10 Facts You May Not Know About All on 4
All on 4 is one of the most talked-about ways to replace a full arch of missing teeth, but there’s a lot about it that isn’t widely understood from how the implants are actually positioned to why the teeth you leave with on surgery day usually aren’t your final set. Here are ten clear, honest facts to help you understand what the treatment really involves.
1. The “4” means four implants support a whole arch
All on 4 replaces an entire arch of teeth using just four implants, not one implant per tooth. The four implants act as anchor points for a single fixed bridge that holds a full set of replacement teeth. This is part of what makes the approach efficient compared with placing an individual implant for every missing tooth.
2. The back implants are deliberately placed at an angle
This is the defining feature of All on 4. The two front implants are positioned relatively upright, while the two back implants are tilted typically around 30 to 45 degrees. Angling them allows the implants to anchor into denser, more available bone and to avoid structures such as the sinuses in the upper jaw and the nerve in the lower jaw.
3. The angled design can often avoid bone grafting
Because the tilted back implants make use of bone that is already there, All on 4 can sometimes avoid the bone grafting that other implant approaches might require when bone is limited. Whether grafting is needed still depends on your individual anatomy, which is assessed with a 3D scan.
4. The concept has been around since the 1990s
All on 4 isn’t brand new. It was introduced by Portuguese implantologist Dr Paulo Maló and since its publication, the technique has been extensively
studied and refined [1].
5. The teeth you get on surgery day are usually temporary
A common misconception is that you walk out with your final teeth the same day. In most cases a fixed set of temporary teeth is attached on the day of surgery, but the final, custom-made teeth are fitted later after the implants have healed and fused with the bone, which usually takes several months.
6. Implants help slow jawbone loss
When teeth are lost, the jawbone that supported them tends to shrink over time. Because implants transmit chewing forces into the bone, they can help slow this bone loss in the treated area, something removable dentures, which rest on the gums, don’t do in the same way.
7. An upper All on 4 bridge doesn’t cover the roof of your mouth
Unlike a full upper denture, which usually covers the palate, an All on 4 bridge leaves the roof of the mouth uncovered. Many patients find this more comfortable and notice it can help with the sensation of taste and temperature when eating.
8. It’s still surgery and it isn’t for everyone
All on 4 is a surgical procedure and, like any surgery, carries risks such as infection, swelling, and the possibility of an implant not integrating. It also isn’t suitable for everyone: factors such as the amount of available bone, gum health, smoking and general health all affect whether it’s a sensible option. A thorough assessment is used to work this out beforehand.
9. It works through a natural process called osseointegration
The implants are made of titanium (or a titanium alloy), which the body tolerates well. Over the months after surgery, the jawbone grows around and fuses with the implants a process called osseointegration. This is what gives the implants their long-term stability and is the reason healing takes time rather than happening overnight.
10. All on 4 is one of several full-arch options
All on 4 isn’t the only way to restore a full arch. Alternatives include All on 6 (which uses six implants), implant-retained overdentures, and conventional dentures. None is automatically “better” ; the right choice depends on your bone, health, goals and budget, and is decided after a clinical assessment.
Written by Dr Chin Kent Boon
8 March 2026
All on X treatments at Kita Dental are led by Dr Kent, Principal Dentist and Implantologist, who holds a Master of Oral Implantology. Kita Dental is a dental clinic located in Mascot, NSW, with a strong focus on dental implants.
This article is general information only and is not a substitute for personalised advice from a registered dental practitioner. Outcomes vary from patient to patient.
Want to Know if All on 4 Is Right for You?
The only way to know whether All on 4 suits your situation is a one-on-one assessment of your bone, oral health, and goals.
Book a Consultation at Kita Dental to discuss your options.
This article is general information only and is not a substitute for personalised advice from a registered dental practitioner. Outcomes vary for individuals.
References
[1] Malo P, Rangert B, Nobre M. “All-on-4” immediate-function concept with zygomatic implants for the rehabilitation of the severely atrophic maxilla: a preliminary prospective study. Clin Implant Dent Relat Res. 2003;5(Suppl 1):2-9.
[2] Dental Board of Australia / AHPRA Guidelines for advertising a regulated health service. ahpra.gov.au
[3] Australian Dental Association: Patient information on dental implants. ada.org.au
[4] Healthdirect (Australian Government): Dental implants. healthdirect.gov.au
