All-on-4 Dental Implants in Vestal, NY

All-on-4 replaces a full arch of teeth on four implants rather than the six to eight a traditional full-arch case uses. Fewer implants, usually no bone graft, and a fixed set of teeth fitted the same day the implants go in.

It is an excellent option for many patients, and part of your consultation is confirming that it is the right one for you.

What Is All-on-4, and How Does It Work?

Four implants are placed in each arch being restored. The two at the front go in straight. The two at the back go in at an angle, which is the whole trick: angling them lets the implant engage dense bone toward the front of the jaw and avoid the sinus above and the nerve canal below.

That angle is why bone grafting is often unnecessary. Patients who have been told there is not enough bone for conventional implants frequently do qualify for All-on-4, because the technique is designed around working with the bone that is left rather than rebuilding what is gone.

A fixed bridge is then secured to those four implants. It does not come out at night. It is not a denture that clips on, which is the implant-supported denture, a different and usually less expensive solution.

What All-on-4 Gives You Back

• Teeth the same day. A fixed provisional bridge is attached at the surgical appointment. You do not go home without teeth and you do not wait months in a temporary denture.
• It stays put. No adhesive, no movement while eating, no palate coverage on the upper arch, so food tastes the way it should.
• Bite force close to natural. Implants transmit load through bone rather than resting on gum tissue, which is the difference between eating an apple and thinking about eating an apple.
• The bone stops shrinking. Implants load the jaw the way tooth roots did. A conventional denture does not, which is why the jaw keeps resorbing underneath one and the fit keeps loosening.
• Four implants instead of eight. Fewer surgical sites, less healing, lower cost than a full set of individual implants.

What to Know Before You Decide

Worth knowing as well: the bridge fitted on surgery day is provisional. Your final restoration is made after the bone has integrated around the implants, and the two are not the same thing in strength, fit or appearance. Anyone presenting the same-day bridge as the finished result is skipping a step.

The Process, Start to Finish

1. Consultation and imaging

A full examination with 3D imaging. We assess bone volume and quality, the position of the sinus and nerve, the health of any remaining teeth, and your medical history. This is also where we tell you if All-on-4 is the wrong answer for you, which happens.

2. Digital treatment planning

Your case is planned on digital implant planning software before anything is done in your mouth. The surgery is rehearsed virtually, implant positions and angles are set against your actual anatomy, and surgical time comes down accordingly.

3. Implant placement

Any failing teeth are removed and the four implants placed. Comfort is managed with local anesthesia and, where appropriate, sedation options. Most patients describe the day as considerably less difficult than they had braced for.

4. Same-day provisional bridge

A fixed provisional bridge is attached before you leave. You go home with teeth, on a soft diet, with clear instructions about what not to do to them for the next few months.

5. Healing, then the final bridge

Three to six months of osseointegration while the bone grows onto the implant surfaces. Then the final restoration is designed, made and fitted, with the shade, tooth proportions and lip support decided with you rather than for you.

The surgery is rehearsed on a 3D model of your jaw before the day itself, so implant angle and depth are decided against your anatomy rather than judged in the moment.

Planned on our Orthophos SL 3D imaging and guided planning system. See our knowledge and technology.

Why This Practice for a Full-Arch Case

Full-arch implant work is the least forgiving thing in general dentistry, because there is no natural tooth left to hide a compromise behind. Three things matter more here than on a routine case.

A prosthodontist in the building. Dr. Fritz Zietsman is board eligible in prosthodontics, the specialty dedicated to replacing missing teeth. Full-arch restoration is the center of that discipline rather than an add-on to it. You can read about the team and what each dentist focuses on.

Planning, surgery and restoration under one roof. Imaging, guided planning, CEREC milling and our own ceramic furnace are all here. Nothing is handed to an outside surgeon and handed back, which is where full-arch cases usually lose their coordination.

Here since 1955. An implant case is a twenty year relationship, not a transaction. It is worth asking any practice quoting you for one how long they intend to be there to maintain it.

All-on-4 Questions We Hear

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  Am I a candidate for All-on-4?
  Most adults with a failing or already missing arch of teeth are. The technique was designed for reduced bone volume, so a previous "you do not have enough bone for implants" is often not the final word. What does need assessing is bone quality rather than only quantity, gum health, whether you smoke, and conditions such as uncontrolled diabetes that affect healing. If All-on-4 is not right for you we will say which of the other implant options is, rather than pushing this one.
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  How long does the whole thing take?
  The surgical appointment usually runs two to three hours per arch, and you leave that day with a fixed provisional bridge. The full sequence from consultation to final restoration is generally four to six months, and almost all of that is healing rather than appointments. We will give you a dated plan at the start so you can work around anything you have coming up.
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  How comfortable is the procedure?
  The appointment itself should not hurt. You are fully numbed and sedation is available if the prospect is what is stopping you. Afterward, expect swelling and soreness for several days, peaking around day two or three and managed with ordinary pain medication. Most people are back at work within a few days. Pain that is increasing rather than settling after the first week is worth a call.
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  How do I clean underneath a fixed bridge?
  This is the question that decides how long the case lasts, and it deserves more attention than it usually gets. You brush as normal, then clean underneath the bridge daily with a water flosser and the specific threaders or interdental brushes we fit you with. It takes a few extra minutes a day. We will teach the technique at the fitting appointment, check it at every recall, and clean professionally around the implants on a schedule set to your case.
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  How long will it last?
  Implants themselves have a strong long-term record, with the large majority still in function well beyond a decade. The bridge on top is the part that wears, and it may need repair or replacement over the years in the same way any restoration does. What shortens both is poor cleaning around the implants, smoking, and unmanaged grinding. We would rather you heard that now than in year six.
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  What does it cost, and what does insurance cover?
  Cost depends on whether one arch or both are being restored, whether extractions or grafting are involved, and the material chosen for the final bridge. Coverage for full-arch implant work is inconsistent, and plans that do contribute usually do so toward parts of the case rather than the whole. We work out your actual benefits and give you a written figure for each route you are weighing, including conventional dentures and implant-supported dentures, so you are comparing like with like. Our payment options page covers the financing most cases use.