All-on-4 Dental Implants in Gilbert, AZ

You’re here because you’ve been told (or you’ve concluded) that some or all of your teeth need to come out, and you want to know what comes next. All-on-4 is one answer — a full arch of fixed, non-removable teeth supported by four implants, placed in a single surgical visit. This page is the honest version of when it’s the right answer, when it isn’t, and what the year actually looks like from consultation to final teeth.

What All-on-4 actually is

All-on-4 is a full-arch implant prosthesis. Four titanium implants are placed in the jawbone — two in the front, two angled in the posterior — and a single connected bridge of teeth is anchored to all four. The angled placement of the two back implants is the technique’s signature: it lets the prosthesis avoid the sinus cavities (upper jaw) and the inferior alveolar nerve (lower jaw) without needing bone grafting in most cases.

The phrase “all on four” refers to a complete arch (10-14 teeth) supported by four implants. There are variations — All-on-6, All-on-8 — but four is the documented sweet spot for most patients: enough fixation to handle bite force, few enough implants to keep the surgery and the cost reasonable, and the angled placement opens up bone that wouldn’t otherwise be usable.

Who’s a candidate, and who isn’t

The honest yes-or-no on candidacy comes from your CBCT scan and a clinical exam, not a phone call. The rough buckets:

• Strong candidates. Fully edentulous patients (no remaining teeth in the arch) and patients with a failing dentition (teeth too compromised to save individually) are the textbook cases. Most patients in this category are good fits.
• Bone loss patients. The angled posterior implants are designed specifically for arches where vertical bone height is reduced. Many patients who’ve been told “you don’t have enough bone for implants” are still candidates for All-on-4 because of how the angled placement uses available bone differently. We confirm with a CBCT.
• Patients with periodontal disease. Severe periodontal disease that’s destroying the bone around your remaining teeth is one of the clearest indications. Removing the diseased teeth, debriding the bone, and placing implants in a single visit interrupts the disease cycle.
• Not candidates (or candidates after intervention). Active heavy smokers (implant failure rates are 2-3x higher; we ask patients to stop for 4 weeks pre-op and 8 weeks post-op), uncontrolled diabetes (HbA1c above 7.5 raises infection risk substantially), recent IV bisphosphonate therapy (oncology-dose; risk of osteonecrosis), and active oral infections that need treatment first.

Dr. Dawood will tell you which group you fall into after the consultation X-rays — not on the phone, and not based on your age. We’ve placed All-on-4 cases on patients in their 80s and turned down healthier 50-year-olds whose cases needed staging. Each patient is evaluated individually.

The All-on-4 procedure, step by step

A typical All-on-4 case runs from consultation to final prosthesis over 4-6 months. The sequence:

1. Consultation + CBCT scan (1 visit, 60-90 minutes). 3D imaging of your jaw, examination of remaining teeth, treatment plan with cost. We rule in or rule out candidacy here.
2. Pre-op planning (off-visit, 2-4 weeks). Dr. Dawood maps the implant positions on the CBCT, designs the temporary prosthesis, and orders the surgical guide.
3. Surgery day (4-6 hours, IV sedation). Any remaining teeth are extracted. The four implants are placed using the surgical guide. Immediate temporary prosthesis (a fixed acrylic bridge) is screwed onto the implants the same day. You leave with teeth.
4. Immediate post-op (week 1). Soft-food diet, no chewing on the new bridge for the first 2 weeks. Pain is moderate for 3-5 days, manageable with prescription medication transitioning to ibuprofen. You’ll come in once for a check-up at day 7-10.
5. Healing phase (weeks 2-16). The implants integrate with bone (osseointegration). You’re eating normally on the temporary by week 6. You’ll have one or two short check-ins in this period.
6. Final prosthesis fitting (1-2 visits, total 3-4 hours, around month 4-5). The temporary acrylic bridge is replaced with the permanent prosthesis — your choice of monolithic acrylic-on-titanium ($20,000 starting) or full-zirconia ($28,000 starting).
7. Annual maintenance. Cleanings every 6 months. Once a year we remove the prosthesis, clean the implant interfaces, and reseat. Most patients need a prosthesis replacement at year 10-15.

Single arch vs double arch

Most patients only need one arch done. The decision points:

• Single arch (most common). One arch is failing or fully edentulous; the other arch is healthy or has restorations that are working. We do All-on-4 on the failing arch and leave the healthy arch alone.
• Double arch (less common). Both arches are failing simultaneously. Less than 30% of cases. Costs are higher ($38,000-$65,000 total) but procedure time is similar (we do both arches the same day under one IV sedation, saving you a second healing period).
• Single arch with planning for the second. If your upper arch is failing now and your lower will probably need treatment in 5-10 years, we still do the upper now and revisit the lower later. There’s no benefit to pre-emptive double-arch surgery.

Material choice: acrylic vs zirconia

The final prosthesis (the part you see and chew with) comes in two materials. The trade-offs:

• Acrylic on titanium bar. $20,000 starting. Acrylic teeth bonded to a titanium reinforcing bar. Lighter, more forgiving on the implants under heavy bite force, repairable in-office if a tooth chips. Lifespan 10-15 years before replacement is typical. Aesthetic result is good — most patients are happy with the appearance.
• Monolithic zirconia. $28,000 starting. The entire prosthesis milled from a single block of zirconia, with esthetic layered ceramics for the front teeth. Stronger, more stain-resistant, better long-term aesthetic match. Lifespan 15-25+ years. The trade-off: zirconia is harder than acrylic, so it transmits more force to the implants — patients with very heavy bite force may be steered toward acrylic.

For most patients we recommend the acrylic-on-titanium for the first prosthesis (gives you a 10-15 year window to evaluate how you actually use the bite) and the option to upgrade to zirconia at the first replacement.

Alternatives compared

• Traditional removable dentures. $1,200-$2,800. Lowest cost, no surgery, but they sit on your gums (not anchored), shift while eating, accelerate jawbone resorption (20-30% bone loss in the first 5 years), and most patients find chewing efficiency drops to 20-30% of natural teeth.
• Implant-supported overdenture (snap-on). $8,000-$15,000. Removable denture that snaps onto 2-4 implants. More stable than traditional dentures, retains bone better, but you still take it out at night. Chewing efficiency 50-70% of natural teeth.
• All-on-4 (this page). $20,000-$28,000 per arch. Fixed, non-removable, brushed in your mouth like natural teeth. Chewing efficiency 80-95% of natural teeth. The patient-experience standard for full-arch replacement.
• Individual implants for each missing tooth. $30,000-$50,000+ per arch (8-10 implants). Most predictable long-term outcome but rarely the right call for a fully edentulous arch — All-on-4 produces a comparable functional result at half the cost.

Long-term maintenance

All-on-4 is not a one-time procedure that’s done forever. The maintenance:

• 6-month cleanings. Same schedule as natural teeth. We use specialized instruments around implant interfaces (titanium can scratch under regular metal instruments).
• Annual prosthesis service. Once a year we remove the prosthesis, clean it thoroughly off-mouth, inspect the implant interfaces, replace any worn O-rings or torque washers, and reseat. About a 90-minute visit.
• Daily cleaning. Twice-daily brushing as normal. A water flosser is the most effective at-home tool for the implant interfaces — we’ll show you the technique at the post-op visit.
• Prosthesis replacement. Acrylic prostheses typically need full replacement at 10-15 years; zirconia at 15-25 years. The implants themselves last 25+ years with proper maintenance.
• What can fail. Acrylic teeth occasionally chip — repaired in-office in a single visit, no implant impact. Implants themselves rarely fail (under 3% at 10 years in non-smokers); when they do, the prosthesis is removed, the failed implant is replaced, and the prosthesis goes back on.