While having original parts on hand can be helpful, a skilled implant dentist should still be able to maintain and support your All-on-4 implants, ensuring their long-term success even after you move.
Are Zirconia Bridges Too Heavy for All-on-4 Implants?
A zirconia bridge is generally not too heavy for four upper implants, but several factors determine whether it is the right choice for you.
Key Factors to Consider:
- Implant positioning – The implants must be placed correctly to evenly distribute the bite force.
- Implant quality and strength – High-quality implants are designed to handle the load of a zirconia bridge.
- Bone density and volume – Strong and sufficient bone support is crucial for long-term stability.
- Bridge design – The size, length, and overall design of the bridge can influence the pressure on the implants.
Zirconia is heavier than acrylic or titanium-based alternatives, but it is also highly durable and resistant to wear. When implants are properly placed and the bone is healthy, a zirconia bridge should not be too heavy for an All-on-4 restoration.
Zirconia implant bridges are increasingly being used for full-arch restorations, especially in the upper jaw. While they are heavier than acrylic bridges with titanium frameworks, their strength and longevity make them a popular choice.
Can You Switch to a Removable Denture After Having Temporary All-on-4 Bridges?
In the All-on-4 implant system, the protruding parts known as multiunit abutments extend from the gums, which prevent the use of removable dentures. These abutments make it impractical to transition to a removable denture after having temporary All-on-4 bridges. Therefore, it is generally more logical and beneficial to keep the fixed temporary prosthesis in place rather than opting for a removable denture.
That being said, it is technically possible to switch to regular dentures after All-on-4 implants, but this may not provide the same level of comfort and stability you had with the All-on-4 system. Multiunit abutments can be removed, and in some instances, the implants can be buried under the gums. Then, a denture can be worn. In other cases, multiunit abutments can be replaced with abutments suitable for removable implant-retained dentures. This option can be just as comfortable as a fixed prosthesis, but there will be greater costs associated with this change.
Do All-on-4 Implants Clack When Speaking or Eating?
The clacking sound that some patients experience with All-on-4 implants is often due to both arches being made from zirconia. When the zirconia arches meet, they can create a distinct noise.
One solution is to make one arch from zirconia and the other from a different material, such as acrylic, which can help reduce clacking. Another option is where a metal frame is used with projections where each tooth sits, and individual crowns are made for each tooth. This design can help dissipate the noise and offers the added benefit of being repairable in the future if a tooth chips or breaks. However, these alternatives generally involve remaking one or both arches and can be very expensive.
Is Acrylic or Zirconia Best for All-on-4?
The choice between acrylic and zirconia for All-on-4 implants depends on several factors, including your specific needs and lifestyle. Both materials have their pros and cons:
Acrylic:
- Cost-Effective: Acrylic is generally more affordable than zirconia.
- Gentle on Opposing Teeth: If you have natural teeth, acrylic may be kinder to them, especially if you grind your teeth.
- Wear and Tear: Acrylic wears down over time, and while it may look good initially, it may need to be replaced or upgraded in the future. Acrylic alone is not strong enough for long-term use, so it typically needs a titanium frame for added durability.
- Breakage: Acrylic can break or wear down more easily, particularly for those who grind their teeth. It may need repairs or replacements more frequently.
- Repair: Acrylic can be repaired cost-effectively if it breaks
Zirconia:
- Durability: Zirconia is a stronger, more durable material that resists wear and tear better than acrylic. It is highly resistant to fractures and is considered more long- lasting.
- Aesthetic: Zirconia offers superior aesthetics and is more tooth-like in appearance. It is highly polished, which helps reduce plaque build-up.
- Heavier: Zirconia is heavier than acrylic, and some patients may notice the difference in weight, though most don’t find it bothersome.
- Cost: Zirconia is more expensive than acrylic, so budget is a consideration.
- Repair: Zirconia part of the bridge needs to be completely replaced if it breaks, as zirconia cannot be repaired like acrylic
Ultimately, zirconia is often the better choice for strength and aesthetics, but it may not always be the best option for everyone. For example, if you grind your teeth, zirconia is more suitable, especially for upper arches. However, if you have natural teeth or dentures opposing your All-on-4 implants, acrylic may be a more appropriate choice.
Patient-Specific Factors to Consider:
- Opposing Teeth: Are your opposing teeth natural, dentures, or crowns? This can affect your choice of material.
- Teeth Grinding: If you are a teeth grinder, zirconia is typically the better option.
- Budget: Zirconia is more expensive, so your budget may influence the decision.
- Age and Bone Health: These factors may also affect the best material for your case.
- Implant Placement: The placement and spread of implants are important considerations.
There is no one-size-fits-all solution. Your dentist will help you determine which material is best for you based on your individual needs and circumstances.
Will I still have enough bone for All-on-4 implants if my teeth have been missing for years?
The short answer is: in many cases, yes! Even if your teeth have been missing for years, you might still be a good candidate for All-on-4 dental implants.
To be more specific to your individual situation, a 3D CBCT scan will help us see the full picture: the height, width, and density of your jawbone.
Now, if there’s not quite enough bone or the bone isn’t ideal, don’t stress. There are options! Sometimes, an extra implant can be added for better support, or we can perform targeted bone grafting if needed.
Of course, your overall health matters too. Things like smoking, uncontrolled diabetes, or certain medications can affect healing and implant success, so a full medical history is part of the planning process.
Even if it’s been years since you’ve had teeth, don’t rule yourself out. With the right planning, you might still be a good candidate for implants.
What type of bridge is best for All-on-4 dental implants?
When it comes to the final teeth on your All-on-4 dental implants, there’s no one-size-fits-all answer.
Most All-on-4 bridges fall into two main categories: PMMA (a type of durable acrylic) and zirconia. Each has its own pros and cons, and the right one for you depends on a few factors like bone structure, implant position, bite force, and aesthetic goals.
PMMA (with a metal frame)
This is often used as the first long-term bridge after your surgery. It’s lightweight, more affordable, and provides good aesthetics. When reinforced with a titanium bar, it offers solid strength and is gentle on the implants. The catch? It can break and wear over time, so you may need to repair or replace or refresh it after a few years.
Zirconia
This is the tough stuff. Zirconia bridges are extremely strong, look beautiful, and last longer than acrylic. They’re also more resistant to chips or stains. However, they can feel a bit “hard” when biting—some people describe a “clink” when upper and lower zirconia arches meet. Because of that, it’s common to have zirconia on top and a softer PMMA bridge on the bottom to balance things out.
Now here’s the thing: All-on-4 is a treatment protocol, originally designed with acrylic hybrid bridges,not full zirconia. That’s because zirconia, while strong, is heavier and can put more pressure on the implants over time. So while it can be used, it needs to be done carefully and with the right planning.
At the end of the day, the best bridge for you depends on your individual anatomy, implant placement, bite, and budget.
Do you need a gap between the bridge and the gums for cleaning?
A small gap between your All-on-4 bridge and your gums is actually a good thing. It’s not just about comfort—it’s all about keeping your implants clean and healthy.
When your final All-on-4 bridge is designed, it should have a convex or flat surface that gently sits against the gums. This design mimics the natural contours of your mouth and makes it easier to keep clean. While the bridge usually fits snugly, there’s often a tiny gap underneath—just enough to allow cleaning with floss.
Just like natural teeth, dental implants need daily plaque removal to stay healthy. If bacteria are left to build up around the implants, they can cause inflammation in the gums and bone—a condition called peri-implantitis, which can lead to implant failure if left untreated.
Can a gummy smile be corrected with All-on-4 surgery?
Yes. A big part of the All-on-4 procedure involves designing a smile that looks natural. One step we often take during surgery is removing a few millimetres of bone from the front of the jaw. This isn’t just for implant placement—it also helps hide what’s called the “transition line” (where the bridge meets your gums). By adjusting this line higher up, we can dramatically reduce how much gum shows when you smile, creating a more balanced and aesthetic result.
Now, if your natural teeth are still in good shape and don’t need to be removed, there are less invasive options to fix a gummy smile, like gingivectomy (shaving the gum line). But if you’re already heading toward full-mouth implants, All-on-4 can absolutely help improve your gum-to-teeth ratio as part of the overall treatment plan.
Does All-on-4 require sinus lifts?
In most cases, no, All-on-4 dental implants do not require sinus lifts.
One of the big advantages of the All-on-4 method is that it was specifically designed to avoid extra surgeries like bone grafts and sinus lifts. This is possible thanks to the angled placement of the back implants to avoid the sinus area altogether.
That said, everyone’s anatomy is different. If there has been severe bone loss in the upper jaw or the sinuses have expanded significantly (which happens naturally over time when teeth are missing), a sinus lift might still be needed.
In very advanced cases, zygomatic implants (which anchor into the cheekbone) can be used instead of sinus lifts. These are longer implants that bypass the upper jaw entirely and are a great option for people with extreme bone loss.
Bottom line: All-on-4 is often a “graftless” solution—that’s part of what makes it so appealing. But to know for sure what’s right for you, your dentist will need to make an assessment with a 3D CBCT scan.
Will Medicare pay for All-on-4 dental implants?
Unfortunately, Medicare does not cover All-on-4 dental implants—or any kind of dental implant treatment, for that matter.
This is because dental implants, including the All-on-4 procedure, are generally considered elective surgery by Medicare. So if you’re planning for this type of full-mouth restoration, it’s best to assume you’ll be paying out-of-pocket or exploring other financing options..
If you’re looking into ways to manage the cost, many dental practices (like ours) offer payment plans, early release of superannuation options, or work with third-party financing to help make treatment more accessible.
If my implants are rejected the first time, will they be successful the second time?
In most cases, yes—implants can still be successful the second time around.
While no treatment is ever 100% guaranteed, redoing dental implants, especially after an initial failure, often has a higher chance of success, particularly when done under the right conditions. Here’s why:
When implants are placed during the initial All-on-4 surgery, it’s often done right after teeth are extracted, which means the bone may still be healing and vulnerable to bacteria. If an implant fails and needs to be replaced later, that area is usually fully healed, making it easier to control infection and providing stronger, more stable bone to work with.
Factors like autoimmune conditions, certain medications, or rushed timelines (e.g., immediate loading) can increase the risk of failure. That’s why it’s important to work with a team that can carefully assess your health and create a personalised treatment plan—sometimes with extra healing time or a greater number of implants for added support.
What’s the difference between “All-on-4” and “3-on-6” dental implants—and which is better?
The choice between All-on-4 and 3-on-6 dental implants depends on your individual needs, anatomy, and long-term goals. Neither option is universally “better”—it’s about what’s most appropriate for your situation.
Here’s how they differ:
- All-on-4 involves placing four dental implants per arch, supporting a single full-arch bridge. It replaces both teeth and gum tissue, making it ideal for patients with significant bone and gum loss. This design also provides cross-arch stabilisation, meaning the implants work together to balance biting forces across your mouth. This is why All-on-4 often allows for immediate loading—attaching the teeth on the same day as implant placement.
- 3-on-6, by contrast, uses six implants to support three separate bridges. It replaces only the teeth, not the gums, so it works best if you’ve maintained enough healthy bone and soft tissue. However, 3-on-6 lacks the stabilising effect of a full-arch bridge and may require additional bone grafting procedures to support the extra implants.
Key things to consider:
- Aesthetics – If you’ve lost significant gum tissue, All-on-4 can provide a more natural look by replacing both teeth and gums.
- Bone structure – 3-on-6 requires good bone volume and may not be suitable if you’ve had bone loss.
- Hygiene & maintenance – Each design has unique cleaning needs. Ask your dental specialist what kind of follow-up care will work best for you.
- Budget & procedure time – All-on-4 is typically more cost-effective and predictable, especially for full-arch restoration.
What’s the difference between acrylic and ceramic (zirconia) All-on-4 implants?
When we talk about acrylic vs ceramic All-on-4, we’re referring to the prosthetic teeth. It’s important to note that the actual dental implants (the titanium screws placed in the jaw) are the same in both options. The difference lies in the material used for the visible teeth (the bridge).
Acrylic All-on-4 restorations
- Typically made from acrylic teeth over a metal (usually titanium) framework
- Lower cost option and often used for temporary restorations
- Can be used permanently, but they are more prone to wear, breakage, and discolouration over time
- May need to be replaced or repaired every 5–7 years
- Easier and quicker to repair
- More forgiving on the opposing teeth (less wear)
Ceramic/Zirconia All-on-4 restorations
- Made from solid zirconia or zirconia fused to a titanium or metal base
- Stronger, more durable, and far more resistant to chipping or discolouration
- Can last 10+ years with proper care and maintenance
- Offers the best aesthetic results—looks more natural and retains shine
- Higher upfront cost, but less long-term maintenance
What happens if my All-on-4 prosthesis breaks?
If your All-on-4 prosthesis breaks, don’t panic—but do act quickly. While implant-supported bridges are designed to be strong and long-lasting, wear and tear or sudden impact can cause damage over time. The break may be limited to the prosthesis (the teeth and bridge), or it may involve the underlying implants, which is more serious.
Contact your dentist as soon as possible. Ignoring a broken prosthesis could lead to more complications, including damage to the implants themselves. A prompt assessment can prevent further issues.
What are the possible causes?
- Material fatigue or wear over time (common with acrylic bridges)
- Heavy biting or grinding habits
- Poor bite alignment or occlusion issues
- Trauma or chewing on something too hard
Understanding why the prosthesis broke is just as important as fixing it. If you’re not already using a night guard, your dentist may recommend one to protect the new set.
What’s the solution?
- If the implants are still intact, only the bridge (prosthesis) will need to be replaced—this is the most common scenario.
- If there’s any sign of implant damage, additional treatment might be required
Will it cost the same as the original treatment?
Not likely. Since the implants are already in place, replacing just the prosthesis is usually less expensive than your initial All-on-4 procedure. However, pricing depends on the material you choose and the complexity of the repair
Will All-on-4 Change Your Facial Structure?
While All-on-4 dental implants can lead to some facial changes, they are generally subtle rather than dramatic. This can be both good and bad—if you’re hoping for a major transformation in your facial appearance, you may be disappointed. However, the treatment can still provide meaningful improvements by restoring lost support to the facial muscles and lips.
When natural teeth are removed, bone loss and changes in facial muscle support naturally occur over time. All-on-4 implants help counteract these effects by providing a stable foundation for a full-arch prosthesis (teeth). Once your implant-supported teeth are in place, they can correct a collapsed bite, increase vertical dimension, and help restore a more youthful facial profile.
The position of your new teeth—especially the front teeth—also affects the fullness and position of your lips. This is why it’s important to spend time with your dentist designing the prosthesis. A few millimetres of adjustment forward or backward can make a noticeable difference in lip support and overall facial harmony. If further enhancement is desired, small aesthetic refinements—such as dermal fillers—can be used to complement the results.
In summary, while All-on-4 implants won’t dramatically change your face, they can improve facial support, enhance lip position, and help you achieve a healthy, rejuvenated appearance.
Should you consider a periodontist or maxillofacial surgeon to do your All on 4?
When considering All-on-4 dental implants, choosing the right provider is one of the most important decisions you’ll make. While periodontists and maxillofacial surgeons have specialist training in gum and jaw surgery, experience with the All-on-4 technique is often more important than a specific title. In many cases, an experienced dentist who specialises in placing and restoring dental implants may be the best choice.
Dentists with extensive experience with dental implants focus not only on the surgical placement of implants but also on designing and fitting your prosthetic teeth, ensuring the final result is both functional and aesthetically natural. Their blend of surgical skill and artistic precision can have a significant impact on your overall outcome.
When choosing your provider, it’s important to look beyond titles and focus on experience, patient results, and long-term success. Ask for before-and-after photos, patient testimonials, and examples of cases that have been in function for several years. A consultation is also key—it’s your opportunity to ask questions, share your concerns, and make sure you feel confident and supported throughout your journey.
In short, no matter what practitioner you choose, the best provider is one who has the experience, skill, and artistic eye to deliver a smile that looks and feels like your own.
What's the best material available now for All-on-4s? Is there continuing research and development into newer materials?
There’s no one-size-fits-all answer to this question—the best material for All-on-4 dental implants depends entirely on your individual needs, anatomy, and lifestyle. Each material option has its own pros and cons, and the right choice is best made in consultation with a trusted implant dentist who can evaluate your specific case.
Implant Materials: Titanium vs Ceramic
When it comes to the implants themselves (the part placed into the jawbone), the two main materials are titanium and ceramic (zirconia):
- Titanium implants have been used successfully for over 40 years and are the gold standard due to their high success rate, strength, and biocompatibility. Most patients, including many dentists themselves, have titanium implants with no issues.
- Ceramic implants are newer, less commonly used, and often chosen for aesthetic reasons or by patients with metal allergies. However, they are more likely to fracture, have more limited clinical applications and are typically more expensive.
Restoration Materials: PMMA, Zirconia, Hybrids & More
Once the implants are placed, the restoration (your new set of teeth) can be made from a variety of materials:
- PMMA (Acrylic) – Often used for temporary teeth or “Teeth-in-a-Day.” Lightweight and cost-effective, but not long-lasting.
- Solid Zirconia – Extremely strong and durable, resistant to stains and wear. However, it’s heavy, brittle if impacted, and impossible to repair if damaged.
- Titanium-Acrylic Hybrid – Combines a titanium bar with acrylic teeth. Easier and cheaper to repair, with a softer bite feel, but the acrylic wears down faster.
Research is Ongoing
Dental technology is evolving rapidly. New materials and techniques are constantly being developed to improve strength, aesthetics, reparability, and patient comfort. However, many of the newer options may not yet have long-term data to support their durability, so it’s crucial to balance innovation with proven reliability.
How to Decide?
Rather than focus solely on the material, focus on choosing an experienced implant dentist and a skilled dental lab. The right professional will guide you through the pros and cons of each material, based on:
- Your bone structure and bite
- Whether you grind your teeth
- The amount of space available in your mouth
- Your aesthetic goals
- Your budget
Often, you’ll begin with a temporary prosthesis while the implants heal, so you’ll have time to finalise the best long-term material later.
In short: There’s no “best” material for everyone, but there is a best material for you. Trust your dentist to help you make an informed choice that balances durability, comfort, aesthetics, and cost.
Can you go from implants to dentures to fixed All-on-4?
Yes, it is possible to transition from implant-retained dentures (such as overdentures) to a fixed All-on-4 dental implant solution, but there are some important factors to consider.
Most overdentures are supported by implants placed near the front of the jaw, which is ideal for removable dentures but not always suitable for a permanent All-on-4 bridge. The All-on-4 technique typically requires strategic placement of four implants, including two positioned further back in the mouth and angled to maximise bone support and stability. This often means that additional implants may need to be placed, especially if you only have two implants currently supporting a lower denture.
Another critical factor is the transition line—the point where the prosthetic meets your natural gum tissue. In All-on-4 treatment, this line must be carefully designed and ideally hidden under your upper lip for a natural appearance. Overdentures use a flange to conceal this, but fixed bridges do not. If your existing implants weren’t placed with this consideration in mind (or if they’re too shallow or in the wrong position), they may not be suitable for a permanent bridge. In some cases, existing implants may need to be removed and replaced.
To determine if you’re a candidate for conversion, your implant dentist will typically recommend a 3D CT scan to assess bone density, implant position, and whether additional surgical planning is needed.
How to stop food from getting under your prosthetic teeth?
How do I stop food from getting under my prosthetic teeth?
It’s a common concern among patients with All-on-4 or other implant-supported teeth: food getting trapped under the prosthesis. While a small amount of food debris can be normal, excessive food collection is often a sign of an issue with the fit or contour of the prosthesis—and there are ways to address it.
Why Does This Happen?
When teeth are first removed and implants placed, a temporary prototype (often made of acrylic) is fitted immediately. During this initial healing phase, your gum tissue is still adjusting and shrinking. If the final prosthesis is made before the gums have fully healed and reshaped, a gap can form between the prosthetic teeth and the soft tissues, leaving room for food and liquids to get underneath.
Additionally, the design and contour of the underside of the prosthesis plays a major role. If the base is concave or poorly adapted to your gums, it may trap more debris. A cleanable and well-adapted shape—ideally slightly convex—is key to reducing food accumulation.
How to Minimise Food Getting Under Your Denture
- Wait for complete healing: Ideally, your permanent prosthesis should be made only after your gum tissues have fully settled, to ensure the best fit and minimal gaps.
- Proper prosthesis design: Your dentist should work with the lab to ensure a tight seal with soft tissues and smooth, hygienic contours.
- Adjustments or remakes: If your prosthesis is acrylic, minor adjustments can often be made to improve the fit. For zirconia or porcelain-fused restorations, a new prosthesis may be needed.
- Use the right cleaning tools:
- A Waterpik with the correct tip (such as a perio or implant tip) helps flush out trapped debris.
- Textured dental floss or floss threaders can help clean along the gum line more effectively than smooth floss.
- Regular dental reviews: Having your prosthesis checked periodically allows your dentist to catch and correct fit issues early.
When to Seek Help
If you notice increasing discomfort, persistent food accumulation, or difficulty keeping the area clean, it’s best to book an appointment. A small adjustment or professional clean may be all that’s needed—or, in some cases, a remake of the prosthesis may be required for long-term comfort and hygiene.
All on 4 dental implants are loose - what can be causing this?
If your All-on-4 dental implants feel loose, it’s important to address the issue promptly, but first, it’s crucial to understand what exactly is loose. In an implant-supported restoration, there are three main components:
- The implant fixture – the part surgically placed into the bone
- The abutment – a connector piece between the implant and the bridge
- The prosthesis (bridge) – the visible teeth that attach to the abutments
Looseness can come from any one of these parts, and misdiagnosing the source may lead to ongoing problems or even damage.
Common Causes of Looseness
- Loose abutment screw: Even if the bridge screws feel tight, the abutment itself may be loose, causing micro-movement and instability.
- Worn or damaged screws: Prosthetic screws can wear out over time or during lab processes. Simply retightening may not help; in many cases, these screws need to be replaced.
- Non-passive fit of the prosthesis: If the bridge doesn’t fit passively on the implants, stress is applied during function. This can cause movement, loosening, or long-term damage. A new, more accurately fitting prosthesis may be required.
- Biological complications: If the implant fixture itself is loose or failing, due to infection, insufficient bone support, or poor healing (osseointegration)—it may require more significant treatment or replacement.
- Other contributing factors: Smoking, poor oral hygiene, unsterile surgical conditions, or systemic medical conditions (like uncontrolled diabetes) can compromise implant stability over time.
What Should You Do?
If you’re noticing movement, clicking, discomfort, or changes in how your bite feels:
- Do not ignore it. Continuing to chew on a loose All-on-4 can cause damage to the implants or the surrounding bone.
- Book a review ASAP. A clinical examination and possibly an X-ray will help your implant dentist determine the source of the problem.
Prevention Tips
- Attend regular check-ups to monitor implant health and screw stability.
- Follow a consistent hygiene routine and avoid habits like grinding or smoking.
- If your prosthesis ever feels “off,” don’t wait—early intervention is key.
Should you replace your teeth or restore and save them?
Deciding between restoring your natural teeth or replacing them with treatments like All-on-4 dental implants is a major decision—and one that should be made carefully, based on clinical evidence, long-term outcomes, and your personal situation.
When Should You Restore Your Natural Teeth?
If your teeth are not yet hopeless, preserving them is generally the better—and more conservative—option. Advances in dentistry today allow us to restore even heavily damaged teeth using:
- Fillings or bonding
- Root canal treatments
- Crowns or veneers
- Orthodontics to improve spacing and bite
- Gum treatments to manage periodontal disease
Saving natural teeth, when possible, supports the jawbone, maintains natural sensation and bite force, and helps you avoid the irreversible steps involved in full-arch replacements.
When Is Tooth Replacement (All-on-4) the Right Choice?
The All-on-4 dental implant procedure is typically recommended when:
- Most or all teeth in an arch are non-restorable or failing
- There is an advanced periodontal diseaseor bone loss
- You’ve had multiple failed dental treatments or extractions
- A traditional denture is no longer working well for function or comfort
All-on-4 is not suitable for people with many healthy or salvageable teeth. The procedure involves removing teeth and reshaping bone, which is irreversible. Think of it as a “last resort” treatment for cases where no other options offer a predictable, long-term solution.
Why a Conservative Approach Is Often Best
Jumping straight into All-on-4 when other treatments are viable is like “dropping a nuclear bomb to resolve a small dispute.” It may work—but at a cost. Most experienced dental professionals will prioritise preserving your natural dentition and recommend full-arch implants only when absolutely necessary..
If All-on-4 Fails Completely, Can You Go Back to Full Dentures?
Yes, it is technically possible to return to removable full dentures if an All-on-4 restoration fails completely. However, the bone reduction (alveoloplasty) typically done during the All-on-4 procedure can impact how well those dentures will fit and stay in place. During the All-on-4 process, a small amount of bone is removed to create a level surface for the prosthesis and ensure the gumline transition is hidden for a more aesthetic result. While this is standard and necessary for the procedure, it may reduce the bone ridges that dentures typically rely on for support and suction.
As a result:
- Lower denture stability may be compromised
- Upper dentures may require adhesive for added retention
- Comfort and chewing function may not be as good as with implants
What If Only One or Two Implants Fail?
In reality, complete failure of all implants is rare. If one or two implants fail, they can often be replaced with a new implant or repositioned, and the restoration adjusted accordingly. Modern techniques and high implant success rates (often 95–98%) make total failure extremely uncommon when the procedure is done by a skilled professional.
What Are the Options If All-on-4 Fails?
If an implant-supported restoration needs to be removed entirely:
- Denture reline or custom-fit full dentures may still be possible
- Implant replacement may be considered, depending on the remaining bone
- Bone grafting could help rebuild lost bone for future implant use
If you don't have enough bone for all-on-4, what are your other options?
If you’ve been told you don’t have enough bone for an All-on-4 procedure, don’t worry—there are still several effective options for restoring your smile.
1. Bone Grafting with Delayed Implants
If you’re set on a fixed full-arch solution like All-on-4, bone grafting can rebuild the missing bone first. This may involve sinus lifts (for the upper jaw) or block grafts, and does require more healing time, but it opens the door to traditional implant options once bone volume is restored.
2. Zygomatic Implants
If bone loss is severe in the upper jaw, zygomatic implants may be a solution. These longer implants are anchored into the cheekbone (zygoma), which typically has sufficient bone even when the jaw does not. This option avoids bone grafting and can still support a fixed bridge.
3. All-on-6 or Strategic Implant Placement
In some cases, adding more implants (like an All-on-6) in strategic positions or using ultra-short or angled implants may allow for fixed teeth without traditional bone grafting.
4. Removable Implant-Supported Dentures (Overdenture)
If fixed teeth aren’t suitable, a removable implant denture may still be an option. These are held in place with 2–4 implants and snap on and off, offering better stability than traditional dentures while requiring less bone than All-on-4.
5. Conventional Dentures
If none of the implant options are feasible due to health, budget, or anatomical limitations, well-made conventional dentures can still restore function and appearance, although they won’t offer the same stability or chewing power as implants.
Who is the best candidate for All-on4?
The best candidate for All-on-4 dental implants is someone who:
- Has many failing or missing teeth: All-on-4 is ideal for people with severe tooth decay, gum disease, or teeth that can no longer be restored.
- Wears dentures or is about to lose all their teeth: It’s a great alternative to removable dentures, offering a fixed, more comfortable solution.
- Has moderate bone loss: Unlike traditional implants that may require bone grafting, All-on-4 implants are strategically angled to maximise the use of existing bone, even when some loss has occurred.
- Is in good general health: Conditions like uncontrolled diabetes or smoking can affect healing and implant success, so candidates should be reasonably healthy and committed to post-surgical care.
- Wants a fixed, long-term solution: If you’re looking for teeth that look, feel, and function like natural teeth—and you’re ready for the upfront investment—All-on-4 can be life-changing.
However, it’s not the right fit for everyone. Sometimes, saving natural teeth or combining different treatments could be a better, more conservative approach.
Will dental insurance pay for All-on-4?
In most cases, insurance does not pay much for All-on-4 dental implants. Some private health funds may contribute a portion toward parts of the treatment—such as extractions, surgery, or prosthetics—depending on your level of extras cover.
Here’s what you should know:
- Medicare won’t cover itunless the dental issue is directly related to a serious medical condition treated in a hospital setting.
- Private dental insurancemay offer limited rebates for individual steps in the process (like consultations, x-rays, or certain components of the prosthesis), but not for the entire All-on-4 procedure.
- Annual limits and waiting periods often apply, so it’s worth checking your policy in detail.
What are the components in "All-on-4"
The All-on-4 dental implant system has four main components:
1. Dental Implants
These are four titanium screws surgically placed into the jawbone.
- Two are placed vertically at the front.
- Two are placed at an angle at the back to maximise support and avoid bone grafting.
They act as artificial tooth roots.
2. Multiunit Abutments
These are connectors that join the dental implants to the prosthetic teeth.
- Customised for each patient
- Ensure a secure and stable fit between the implants and the bridge
3. Prosthetic Bridge
This is the full arch of artificial teeth (either upper or lower) that attaches to the implants.
- Can be made from acrylic, zirconia, PMMA, or a hybrid of materials
- Designed to look and function like natural teeth
- Can be temporary (used during healing) or permanent (final set)
Is it Better to Do Dental Implants in Melbourne or Overseas?
If you’re thinking about getting dental implants done overseas, here’s the short answer: you can—but it’s at your own risk.
There are good surgeons all over the world, and you might even get lucky. But the real question is: what happens if something goes wrong once you’re back in Australia? Complications don’t always happen straight away. What if you’re sitting on a long-haul flight home and you develop an issue? Who’s going to help you at 30,000 feet—or even once you land?
And let’s talk about implant parts. There are over 500 implant brands globally, many of which are not approved by the TGA (Therapeutic Goods Administration) here in Australia. If you ever need repairs or replacement parts, a local dentist may not be able to help. Yes, custom parts can sometimes be made, but it comes at a significant cost and time.
“After” can be Too Late
We’ve tried many times to help patients who’ve had implants placed overseas. We reach out to the overseas clinics asking for implant specifications or records… and more often than not, we hear nothing back. No files, no x-rays, no idea what materials were used. You’re left in the dark—and so are we.
Dental implant surgery is not as simple as placing a screw in a wall. There are so many variables—bone volume and density, your general health, genetic predisposition to gum disease, jaw function, grinding, and the aesthetics of your smile. In Australia, we often take a staged approach over several months to give you the best possible long-term result. That might include bone grafting, healing periods, and carefully timed surgeries.
So, what do you think an overseas dentist will say when you tell them you’re only there for a 3-week holiday? They’ll likely find a way to “make it work” within your schedule. But here’s the issue: good dentistry works to your biology, not your itinerary.
Even in countries with excellent healthcare systems like Germany, Japan, Sweden, or Israel, unless you’re planning to stay for 6+ months, it’s just not realistic to expect the same quality of long-term care as you would at home. And just so you know, the cost in those countries is often similar to Australia’s anyway.
Australia Has Some of the Highest Standards in the World
Here in Australia, we’re held to strict standards by AHPRA (the Australian Health Practitioner Regulation Agency). That’s not the case in many parts of the world, where dental training may be less consistent, and oversight is limited or non-existent. Our dentists are trained, regulated, and monitored to ensure patient safety and professional accountability.
We’ve seen both sides. Yes, some people come back from overseas with successful results—but we’ve also seen the other end: failed implants, broken prosthetics, poor placement, and short-term fixes that don’t hold up. Maybe my view is skewed because the people who come to me are the ones with complications. When things go wrong here in Australia, the person who did the work is usually still here to help.
So… Is it Really Cheaper?
Before you make your decision, take a moment to do the full maths. Flights, accommodation, living expenses, time off work, and—importantly—the cost of fixing things if they don’t go to plan. Then factor in the emotional toll if you find yourself in a tricky spot with no support.
At the end of the day, it comes down to how much risk you’re prepared to take—and at what cost.
What Implants Are Commonly Used for All-on-4 in Melbourne?
In Melbourne, several well-known and widely used dental implant systems are trusted for All-on-4 treatments. These include:
- Nobel Biocare– Known for developing the original All-on-4 protocol, this brand is commonly used and supported by years of clinical research and global recognition.
- Straumann– Another highly respected brand often used in full-arch cases. Known for precision engineering and strong research backing.
- Neodent– A more cost-effective alternative (part of the Straumann group), gaining popularity in Australia for full-arch implant work due to its accessibility and quality.
Other systems like Astra Tech, MIS, and Zimmer Biomet are also used by some clinicians depending on their experience and patient needs.
Is the Brand of Implant Important?
Not necessarily. The name itself isn’t what matters most. It’s the design of the implant, the versatility of its components, and the company’s aftercare support that truly count. A reliable implant company should stand by its product, especially if something goes wrong down the track.
These days, many implant manufacturers produce high-quality implants, so patients don’t need to get caught up in marketing slogans or claims that one brand is “the best” or “the original.” If a clinic insists its system is superior purely because of branding, it’s worth approaching with healthy scepticism.
What matters more is:
- The planning and skillbehind your treatment
- Whether the implant system is TGA-approved
- The availability of replacement partsin Australia
- Long-term clinical supportfor the system used
The success of All-on-4 isn’t just about the implant—it’s about how it’s used, how it’s maintained, and how well it’s planned from the start. A quality implant system, placed correctly and supported long-term, is far more valuable than a brand name alone.
How to Prepare for Full Mouth Dental Implant Surgery
Preparing for full mouth implant surgery isn’t complicated, but a few simple steps can make a big difference to your comfort and recovery.
If your procedure is being done under general anaesthesia, there are some important things to know:
- Fasting is essential.You’ll need to stop eating and drinking seven hours before surgery—this includes water, coffee, or even chewing gum.
- Dress comfortably.Loose, soft clothing is best. You’ll want to feel relaxed before and after surgery.
- Arrange a lift home.You won’t be in any shape to drive yourself. Make sure a trusted friend or family member can take you home and ideally stay with you for a few hours.
- Plan for downtime.Most patients need about a week off work to rest and recover at home. Swelling, bruising, and general fatigue are completely normal in the first few days.
If you’re having your surgery under local anaesthetic with or without sedation, the fasting and recovery requirements may vary slightly—your dental team will give you clear instructions tailored to your procedure.
A Few Extra Tips:
- Stock your fridge with soft foods like soups and smoothies
- Avoid alcohol, smoking, and strenuous activity during the healing period.
- Set up a comfy recovery space at home with pillows, entertainment, and any medications you’ve been prescribed.