Replacing Missing Teeth: What Is the Procedure to Get All-on-4® Like?

All-on-4 Dallas, TX

An All-on-4® system is a bridge of false teeth held in place by four dental implants in either the upper or lower jaw. It is an alternative available to patients who want the advantages that dental implants provide but are missing too many teeth to make a full-mouth restoration practical. The system offers many significant benefits over traditional removable dentures. Because of the procedure's complexity, it takes time to complete.

Planning, procedure and placement

Placing an All-on-4® requires planning beforehand, followed by surgical procedures and healing. It can be helpful to examine each part of the overall process individually to understand what it entails.


The first step is for the dentist or oral surgeon to determine whether the patient is a good candidate for the implant surgery. This involves a consultation in which X-rays and imaging of the jaw are taken. The oral surgeon examines the images to determine whether there is sufficient bone density to place the four implants in the jaw and, if so, where the optimal place to put them will be. If the patient is a candidate, the next step is to take impressions of the mouth. These guide the lab technicians who design and craft the dental bridge.

If a patient is not a candidate for an All-on-4® system, the dentist or oral surgeon can discuss additional treatment options at the initial consultation. A patient who has insufficient bone density in the jaw for implants may still be a candidate if a bone grafting procedure takes place first.


If there are still teeth remaining in the jaw, these have to be pulled before the procedure to place the implants can occur. Sometimes pulling the remaining teeth requires an extra appointment, while in other cases it can be performed on the same day as the implantation procedure. This involves placing the four implants, which are posts made of a strong metal, usually titanium, into position in the jaw. Typically, the two posts in the front go straight down into the bone, while the two along the side are placed at an angle.

The surgeon places each post into a hole drilled directly into the jawbone. To access the bone, it is necessary to first incise the gums. These holes are stitched back up once the implants are in place to allow healing. Then there is typically a three- to four-month period of osseointegration to allow the implants to fuse completely with the bone. During this time, the patient may wear temporary dentures.


Once healing and osseointegration has taken place and the bridge of new teeth is available from the laboratory, the restoration can be completed by placing the bridge in the mouth. This requires another procedure to attach the abutments to the implants. These are the parts that connect the bridge to the posts.


All-on-4® implants can allow for effective tooth restoration options. Talk with a dentist to learn whether you could be a candidate for this technique.

Request an appointment here: or call Highlands Family Dentistry at (214) 491-5362 for an appointment in our Dallas office.

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