What All-on-4 actually is
All-on-4 replaces a whole jaw of missing or failing teeth with a single fixed bridge carried on four implants. It was developed by the Portuguese dentist Paulo Maló and the idea behind it is geometric rather than technological: instead of standing every implant straight up in bone that may no longer be there, the two at the back are tilted. A tilted implant reaches forward into the denser bone at the front of the jaw, passes in front of the sinus in the upper jaw and in front of the nerve in the lower, and spreads the bridge over a longer span. That one change is what lets most patients avoid grafting entirely.
The result is fixed. It is screwed down, you do not take it out, and it does not cover the palate — which is the difference most denture wearers notice first, because taste and temperature come back. For the broader comparison of implants against bridges and dentures, see the main dental implants page.
What $6,000 covers, and what moves the figure
A full fixed arch on four implants starts at $6,000 here. Treat that the way you should treat every published implant figure: as a floor, not a quote. What moves it is specific and you are entitled to see each item written down.
| Factor | Why it moves the number |
|---|---|
| How many implants | Four is the protocol minimum. Softer bone, a larger jaw or a heavy bite often calls for five or six, and the extra implants are extra cost |
| The definitive bridge material | Acrylic teeth on a titanium bar costs less and is repairable; a monolithic zirconia bridge costs considerably more and resists wear far better |
| Extractions on the day | Removing remaining hopeless teeth during the same surgery is routine, but it is work and it belongs on the quote |
| Grafting, if the scan calls for it | Usually avoided by tilting, occasionally not — see bone grafting and sinus lift |
| One arch or two | Upper and lower are separate treatments and separate quotes, whether done together or staged |
| The implant system | A documented system from an established manufacturer means parts are still available in fifteen years. Economy systems are cheaper because that is what you are not buying |
The examination is $20 and is deducted from the cost of treatment if you go ahead. After the 3D scan you receive a written, itemised, fixed quote — implants, provisional bridge, definitive bridge and every visit — and it does not change once treatment starts.
All-on-4, All-on-6, or something else entirely
The number in the name is the number of implants, and it should follow your bone rather than a brochure. There is no prize for using fewer.
| Option | When it is the right answer |
|---|---|
| All-on-4 | The standard protocol. Enough for most arches, and the tilting usually avoids grafting. Fewest implants, lowest cost of the fixed options |
| All-on-6 | Softer bone, a bigger arch, a heavy or grinding bite, or simply wanting a margin — if one implant is ever lost, five still carry the bridge. Common in the upper jaw |
| Implant overdenture on 2–4 implants | Removable but clipped firmly in place. Far more stable than a conventional denture, far less expensive than a fixed arch, and the honest answer when budget or bone rules out fixed |
| Individual implants and crowns | When enough natural teeth are sound that a full arch would mean extracting healthy ones. Nobody should lose a good tooth to make a treatment plan tidier |
We will quote the overdenture honestly alongside the fixed arch rather than pretending fixed is the only option. It is a real treatment, and for some patients it is the right one.
The day itself, and the months after
The part patients most want to know is whether they go home with teeth. In almost every All-on-4 case the answer is yes.
- 3D scan and planning. The CBCT decides how many implants, at what angles, and whether anything has to be grafted. This is also when the written quote is issued.
- Surgery day. Any remaining hopeless teeth come out, the implants go in. Carried out with a named oral surgeon, under local anaesthetic with sedation available.
- Fixed provisional bridge, same day or the next. Screwed on. You leave with teeth, and you are never seen in public without them.
- About four months of healing. A softer diet, short review visits, and no heroics — this stage is the treatment, not a wait between appointments.
- The definitive bridge. Impressions, a try-in, then fitting. This is the bridge you keep.
- Maintenance every three to four months, for life. Not optional. See below.
The provisional is not the final bridge, and that matters
This is where full-arch marketing does its most misleading work. The photograph of a patient smiling on the afternoon of surgery is real — but what they are wearing is an acrylic provisional. It is deliberately lighter and more forgiving than the final bridge, because the implants underneath are not yet fused and must not be loaded hard. It can chip. It is meant to.
The definitive bridge comes months later, once the bone has done its work, and it is a different object: acrylic teeth on a milled titanium bar, or a single piece of zirconia. Longer-lasting, more precisely fitted, more expensive. Any quote worth signing names both, prices both, and makes clear which photograph you are being shown. The same honesty applies to the broader “teeth in a day” claim.
Who All-on-4 suits, and who it does not
It suits patients who have lost, or are about to lose, most of the teeth in one jaw: long-term denture wearers tired of adhesive and movement, and people with advanced gum disease facing the loss of a whole arch. For them the change in eating and confidence is among the largest in dentistry.
It is the wrong answer in several situations, and we will say so. If you still have a reasonable number of sound teeth, extracting them to fit a full-arch plan is destruction dressed as treatment — individual implants or a bridge is the honest route. Heavy untreated grinding breaks full-arch bridges and needs addressing first. Severe uncontrolled diabetes and heavy smoking both measurably raise the failure risk, and we will give you the real numbers rather than refuse you or pretend the risk is the same. And if the budget genuinely does not reach a fixed arch, an implant overdenture is a far better outcome than a fixed arch half-funded.
Living with a fixed arch: the maintenance nobody mentions
A full-arch bridge sits slightly off the gum. That deliberate gap is how it is cleaned, and it is also where plaque collects invisibly. Implants do not decay, but the gum and bone around them can become infected — peri-implantitis — and that is what ends full arches, not the implants wearing out.
- A water flosser daily, run along the entire underside of the bridge. This is the single most useful habit.
- Superfloss threaded underneath, which reaches what the water misses.
- Brushing the outside as you always did, at the gum margin.
- Hygiene visits every three to four months, where the underside is cleaned professionally and the bridge is sometimes unscrewed to clean beneath it properly.
Patients who do this keep their arches for many years. Patients who do not lose implants, and the loss is usually painless until it is advanced. Our hygiene visits are built around this, and we would rather have the conversation before you commit than after.
Upper and lower arches are not the same job
The lower jaw is denser bone, which holds implants firmly from the start and makes immediate loading more predictable. The upper jaw is softer and has the sinus above it, so upper arches more often need six implants rather than four, and occasionally need the provisional bridge delayed rather than fitted on the day. Patients are sometimes puzzled that two quotes for “the same treatment” differ between jaws. That is why.
Coming from outside Beirut, or from abroad
Full-arch treatment is the most travel-sensitive thing we do, because the healing months are fixed and cannot be negotiated away. Patients come to us from Saida, Tripoli, Nabatieh, Zahle, Jounieh and the Bekaa, and the plan is built around reducing the number of journeys rather than pretending the timeline can be compressed.
From abroad it is two trips: roughly a week for the scan, surgery and provisional bridge, then four months of healing at home with photo checks on WhatsApp, then seven to ten days for the definitive bridge. Send a panoramic X-ray or CBCT on WhatsApp before you fly and we will tell you honestly whether a fixed arch is realistic for your bone. The guide for expats and visitors covers what fits in one stay and what does not.
Where we are in Beirut
The clinic is on Mar Elias Street, in the middle of Beirut — Hamra, Ras Beirut, Verdun, Mazraa, Tarik el Jdideh, Caracas, Sodeco, Badaro, Achrafieh and Gemmayze are all inside fifteen minutes outside of rush hour, with the Cola and Barbir junctions putting the southern suburbs and the airport road within easy reach. Full-arch treatment means several visits across months, so the drive is worth thinking about before you commit. See how to find the clinic, or read what patients say first.