Home / All-on-4 & Full-Arch Implants
Full-arch restoration
A full arch,
planned before
the first incision.
Four to six implants, one screw-retained bridge, and a plan built in software against your own anatomy before anyone picks up an instrument. It does not come out, and it does not cover the palate.
Why patients come here
- Practice limited to prosthodontics and oral implantology
- Every case CBCT-scanned and fully guided
- IV conscious sedation available in-office
- A written, itemized plan before anything is scheduled
What it is
Why four implants can carry twelve teeth.
The two back implants are tilted forward, which does two things at once: it lets a longer implant engage the dense bone at the front of the jaw, and it moves the rear support further back without entering the sinus or the nerve canal. The result is a wider base of support from fewer fixtures, and often without grafting.
Four is a design minimum, not a rule. Bone density, arch shape, bite force and whether you grind decide whether your case is four, five or six — and that decision is made from the scan, not from the name of the technique.
The bridge itself is milled as one piece, usually zirconia, and screwed onto the implants. It is removed only by us, at maintenance visits.
The digital workflow
Five instruments, one continuous plan.
CBCT scan
A 3D volume of bone, nerve and sinus. Implant length and angle are decided here.
Digital design
The finished teeth are drawn first; implant positions derived from them.
Guided placement
A printed surgical guide transfers the plan to the mouth.
Photogrammetry
Implant positions captured optically — no tray, no impression distortion.
Milled prosthesis
The definitive arch is milled to the verified design and torqued in.
The day itself
Surgery, then teeth, then home.
Full-arch surgery typically runs three to five hours per arch under IV conscious sedation. Failing teeth are removed, the ridge is contoured, the implants are placed through the guide, and the positions are captured for the provisional.
In selected cases a fixed provisional bridge is fitted the same day — not a flipper, not a temporary denture. Whether that is safe is decided during surgery by how firmly each implant seats in your bone. If the numbers are not there, we protect the result and stage it, and you wear a well-fitted temporary while the implants integrate.
The first two weeks
- Swelling peaks around day three and settles through the first week
- A soft diet for the first six to eight weeks — the provisional protects healing, it is not a test of it
- Prescribed medication, a chlorhexidine rinse, and a number you can call over the weekend
- A review at one week and again at four to six weeks
The definitive prosthesis
Four to six months later, once integration is confirmed, positions are recaptured with photogrammetry and the definitive bridge is milled to the design you have been wearing and have already approved in the provisional. That is the point of a well-made provisional: it is the prototype, so the final holds no surprises.
The question everyone asks
How many implants do I need?
All-on-X implant therapy is a modern solution for replacing an entire arch of missing or failing teeth using dental implants. The implants are strategically positioned to support a secure, natural-looking set of fixed teeth. In many cases, patients can receive a temporary fixed smile on the same day as their implant procedure, allowing them to leave with teeth that look and feel more like their own.
One of the most important aspects of All-on-X treatment is that it is customized to each patient. While four implants may provide adequate support for some patients, others may benefit from six or more implants based on their individual anatomy, bone quality, and restorative needs. The appropriate number and position of implants are determined through careful, patient-specific treatment planning rather than a one-size-fits-all approach. By considering each patient’s smile, facial appearance, bone structure, and long-term needs, the goal is to create a comfortable, functional, and confident smile with a strong foundation for lasting results.
On the radiograph
What a finished arch looks like from the inside.
Two completed full-arch cases from this practice, seen on the panoramic radiograph.
One case
Before, and after.
A failing upper and lower dentition rebuilt as a fixed full arch. Dr. Resnik’s own case photography, published with the patient’s permission.
Clinical photographs of a patient treated at this practice. Individual results vary; what is achievable in your case is determined only after an examination and a CBCT scan.
Planned before it is placed
The finished teeth are designed first.
Every implant position on a full-arch case is decided in software, against a CBCT scan and a digital design of the teeth that will sit on top. The plan above is the actual output — implant positions, angles and depths, resolved before anyone picks up an instrument.
That is the step that decides whether the finished arch looks designed or improvised.
Fixed or removable
Full-arch bridge, or implant overdenture.
Both are supported by implants. The difference is whether it comes out.
Fixed full-arch
Screw-retained bridge
- Never removed by the patient — cleaned in place
- No palate coverage; taste and temperature unaffected
- Closest feel to natural teeth; strongest bite
- Four to six implants per arch
- Professional maintenance: unscrewed and cleaned at intervals
Removable
Implant overdenture
- Snaps onto locator attachments; lifts out for cleaning
- Two to four implants per arch
- Lower cost, simpler maintenance, easier to modify later
- Still covers some palate in most upper designs
- A good answer for limited bone or limited budget
Questions
Full-arch specifics.
Is All-on-4 a brand or a technique?
All-on-4 is a trademarked protocol, and the term has become shorthand for any fixed arch on four implants. What matters clinically is not the name but whether four is the right number for your bone — which the scan answers.
Will I have teeth the day of surgery?
In selected cases yes, a fixed provisional is fitted the same day. It depends on the insertion torque and stability measured at placement. If those numbers are not there, loading immediately risks the implant, so we stage it.
Can it be done if I have almost no bone left?
Often, yes — tilted posterior implants exist precisely to avoid grafting in resorbed jaws. Where they are not enough, grafting or zygomatic referral is discussed openly.
How do I clean it?
A soft brush and a water flosser under the bridge, daily. It is removed by us at maintenance visits and cleaned professionally. Cleaning under the bridge is the single habit that most affects how long it lasts.
What if a tooth on the bridge chips?
Because it is screw-retained, the bridge can be removed, repaired or replaced without cutting anything or disturbing the implants.
Start with a scan and a straight answer.
A consultation includes an examination, a 3D scan and a written, itemized plan. If implants are not the right treatment for you, we will say so and tell you what is.