All on Four Implants

All on Four Implants


Without teeth to populate that once glorious smile of yours, countless vital functions are severely compromised:

  • Difficulty eating resulting in poor nutrition
  • Difficulty in articulating and speaking
  • Low self-esteem and confidence

Scientific research has shown there to be a close relationship between periodontal (gum) disease and diseases ofthe
heart, lungs, kidneys as well as diabetes, arthritis and Alzheimer’s. It can even cause complications in pregnancy and this really illustrates the necessity for prompt treatment.

Well I have the answer. It’s called the All On Four Technique. Before the conception ofthe All On Four Dental Implant technique patients presenting with tooth loss and edentulism would have to resign themselves to a fate of denture-wearing. Yet, even today, with the availability ofthis sophisticated, non-removable and long term teeth replacement solution, people continue to struggle with the challenges and repeated costs associated with removable partial and full dentures or false teeth. These include:

  • The need for messy adhesives – a repeat expense – to prevent the dentures from slipping
  • Removal for cleaning after meals and at nighttime, which can prove to be extremely inconvenient, and socially uncomfortable.
  • The risk of falling out causing acute embarrassment
  • Unnatural oral aesthetics arising from the dentures shifting around in the mouth
  • The triggering of gag reflex
  • Taste impediment
  • Removable dentures harbor food, sputum and bacteria causing bad breath if not kept impeccably clean
  • Sore and irritated gums and the need for anesthetic gels – another repeat expense – to minimize pain and discomfort.

But perhaps of all these challenges and repeated expenses, the most crippling for those who have to wear partial or full dentures is the need for repeat bridge work to be done every few years or so as a result of bone loss in the jaw.


Ironically, one of the biggest causes of bone loss … is tooth loss to begin with! The roots of your teeth provide a fundamental source of stimulation to the underlying bone tissue. The mechanical forces associated with eating and
chewing encourages a healthy jaw, maintaining its bone volume and density. When a tooth is lost, so is this stimulation, or pressure in the area of the root, and the bone tissue begins to atrophy. The subsequent re-absorption of this hard tissue by the jaw results in the loss of bone volume and this is what causes that sunken and aged appearance about the mouth that we traditionally associate with the elderly or denture-wearers. Because the All On Four technique uses dental implants to provide ‘anchorage’ for a non-removable dental prosthetic bridge– which are similar to strong artificial ‘tooth roots’ – they help to restore the stimulation that prevents bone atrophy from occurring. This halts the progression of bone loss in the jaw, thus enabling the All On Four technique to function as a long-term solution to tooth loss and edentulism.


To put it quite simply, there is no comparison between the revolutionary All On Four technique and removable dentures. With this incredible technique, the following benefits and advantages are afforded to almost all patients of all ages and stages of tooth loss:

  • Results of the All On Four procedure are immediate and can be enjoyed on the same day. This means instant oral aesthetics (a beautiful and natural smile) and a fully restored bite functionality, which almost always can be used for eating on the evening of the procedure.
  • The results are fixed and non-removable: The dental prosthetic bridge used in the All On Four is affixed to four dental implants in the mouth. So, unlike false teeth, it does not move around and cannot fall out. This represents the overcoming of a massive hurdle in the field of teeth replacement.
  • In keeping with the previous point, the dental bridge is cared for and cleaned just like natural teeth – with regular brushing, flossing, and rinsing- so no need for removal after meals or at night time.
  • No repeated expenses such as messy adhesives, anesthetic gels and other costs associated with wearing removable dentures.
  • The dental prosthesis is custom fabricated to intimately fit the natural contours ofthe patient’s mouth and jaw, so it doesn’t cause any discomfort and feels like a full set of natural teeth.
  • The All On Four dental bridge does not compromise taste, nor does it trigger the gag reflex as removable dentures tend to.
  • Increased bite strength so patients can enjoy all the foods they love but previously couldn’t with removable dentures and missing teeth.
  • Promotes a healthy jaw bone: The All On Four technique enhances the longevity ofthe underlying jaw bone by preventing atrophy. As a result there is no need for costly bridgework to be done every few years or so as a result of continued bone loss. In other words, the All On Four’ technique can work as a once-off treatment for tooth loss and edentulism.
  • The All On Four teeth replacement solution is long term and can last decades to a lifetime if cared for properly!
    • Patients almost never need to undergo the pain and discomfort associated with bone grafting surgery,
    • Patients save money and time, by avoiding multiple procedures
    • Minimizes the recovery period so that the entire procedure can be completed in as little as a single day
    • Enables patients to receive new and immediately functional teeth in a day!


What has largely set the All On Four apart from all other dental implant techniques and traditional teeth replacement methods is its ability to give patients a full set of beautiful and immediately functional teeth in a single day! You see, in order for the titanium based implant to successfully ‘osseointegrate’ (form a strong biological bond) with the bone of the jaw, there needs to be sufficient bone volume beneath the locations of the missing teeth. Since an untreated acute and chronic bacterial infection of the gums causes bone loss in the jaw, patients suffering from periodontal disease are frequently told that they are not candidates for traditional dental implant techniques. This can be remedied by bone grafting, but this surgery tends to be costly and painful and with months required for healing before patients can receive implants. The All On Four almost always renders bone grafting obsolete thanks to the ingenious positioning and angulation of the four implant screws used to support the rigid prosthetic bridge of artificial teeth. Furthermore, almost everyone is a candidate even those who present with considerable bone loss in the jaw as a result of advanced periodontal disease.

The tens ofthousands of successfully treated cases worldwide have proved the All On Four procedure to be one of the
most comprehensive tooth replacement technique for patients of all ages and stages of periodontal disease.


It is the ingenious design behind the All On Four that enables the dental team at The Florence Dental Implant Center, under the direction of Florence Oral and Maxillofacial Surgery, to give patients suffering from periodontal disease, tooth loss and edentulism a full set of beautiful new and non-removable (fixed) teeth in as little as a single dental appointment!

Traditional techniques generally require six, eight and even more dental implants to be inserted in order to restore the aesthetics and functionality of the oral cavity plagued by periodontal disease. And even then, often this can only be successfully performed once bone grafting had been done, which typically takes between three and nine months to heal before implant placement can commence. The All On Four dental implant technique consists of a fully customized prosthetic dental bridge (a rigid structure consisting of a full set of aesthetic and functional teeth) affixed to only four dental implants:

The day has arrived and I hope that you bid your false teeth a not-so-fond farewell! We begin the All On Four procedure in the morning starting with you getting prepared for surgery. Subsequently, you will gently be anesthetized and possibly given intravenous sedation (if preferred or suggested) so that you feel absolutely no pain or discomfort during the course of the surgery. Once you are adequately anesthetized Isedated, we remove all your remaining failing teeth (that is, if any are left!) and rigorously clean out any unhealthy tissue in your gums or jaw. Then, two dental implants are inserted towards the front portion of your jaw, where there naturally exists a greater volume of atrophy-resistant bone tissue, and another two are inserted at an angle nearer the back of your jaw (in the region of the molars or premolars). This angulation ensures that the All On Four prosthetic dental bridge receives maximum support from the underlying jaw bone while the implants themselves avoid damaging vital structures such as the nerve canal in the lower jaw and sinus cavity in the upper jaw. The strategic positioning of these dental implants is what enables the procedure to almost always be completed in a single day and without the need for bone grafting beforehand.

With the help of sophisticated computer imaging software, 3D CAT scans and X-rays,Florence Oral and Maxillofacial Surgery is able to  insert the dental implants with minimal incisions and sutures, making the All On Four a far less invasive technique. This means minimal post-operative pain and discomfort. Once the dental implants are inserted a temporary prosthetic dental bridge is connected on the same day, giving patients their new and beautiful teeth, which they can admire and use right away


First and foremost I will need to assess your specific oral problems in order to recommend the best possible way forward with regards to treatment. In my initial consultation with you, I will conduct a thorough clinical examination of your mouth and take X Rays to assess your dental needs and the presence and extent of bone loss. Should I recommend the All On Four technique for your oral rehabilitation, I will proceed with taking molds of your mouth to aid in the fabrication of the prosthetic dental bridge you will be receiving on the day of your scheduled surgery. I may also take smaller images of your teeth and jaw as well as photos to facilitate in the detailed planning of your surgery. If you have any questions or concerns, these too will be addressed during your initial consultation.


If you are receiving a fixed (non-removable) bridge that day, once the implants are inserted you will have a short rest while the final touches are done to your customized provisional prosthetic dental bridge. It only takes a short while to affix it to the abutments of the All On Four Implants, so once it’s done you are free to admire your new and beautiful teeth in the mirror and then go home and enjoy a meal that night with your brand new teeth!


In the weeks and months following your surgery, your jaw will be forming a strong biological bond with the tiny titanium implant screws; a process termed ‘osseointegration’. In order to maximize the effectiveness of this essential process, it is advised that you refrain from eating any hard, chewy or crunchy foods; anything that might break the delicate bonds that are beginning to form. Furthermore, it is essential that you help your body through this healing process by:

  • Getting plenty of rest
  • Eating a balanced diet
  • Staying well nourished
  • Avoiding things such as smoking and excessive alcohol consumption: These can severely compromise the ability of the dental implants to remain healthy within in the jaw.

You will be required to periodically visit me in the weeks and months after your surgery so that we can make sure you are healing up uneventfully and that your mouth is free from any signs of infection. While patients seldom complain of severe post-operative pain, we will make sure that you go home with a prescription of analgesics (pain-killers) and anti-inflammatories to effectively manage any pain and discomfort you may experience. Regular brushing and flossing and rinsing, along with periodic hygiene visits, is all that is required to keep your new and beautiful All On Four teeth healthy and clean!


More than 100 million people in the United States alone are missing between 11 and 15 (and more) of their permanent  adult teeth. By the age of 60, a staggering 70% of these people are completely edentulous (no teeth at all) and in  desperate need of complete oral rehabilitation. The comprehensive solution to edentulism and tooth loss, the All On  Four dental implant technique, almost always makes new teeth in a day possible for people across the age spectrum.

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