Dental Implants & All-on-4

When a person loses their natural teeth due to cavities, gum disease, or trauma in the pre-implant era:

The dentists would grind around the two adjacent teeth ( in most cases perfect teeth ), and use those two teeth to connect a middle tooth to it ( pontic ) to form a bridge. Bridges have disadvantages:

1- There is bone loss occurring over time, and food gets stuck under the pontic of the bridge because the bone under the middle tooth is not getting stimulated, so bone atrophy occurs.

2- Dentist is grinding perfect teeth that cuts down on the longevity of the teeth.

3- If there is a problem (cavity or fracture) on one of those teeth, the whole bridge (3 or more teeth) has to be replaced again.

4- In some cases, there are no reliable or strong teeth around the missing tooth to be used for support.

5- If the missing tooth is the last tooth in the mouth, meaning there is no tooth behind it, a bridge cannot be performed.

Dental Implants 


Dental Implants Image

When there is a tooth missing, the root of that tooth will be replaced with an Implant screw made with Titanium or Zirconia which is biocompatible. An Implant is the best replacement for natural teeth to regain your smile. People with implanted teeth have no difficulty in chewing and biting food. Implant crowns look natural and feel like the original teeth. There is no need to grind the teeth adjacent to the missing tooth anymore.

When Implants are done correctly, there should not be any pain ( minimal ) after surgery. When there is a screw in the jawbone, the bone is stimulated, and stays intact overtime. The sequence is: extract the tooth > bone graft > Implant > screw an abutment that hold the crown to the implant > place the final crown. Normally it takes 3.5 months for the lower jaw, and 4-6 months for the upper jaw.


If the patient does not have enough bone, there is a procedure called All on 4 , that the dentist will permanently screw the bridge to the 4 implants which is fixed ( just like a table that only needs four legs ). In case the missing tooth is a molar (which has more than one root, 2 or 3), the roots are pulled, and bone grafted ; then we wait  ( 3-4  months for lower jaw, and 4-6 months for the upper jaw for bone to grab the implant tightly    ( osteointegration ); therefore the implant is placed in two steps. In a few cases, the implant and the crown can be done at the same time or within 2 weeks, called immediate loading ( the area needs to be out of the occlusion or bite ).

Implants are the best treatment available for people with missing teeth. Implants could last a lifetime with proper care. Implants do not get cavities, and the patient can maintain the bone health around the screw of the implant with routine cleaning, and healthy gums. Unlike popular beliefs, the implants are almost painless because there are no nerves involved; the nerve was in the root that was pulled and replaced with an Implant. As you get older, the nutrition becomes more crucial in your health; and when the patient uses implant supported bridges that can last a lifetime, a person can live longer.
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All-on-4® Dental Implants:

All-on-4 Implant ImageIn extreme cases when most or all of the patient’s teeth are loose, lost, or need to be extracted, there is a procedure that can restore the patients teeth in one appointment called All-on-4®. Basically the first appointment will consist of Xrays, Catscan from the jaw, impression and records from the teeth and the jaw, and before pictures are taken so the lab can make an all around one piece bridge.

Second appointment, patients teeth are removed, smooth and level the bone; then 4 implants are placed strategically in the jaw ( just like a table needs 4 legs only ), then the pre-made temporary bridge is going to be screwed on the top of the 4 implants ( All on 4 implant ); so the patient can lead a normal life. After a short period of time, third appointment the permanent bridge will replace the temporary bridge.

Permanent All on 4  have a stronger base and the Patient can request to change the shape and shade of the teeth for the permanent All on 4 bridge. This All on 4 treatment concept (made possible by Nobel Biocare Implant company) has revolutionized dentistry.

Before All on 4 Implants, patients had to get dentures that were not secured, very unstable, continuous bone loss under the dentures needed to be relined or changed, painful, with limited success rate. With dentures, chewing food is not enjoyable, and because the denture covers most of the gum, it diminishes the taste of the food.


All on 4 dental implants (All-on-4® treatment concept) are a registered trademark of Nobel Biocare Implant company. The All on 4 replaces your teeth with a Bridge that is permanently screwed to 4 implants. No more cavities, bad smell. All the patient has to do is do routine gum cleaning, and use water pick to keep the gums healthy. Because Implants are used in the jaw, it also stimulates the bone, reducing the bone loss. Since only 4 Implants are used, All on 4 implants cuts down on the cost, and time. The patient’s confidence will be back with a normal beautiful smile.

The All on 4 implant concept has many advantages:

  • No bone grafting needed; specially when patients have a lot of bone loss in the back of the mouth. All-on-4 dental implantsmakes it possible for the majority of the people who are not candidates for the typical implants to get implants.
  • Cost effective; because only 4 implant is needed per jaw.
  • Saves lots of time; no time needed for implants to get integrated to the bone; no temporary denture needed for 6 months, and no wait for bone graft material to be hard.
  • No more Cavities and bad breath; because the All on 4 implant bridge is made with titanium, acrylic, and porcelain which cannot get cavities.
  • The only trip to the dentist is to maintain the health of the gum.
  • In 98% of the cases, the All on 4 Bridge lasts a lifetime.
  • If you are diabetic, you can still use the All on 4 implant bridge, because no bone graft is needed.

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