All-on-4 Dental Implants Explained by an Implant Surgeon
All-on-4 is a full-arch dental implant technique designed to restore an entire upper or lower arch using four implants.
It is not a shortcut. It is a biomechanical strategy.
At Fusion Dental Implants, our surgeons have extensive experience with All-on-4 procedures, serving patients throughout Sacramento, Roseville, and Northern California.
The Core Concept
All-on-4 uses:
- Two vertical implants in the front
- Two angled implants in the back
The posterior implants are angled to:
- Avoid anatomical structures
- Increase bone contact
- Eliminate the need for grafting in many cases
Why Angulation Matters
Angled implants increase the anterior-posterior spread, improving load distribution across the prosthesis.
This allows:
- Fewer implants to support a full arch
- Immediate provisional teeth in some patients
- Reduced surgical complexity in selected cases
Immediate Load vs Traditional Healing
Many All-on-4 cases involve immediate loading, meaning a temporary fixed prosthesis is attached the same day.
Immediate load requires:
- High primary stability
- Controlled bite forces
- Rigid prosthetic splinting
If these conditions are not met, immediate load increases failure risk.
When All-on-4 Is Not Appropriate
All-on-4 is not ideal for patients with:
- Severe bone loss in the front of the jaw
- Extreme bite forces
- Poor bone density
- Untreated systemic conditions
In such cases, additional implants or alternative designs may be safer.
All-on-4 vs Traditional Full-Arch Implants
Traditional full-arch restorations may use:
- 6–8 implants per arch
- Longer healing periods
- Bone grafting
All-on-4 trades redundancy for efficiency. This tradeoff must be deliberate, not automatic.
Long-Term Considerations
Success depends on:
- Prosthetic design
- Hygiene access
- Occlusal management
- Ongoing maintenance
Most late failures are prosthetic or maintenance-related, not implant-related.
The Surgeon Factor
All-on-4 is technique-sensitive. Outcomes vary dramatically based on:
- Surgical planning
- Implant positioning
- Prosthetic collaboration
The procedure itself is standardized. Execution is not.
All-on-4 Specialists in Sacramento
At Fusion Dental Implants, our team includes specialists with advanced training in full-arch implant techniques. We use 3D imaging and digital planning for precise implant placement.
Schedule your free All-on-4 consultation
About Fusion Dental Implants: Full-arch implant specialists serving Roseville, Sacramento, and the Bay Area.