All-on-4 and All-on-X Dental Implants

If you are missing all of your upper or lower teeth, or your remaining teeth are failing, a full arch of replacement teeth supported by dental implants may be an option. At Walnut Creek-Danville Oral Surgery, our oral surgeons place All-on-4 and All-on-X dental implants at our Walnut Creek and Danville offices.

Many patients who come to us have been living with a loose denture, a failing bridge or several teeth that can no longer be saved. Here’s what to know as you consider full-arch treatment.

What are All-on-4 and All-on-X dental implants?

All-on-4 and All-on-X are ways of replacing a full arch of teeth with a fixed set of replacement teeth that is supported by dental implants. “All-on-4” refers to a full arch supported by four implants. “All-on-X” is a broader term used when the number of implants is planned to fit your jaw.

Your oral surgeon will recommend the number and position of the implants after reviewing your 3D imaging, bone structure and treatment goals.

How is a fixed full arch different from an implant-supported denture?

Dental implants can support either a fixed set of teeth or a removable denture. Both options are available at our practice, and the right choice depends on your bone, your goals and how you prefer to care for your teeth.

  • Fixed full arch (All-on-4 or All-on-X): The replacement teeth are secured to the implants and are removed only at maintenance visits.
  • Implant-supported overdenture: The denture snaps onto the implants for stability and can be removed for cleaning.

You can learn more about each option on our Missing All Upper or Lower Teeth and Implant-Supported Overdenture pages.

Who may be a candidate for full-arch dental implants?

Full-arch treatment is generally considered for patients who:

  • Missing teeth: Are missing all or most of the teeth in the upper or lower jaw.
  • Failing teeth: Have remaining teeth that cannot be restored and are recommended for extraction.
  • Denture concerns: Wear a complete denture and would like a more stable or fixed alternative.

Every patient is different. During your consultation, your oral surgeon will evaluate your bone, overall health and goals to determine whether All-on-4, All-on-X or another option is most appropriate for you.

What happens during full-arch treatment?

Full-arch treatment is planned in stages, and your oral surgeon will review each step with you before treatment begins.

Consultation and 3D imaging

Your first visit includes an examination and a cone beam CT (CBCT) scan. This 3D image allows your surgeon to evaluate the bone and plan the position of each implant. Our team will also review your treatment plan, estimated costs and insurance with you.

Bone grafting, if needed

Some patients need additional bone before or during implant placement. Depending on your needs, this may include bone grafting or a sinus lift in the upper jaw. Your surgeon will discuss whether this applies to you.

Implant surgery and temporary teeth

On the day of surgery, any remaining teeth that need to be removed are extracted and the implants are placed. For All-on-4 and All-on-X cases, temporary fixed teeth can be placed the same day as the implants while they heal. Your surgeon will review your anesthesia options with you before surgery.

Healing

After placement, implants typically require 3–6 months to heal and integrate with the surrounding bone. Your oral surgeon will monitor your healing at follow-up visits.

Final replacement teeth

Once healing is complete, your oral surgeon will clear you to return to your general dentist for placement of the final prosthesis. Both doctors are involved in planning your treatment from the start.

Preparing for surgery

If your treatment includes IV sedation/general anesthesia, we recommend preparing for the following:

  • Fasting: Nothing to eat or drink for 8 hours before surgery.
  • Transportation: An adult 18 or older must accompany you, remain at the office during the procedure and drive you home. Rideshare and taxi services such as Uber or Lyft cannot be used.
  • Postoperative instructions: Review our dental implant postoperative instructions before your surgery date.

Caring for a fixed full arch

A fixed full arch is cleaned in place rather than removed at home. Cleaning under the bridge takes more time and dexterity than cleaning natural teeth, and regular maintenance visits are an important part of keeping your implants and gums healthy. Our team will review home care with you after surgery.

How much do All-on-4 and All-on-X implants cost?

The cost of full-arch treatment depends on how many implants are placed, whether bone grafting is needed and the type of replacement teeth. We review all costs with you before treatment. Your oral surgeon and your general dentist bill separately, and our team will help estimate your out-of-pocket cost after reviewing your insurance. Financing is available through CareCredit.

Frequently asked questions

Is All-on-4 the same as All-on-X?

Both replace a full arch of teeth with fixed teeth supported by dental implants. All-on-4 uses four implants, while All-on-X describes treatment where the number of implants is planned for your jaw. Your oral surgeon will recommend the most appropriate approach during your consultation.

Can I get teeth the same day as my implants?

For All-on-4 and All-on-X cases, temporary fixed teeth can be placed the same day as the implants while they heal. Your final replacement teeth are placed after the implants have healed. Your oral surgeon will confirm whether same-day temporary teeth are appropriate for you.

How long does full-arch treatment take?

Implants typically require 3–6 months to heal and integrate with the surrounding bone before the final replacement teeth are placed. The overall timeline may vary depending on your individual needs, including whether bone grafting or additional procedures are necessary.

Will I need a bone graft?

Some patients need bone grafting or a sinus lift to provide enough bone for the implants. Your oral surgeon will evaluate your bone with a cone beam CT (CBCT) scan and let you know whether additional procedures are recommended.

Are All-on-4 teeth removable?

A fixed full arch is secured to the implants and is removed only at maintenance visits. If you prefer teeth you can take out for cleaning, an implant-supported overdenture may be an option. Your oral surgeon will discuss both options with you.

Does insurance cover All-on-4 or All-on-X implants?

Some dental insurance plans cover part of implant treatment, and some cover little or none. Our team reviews your plan and gives you an estimate of your out-of-pocket cost before treatment begins.

Schedule a consultation

To find out whether All-on-4 or All-on-X dental implants are right for you, call our Walnut Creek or Danville office at 925-934-5565 to schedule a consultation with one of our board-certified oral surgeons, Dr. Adam Marre or Dr. Raghav Khandelwal. Both are Diplomates of the American Board of Oral & Maxillofacial Surgery.