All on 4

All-on-4 is a dental concept for edentulous patients to anchor a fixed dental prosthesis on four dental implants. Only titanium is suitable for the material of the implants; a fixed All-on-4 is not possible with ceramic implants.

Procedure for All-on-4

Edentulous patients receive four dental implants in each jaw. A horseshoe-shaped dental prosthesis is firmly connected to the inserted implants with screws. The screwed prosthesis remains immobile anchored in the jaw and can only be removed by a dentist.


  • Lower costs, as fewer implants are used.
  • Shorter surgery duration compared to eight implants.
  • Bone augmentation can often be avoided due to the angled position of the implants and the prosthesis.


  • Only titanium implants can be used.
  • Unfavorable loading of the bone.
  • Bone resorption continues between the implants.
  • Food residues can remain under the prosthesis, affecting hygiene. Bad breath, gum inflammation, and peri-implantitis can be the result.
  • A gap between the fixed dental prosthesis and the gums can cause difficulties in speaking, and unwanted hissing may occur.
  • The horseshoe-shaped prosthesis blocks the entire jaw. Physiological movements in the area of the sutures are no longer possible.
  • Aesthetics are limited, and the restoration often looks unnatural.
  • The screwed prosthesis frequently leads to a foreign body sensation in the mouth.

Do we recommend the traditional All-on-4 concept?

No. In our opinion, the All-on-4 method has too many disadvantages for patients.

We do not offer this concept in our dental practice. To avoid the drawbacks and to provide a edentulous patient with a fixed restoration without compromises, a minimum of eight dental implants per jaw is required. Read more about All-on-8.

Even the All-on-6 concept is insufficient to achieve a permanently stable fixed solution with ceramic implants.

Alternatives to All-on-4

The choice of alternatives depends on whether the patient prefers a fixed or removable dental prosthesis. Generally, we recommend a permanently stable, fixed restoration in most cases.

  • A satisfactory fixed restoration for an edentulous jaw can only be achieved with a minimum of 8 implants per jaw. Read more about All-on-8.
  • A removable restoration with a dental prosthesis can be achieved with 4 to 6 ceramic implants.

Dr. med. dent. Tobias Steinherr M. Sc.

With the All-on-4 concept, four implants are used for your dental restoration. We are happy to show you the advantages and disadvantages.

Dr. Tobias Steinherr Dentist St. Gallen

Further information

Here you will find further information on the subject for a deeper insight.