All-on-4 restores a whole jaw on just four implants: two straight ones at the front and two rear ones tilted up to 45°. The tilt makes use of the existing bone in the front and bypasses the sinus (upper jaw) or the jaw nerve (lower jaw) — so in most cases no bone grafting is needed. A bridge of 10–12 teeth is screwed onto the four implants: provisional on the same day, permanent after healing.
Why four, and why tilted
Jawbone resorbs over the years where there are no teeth, especially at the back. Instead of building new bone (a months-long process) the method uses the good bone that remains at the front: the rear implants “lie” at an angle and reach further back, so the bridge is supported along most of the jaw. Four implants joined by a rigid bridge brace each other — which is what makes same-day loading possible.
Pros and cons — honestly
| Pros | What to know |
|---|---|
| Fixed teeth the same day | The provisional bridge is acrylic; the permanent one comes after 3–6 months |
| Usually no bone graft | When the front bone is also very thin we consider All-on-6, longer implants or preparation |
| One surgery, fast recovery | A week of swelling and a soft diet for a few months |
| Easier to maintain than single teeth | Needs daily cleaning under the bridge and a yearly check-up |
| Lower cost than 8–10 single implants | If one of four implants fails it must be dealt with quickly; hence the importance of experience and follow-up |
How Dr. Koter does it
CT & planning
Three-dimensional imaging and computer planning of the four implants, including the future bridge.
Surgical guide
Printed from the plan — the implants go in exactly at the planned position, angle and depth.
Surgery
Extractions if needed, implant placement, stability measurement. Local anaesthesia, sedation available.
Provisional bridge
Fitted and screwed in the same day. You leave with teeth.
Permanent bridge
After healing — scan, try-in, and a zirconia or hybrid bridge.
All-on-4 or All-on-6?
The decision follows from the quantity and quality of bone, the jaw (upper or lower), chewing force and habits (grinding). In the upper jaw, where bone is softer, we often prefer six implants. In the lower jaw four is enough in most cases. It is a planning decision, not a marketing one.
Frequently asked questions
Are four implants really enough for a whole jaw?
Yes, when they are placed correctly and joined by a rigid bridge. The method has existed and been documented since the 1990s with high success rates over the years. With soft bone or heavy chewing we consider six.
How many teeth are in an All-on-4 bridge?
Usually 10–12 teeth per jaw — up to the first molar. That is enough for full chewing; the rearmost molars contribute little and load a lot.
Is a bone graft needed before All-on-4?
In most cases no — that is the main advantage of tilted implants. When the front bone is also very thin, we discuss preparation or alternatives.
Want to know if immediate loading is right for you?
A first consultation at any clinic in the network includes an exam, a scan and an explanation of your options — no obligation.