Facing the loss of most of your teeth?
When both arches are failing, patching them one crown at a time is expensive and it does not hold. There is a point where rebuilding is the cheaper and more honest answer. Send us a photo and we will tell you where you actually are.
- A call within two hours during office hours.
- A written cost from us, before you commit to anything.
- No obligation. Many patients take weeks to decide. That is normal.
What this case cost
$622/month
144 payments at 9.99% APR, on approved credit.
Total: $52,000 for both arches on eight implants.
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Treatment Plan by Dr. Mehdizadeh
- Extraction of infected teeth causing progressive bone loss and systemic health concerns
- Healing period to establish optimal bone and soft tissue foundation for implant placement
- Strategic placement of 4 implants per arch using angled posterior positioning to maximize bone contact
- Custom bite and smile design mapped to facial proportions, lip dynamics, and aesthetic goals
- Upper and lower implant-supported bridge fabrication with natural translucency and custom gum tissue
- In-house laboratory collaboration for real-time adjustments during prosthetic fabrication
What Is All-on-4 Full Mouth Reconstruction and Who Needs It?
This patient came to us with multiple infected teeth causing progressive bone loss that affected both his oral and systemic health. Years of deterioration had left him overwhelmed and uncertain about where to begin. We developed a comprehensive treatment plan to address the immediate dental problems and restore full function and aesthetics within a single coordinated treatment.
The All-on-4 technique uses four strategically placed dental implants per arch to support a complete bridge of teeth. Rather than requiring one implant per missing tooth—which would mean 12–14 implants per arch—the protocol positions four implants at calculated angles that maximize contact with available bone. The two posterior implants sit at an angle of approximately 30–45 degrees to engage longer spans of bone and avoid anatomical structures such as the maxillary sinus in the upper jaw and the inferior alveolar nerve in the lower jaw. This angled placement often eliminates the need for separate bone grafting procedures, reducing both treatment time and surgical complexity.
“It is important in a case like his to work with a team who has experience handling all aspects of the case—surgery, prosthetics, and laboratory work—under one roof.”
Why Did We Extract the Infected Teeth First?
The first critical step involved removing all infected teeth that were actively destroying jawbone. Chronic dental infections do not remain localized; the bacteria progressively dissolve surrounding bone, and the longer compromised teeth remain in place, the less bone is available for future implant placement. The infections had already caused significant bone loss in multiple areas. Dr. Mehdizadeh extracted the compromised teeth, and we allowed time for the bone and soft tissue to heal and stabilize before implant surgery.
The All-on-4 Advantage Over Traditional Implant Approaches
Traditional full-arch implant reconstruction may require 6–8 implants per arch, multiple bone grafting surgeries, and 9–12 months of treatment. The All-on-4 protocol achieves comparable results with 4 implants per arch, frequently eliminates the need for grafting by utilizing angled posterior implants, and typically takes 12–20 weeks.
How Did We Design the Smile to Match His Face?
Once he had healed, Dr. Mehdizadeh designed a custom bite and smile for this patient’s facial features. Every patient has unique facial proportions, lip dynamics, midline position, and aesthetic preferences that determine what the final teeth should look like. He analyzed this patient’s face from multiple angles, studying how his lips moved during speech and smiling, and designed teeth that would look natural in both static and dynamic views.
The final prosthetics feature natural translucency and surface texture that mimic real enamel. Teeth are not uniformly white or opaque—natural teeth have subtle color gradients, translucent incisal edges, and surface characterization that catch light realistically. We designed the gum portion of the bridges to look like natural tissue, with no pink acrylic flanges, no visible transition lines and no bulky contours that signal dental work.
Why Does In-House Laboratory Work Matter for All-on-4 Cases?
We do the surgery and the laboratory work within one practice, and the same team completed all of this patient’s surgery and prosthetic fabrication. That avoids the communication gaps that open when a case goes to an outside laboratory: the surgeon describes what the case needs, the technician interprets those instructions, and the result may require multiple remakes to achieve the intended outcome.
With in-house fabrication, we work directly alongside our ceramist, making real-time adjustments to shade, contour, texture, and fit. We can try in, modify and refine the prosthetic chairside rather than ship it back and forth, which matters in full-arch cases, where millimeters of adjustment affect both function and aesthetics.
- Complete surgical planning, implant placement, and prosthetic delivery by one provider
- Our own laboratory for custom prosthetic design and real-time adjustments
- Direct collaboration between clinician and ceramist throughout fabrication
- Immediate chairside modifications for optimal fit, function, and aesthetics
- Continuity of care from initial consultation through final delivery and follow-up
What Was the Final Result After 16 Weeks?
Treatment took 16 weeks from initial consultation to final delivery. This patient now has a complete set of natural-looking teeth on dental implants in both upper and lower arches. He eats without restriction, speaks clearly and smiles with confidence. Removing the chronic infections also eliminated a source of systemic inflammation, and the implants hold both bridges firmly.
“Natural translucency, realistic texture, gum tissue that mimics nature—nothing fake, nothing bulky.”
Frequently Asked Questions About All-on-4 Implant-Supported Bridges
What is All-on-4 dental implant treatment?
All-on-4 is a full-arch restoration technique that uses four strategically placed dental implants per arch to support a complete bridge of teeth. We tilt the two posterior implants at approximately 30–45 degrees to maximize bone contact and avoid anatomical structures like the maxillary sinus and inferior alveolar nerve, often eliminating the need for bone grafting. This gives you a fixed, long-lasting solution if you have lost most or all of your teeth, and many implant dentists consider it the standard of care for full-arch reconstruction.
How long does All-on-4 treatment take from start to finish?
Complete All-on-4 treatment typically takes 12–20 weeks depending on individual healing, whether you need extractions, and case complexity. This case took 16 weeks, which included extractions, a healing period, implant placement, prosthetic fabrication, and final delivery. Where the implants hold firmly, you receive a fixed temporary bridge the day of surgery; otherwise you wear an interim denture made before the surgery. Our laboratory makes the final bridges in the meantime.
How much do All-on-4 implant-supported bridges cost?
This case was $52,000, covering both arches on eight implants. Our three full-arch options today are $19,000 per arch in PMMA on a milled titanium bar ($34,000 for both arches), $24,000 per arch in hand-layered zirconia ($42,000 for both arches) and $34,000 per arch for Complex Reconstruction ($58,000 for both arches). Each includes the surgery, IV sedation, extractions, temporary teeth and the follow-up visits until we deliver the final teeth. $622/month: 144 payments at 9.99% APR, on approved credit.
Why choose implant-supported bridges over removable dentures?
Implant-supported bridges are fixed to the implants and function like natural teeth. They need no adhesives, do not slip when you eat or speak, and you do not take them out for cleaning. Most importantly, implants preserve jawbone by providing the mechanical stimulation that prevents bone resorption—traditional dentures actually accelerate bone loss because they sit on the gum surface without engaging the bone. Over 10–20 years, denture patients typically lose significant jaw volume, causing facial collapse, whereas implant patients maintain their bone structure and facial proportions.
Am I a candidate for All-on-4 if I have significant bone loss?
Many patients with significant bone loss are excellent candidates for All-on-4 precisely because the angled posterior implants can engage available bone that straight implants cannot reach. The tilted placement maximizes contact with existing bone in areas like the anterior maxilla and the mental foramen region of the mandible. However, each case requires individual evaluation with a 3D X-ray (CT scan) to assess bone density, volume, and the positions of critical anatomical structures.
What is the difference between All-on-4 and All-on-6 implants?
All-on-4 uses four implants per arch while All-on-6 uses six. The choice depends on bone availability and the distribution of forces across the arch. Four implants are sufficient for the majority of patients when properly positioned. We may recommend six implants when the patient has compromised bone quality, a particularly long arch, or heavy bite forces. Both approaches support the same type of fixed full-arch bridge. Dr. Mehdizadeh decides the number of implants from your anatomy and functional requirements.
What materials are used for All-on-4 bridges?
The two primary options are monolithic zirconia and hybrid bridges (acrylic teeth over a titanium or cobalt-chrome framework). Monolithic zirconia is the strongest and most natural-looking option, with excellent translucency and resistance to staining and chipping. Hybrid bridges are lighter and easier to repair but may require refurbishment after 7–10 years. We discuss the advantages and trade-offs of each material with you during treatment planning, so you can make an informed decision.
How long do All-on-4 implant-supported bridges last?
The implants themselves typically last many years with proper care. The prosthetic bridges typically last 15–25 years depending on the material used and how well the patient maintains them. Zirconia bridges tend toward the longer end of that range. Maintenance includes professional cleanings every 6 months with specialized instruments, annual evaluation of the prosthetic screws and connections, and diligent home hygiene with water flossers and interdental brushes.
What makes in-house laboratory work important for All-on-4 cases?
Full-arch prosthetics require precise fit across 4 implant connections, accurate shade matching, natural gum tissue contouring, and proper occlusal contacts across all teeth simultaneously. When a practice outsources its laboratory work, each adjustment requires shipping the prosthetic back and forth, adding weeks to treatment and introducing communication errors. Our own laboratory allows direct collaboration between surgeon and ceramist, with real-time adjustments to fit, shade, contour, and texture.
Can infected teeth be extracted and implants placed on the same day?
In some cases, immediate implant placement after extraction is possible, but it depends on the severity of the infection and the condition of the surrounding bone. Active infections can compromise implant integration, so we often recommend a healing period to allow the bone and soft tissue to stabilize. This patient required a healing phase between extractions and implant placement due to the extent of infection and bone loss. Dr. Mehdizadeh sets the timing for each patient from the clinical findings.
