All-on-4 Dental Implants — Full Arch on Four Implants at Deepcar Dental Care

The All-on-4 procedure places four implants in strategic positions and loads them with a provisional fixed bridge on the same day. This immediate-loading protocol is what some clinicians refer to as “teeth in a day” — though the teeth fitted on the day of surgery are a provisional fixed bridge, not the definitive restoration. The tilted placement of the posterior implants increases the anterior-posterior (AP) spread, which distributes biting forces more evenly across the arch and reduces the length of the prosthetic cantilever — the unsupported section of the bridge that extends beyond the last implant. Systematic review evidence (Soto-Penaloza et al., J Clin Exp Dent 2017) reports that insertion torque for immediate loading typically falls between 30 and 50 Ncm to achieve the primary stability the provisional bridge requires. The provisional bridge is acrylic and is designed for function and appearance during the healing period, not as a lifetime restoration. A definitive bridge — typically in monolithic zirconia, ceramic, or an acrylic-metal hybrid construction — is fitted several months later, once the implants have integrated with the bone. At Deepcar Dental Care, implants used for All-on-4 are drawn from established systems including Straumann, Nobel Biocare, and Neodent, chosen for long-term part availability and published clinical evidence. The biomechanics of why four angled implants can reliably support a full arch are explained in more detail on our implant biomechanics page.

The All-on-4 treatment pathway runs from initial consultation through to final bridge delivery over approximately four to six months. The first appointment is a clinical examination and discussion of your situation, followed by a CBCT scan that produces a three-dimensional map of the jawbone used for digital planning. On the day of surgery, any remaining failing teeth are removed, the four implants are placed under local anaesthetic (conscious sedation is available), and — where primary stability allows — patients leave the practice the same day with a fixed provisional bridge rather than a removable denture. Over the following weeks, soft tissues heal and the implants integrate with the bone. Review appointments monitor healing, and the definitive bridge is fitted once integration is confirmed. Patients often describe All-on-4 surgery as more comfortable than they had anticipated — a theme that appears in our patient reviews.

The main risks of All-on-4 are biological — such as peri-implantitis and marginal bone loss — and mechanical, such as wear or fracture of the bridge and loose prosthetic screws. Biological complications — including peri-implantitis (inflammation of the tissue around an implant with progressive bone loss), soft-tissue inflammation, and marginal bone loss — are reported in a minority of patients in long-term follow-up studies, and the risk increases with poor daily hygiene, smoking, and uncontrolled systemic disease. Mechanical complications are more common than biological complications but are generally repairable without removing the implants themselves. In clinical practice, when complications do arise they most commonly surface during the early healing period and are usually linked to hygiene habits, smoking, or a medical factor that was identifiable at assessment, rather than to the implants themselves. Most are manageable when picked up at a routine review. Smoking roughly doubles the relative risk of implant failure compared with non-smokers (PLOS ONE meta-analysis, 2013, >40,000 implants). Long-term success depends on thorough daily cleaning, regular hygiene appointments, and ongoing clinical review. Documented full-arch cases at our practice can be viewed on our full arch implants case study page.