Dental implantation for full arch tooth loss is a modern solution that allows for the complete restoration of dental function and aesthetic appeal. One of the most effective and well-researched methods is the All-on-4 protocol (all on 4 implants) and its modifications (such as All-on-6 when more support is required).
Consequences of Tooth Loss
The loss of natural teeth has both aesthetic and functional consequences:
- Aesthetic Component: Dental implantation is essential to eliminate external deficiencies resulting from tooth loss. This includes sagging mouth corners, sunken cheeks, and the noticeable recession of the jawbone area.
- Functional Component: Basic chewing becomes a serious problem when teeth are missing. Consequences include compromised gastrointestinal function and speech impediments. Additionally: accelerated bone loss (atrophy—up to 60 of volume within 3-5 years), overloading of the temporomandibular joint (TMJ), and chronic pain.
What is a “Turnkey” Dental Implant Procedure?
The classic method of restoring a dental arch using titanium posts involves placing an individual implant for every missing tooth. But what if many teeth are missing, or if the entire arch is edentulous (all teeth are absent)? In such cases, the sequential protocol is time-consuming and financially demanding. There is an alternative: the All-on-4 procedure, which is more cost-effective and significantly faster.
This is a protocol patented in 1998 and currently utilized by dozens of manufacturers. The technology involves placing 4 titanium support posts (implants): 2 are placed vertically in the anterior section, and 2 are tilted at an angle of up to 45° in the posterior (chewing) zone. This angulation is strategic, as it avoids vital anatomical structures (like the nerves or maxillary sinuses) and achieves high primary stability. Prostheses are subsequently affixed to these four supports.
The procedure sequence typically involves:
- The surgeon performs diagnostics and selects a personalized solution based on data and examination.
- The titanium posts are placed.
- In 60-70 of cases, a fixed temporary prosthesis is attached immediately or within 1-3 days (immediate loading).
- In other cases (severe atrophy, inflammation, bruxism), the final restoration is placed after 3-6 months.
A key feature is the ability to choose the optimal protocol. For example, when placing implants in the upper jaw, longer posts may be used to ensure the secure retention of the restoration. Ideally, the implant can be placed immediately after tooth extraction (immediate placement). This eliminates an interim healing period, and tissue regeneration occurs faster.
Types of Prostheses for Implantation
The types of restorations used for implantation include:
- Screw-retained/Fixed Prosthesis: Secured to the implants and can only be removed by a dentist; it is used for both arches.
- Removable Prosthesis: A more budget-friendly design, but typically less comfortable or stable.
It should be noted that the implantologist analyzes the diagnostic indicators and the patient’s preferences comprehensively before providing any recommendations for the type of restoration.
All-on-4 Implantation: Pros and Cons
Recognized advantages of implant-supported restorations include a shorter treatment period compared to the classic protocol and the potential for long-term use. This type of prosthesis does not need to be removed at night, and the cost is significantly lower.
However, this method of full-arch restoration is not suitable for everyone. Sometimes, additional titanium posts, bone augmentation (grafting), or preliminary medical preparation may be required. The choice is purely individual, and the patient’s wishes alone are not sufficient.
Possible Contraindications and Complexities:
- Uncontrolled diabetes mellitus
- Use of bisphosphonates/denosumab
- Smoking more than 10-15 cigarettes per day
- Very severe bone atrophy (requiring All-on-6 or Zygoma implants)
- Severe bruxism without a night guard
How is the Implantation Cost Calculated?
The price depends on the brand of implants, the material and type of the final prosthesis, and the necessity of additional procedures.
In our clinic, for the All-on-4 protocol, we exclusively work with proven premium and mid-premium systems that are ideally suited for immediate loading:
- Neodent
- Prama
Both systems are among the Top 10 most used globally for immediate loading protocols in 2024-2025 and have long-term clinical studies (10+ years).
Therefore, when we say “All-on-4 Turnkey,” you receive the exact implants originally developed for this concept and routinely placed in thousands of clinics across Europe, the USA, and Brazil.
