هي عملية جراحية يتم فيها تثبيت 4 زراعات أسنان في جلسة واحدة للمرضى الذين فقدوا جميع أسنانهم.
Assoc. Prof. Ahmet Ferhat Mısır
Written by DentAkademi Editorial Team
Medically reviewed by Assoc. Prof. Ahmet Ferhat Mısır
Last updated:
النقاط الرئيسية
  • All-on-4 replaces an entire arch of teeth using four implants, two straight at the front and two angled at the back, supporting a full fixed bridge.
  • The angled rear implants use denser bone further forward in the jaw, which often eliminates the need for bone grafting even in patients with significant bone loss.
  • In most cases, a temporary fixed prosthesis is fitted the same day as surgery so you leave the clinic with teeth.
  • The permanent zirconia bridge is fitted approximately 3 to 4 months later once the implants have fully integrated with the bone.
  • At DentAkademi, every All-on-4 case begins with a 3D CBCT scan and guided digital surgery planning. Suitability is confirmed before any plan is finalised.
  • DentAkademi reports a 98.3% implant survival rate because treatment is planned rather than rushed.

If you have lost most or all of your teeth, or you are about to, All-on-4 is the treatment that replaces an entire arch with a fixed bridge supported by just four implants. Not one implant per tooth. Four implants, one complete set of teeth, fitted the same day.

The engineering behind it matters. The two rear implants are placed at roughly 45 degrees rather than straight down. This angle lets them reach denser, better-preserved bone further forward in the jaw, bone that is often still available even when the back of the jaw has resorbed significantly. The result is that many patients who have been told they need bone grafting before implants actually do not need it for All-on-4.

The bridge that attaches to the four implants is fixed. It does not come out at night, it does not move when you eat, and it does not cover the roof of your mouth the way a full denture does. Most patients describe the difference as immediate and significant.

All-on-4 is one of several full-arch approaches. All-on-6 uses six implants, which can be more appropriate for patients with very high bite forces or specific anatomical factors. Neither is universally better since the right choice depends on your jaw structure and clinical assessment, and we will tell you which we recommend and why.

Is All-on-4 Right for You?

All-on-4 is designed specifically for patients with significant tooth loss. The clinical question is not whether you have lost enough teeth, but whether your health and bone structure support the procedure.

✅ Typically suitable

  • Most or all teeth missing (one or both arches)
  • Teeth that are failing, infected, or beyond saving
  • Currently wearing a full denture that does not function well
  • Some bone loss in the posterior jaw
  • Good general health with controlled systemic conditions

❌ May need alternative approach

  • Severe uncontrolled diabetes
  • Active untreated gum disease
  • Uncontrolled cardiovascular disease
  • Insufficient bone even for angled implants (zygomatic implants may be the answer)

⚠️ Needs assessment first

  • Active smoker
  • Osteoporosis or low bone density
  • Blood-thinning medication
  • Recent radiotherapy to the jaw
  • Well-controlled diabetes

If you fall into the middle column, All-on-4 may still be possible as it just needs careful planning and in some cases a modified approach. We will always tell you honestly which category you are in and what we recommend based on your 3D scan.

Not sure if you are suitable? Upload your X-ray and our surgical team will give you a clear answer within 48 hours with no commitment required.

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Clinical Note

Assoc. Prof. Ahmet Ferhat Mısır — Oral & Maxillofacial Surgeon

"The patients I find most rewarding to treat are the ones who have been wearing a full denture for years and assumed that was their only option. Many of them come in expecting us to say the same thing they have heard elsewhere, which is that they have lost too much bone.

In a significant number of those cases, All-on-4 is viable. The angled placement is specifically designed to work around the bone loss that makes conventional implants impractical. But, and this is important, we do not confirm that until we have the CBCT scan. I have also had cases where the scan showed less bone than expected and we had to go a different route. The scan does not lie.

What I always tell patients is that the goal is not just teeth that look good in photos. It is a restoration you will still be happy with in 15 years. That means getting the planning right from the beginning."

— Assoc. Prof. Ahmet Ferhat Mısır, Oral & Maxillofacial Surgeon, DentAkademi

Why Do Patients Choose Istanbul for All-on-4?

All-on-4 is one of the most cost-sensitive treatments in dentistry, not because patients are cutting corners, but because the price difference between Turkey and Western Europe is large enough to be genuinely life-changing. A treatment that costs £20,000 to £30,000 in the UK or €18,000 to €28,000 in Germany is available at DentAkademi for a fraction of that, using the same implant systems, the same zirconia materials, and the same surgical protocols.

ℹ️ Why the cost is lower

The difference comes from operational costs rather than clinical standards. Lower overheads, different salary structures, and government support for health tourism account for this, not reduced materials or care. The implant brands and zirconia used are identical to those in UK and German practices.

What DentAkademi specifically offers for All-on-4 patients:

  • 3D CBCT imaging and digital surgical planning before treatment begins
  • Computer-guided implant placement for precision positioning
  • Same-day temporary prosthesis in eligible cases so you leave with fixed teeth
  • Full-arch zirconia permanent bridge fabricated in our in-house laboratory
  • General anaesthesia available for patients who prefer it
  • Dedicated English-speaking patient coordinator from first enquiry through to aftercare
  • VIP airport transfers and hotel recommendations for every patient
  • WhatsApp availability throughout your recovery period at home

All-on-4 vs. Traditional Implants vs. Dentures

Here is how All-on-4 compares to the main alternatives for full-arch tooth replacement:

العامل All-on-4 Traditional Implants (one per tooth) طقم أسنان متحرك
Teeth on day of surgery? ✅ Usually yes لا ✅ Yes (removable)
Bone grafting needed? ✅ Rarely ❌ Often required N/A
Fixed or removable? Fixed Fixed متحرك (قابل للإزالة)
Palate covered? ✅ No ✅ No ❌ Yes (upper denture)
Number of implants (full arch) 4 6 to 10+ 0
الحفاظ على العظام نعم نعم لا
Overall treatment timeline 3 to 4 months total 6 to 18 months 2 to 4 weeks
Lifespan (with normal care) 15 to 20+ years أكثر من 20 عاماً 5 to 8 years

All-on-4 vs. All-on-6: What is the Difference?

This is one of the most common questions we get, and the answer is more nuanced than simply saying six is better than four.

All-on-4 All-on-6
Number of implants per arch 4 6
Bone requirements Lower because angled placement compensates More bone typically required
Load distribution Across 4 points Across 6 points making it more stable under high bite force
Bone grafting likelihood ✅ Less likely ⚠️ More likely if bone is compromised
الأكثر ملاءمة لـ Significant bone loss and most full-arch cases Good bone density for those who want maximum load distribution
التكلفة ✅ Lower أعلى
💡 How we decide

The decision between All-on-4 and All-on-6 comes down to your bone structure and bite force, both assessed from your CBCT scan. We will recommend whichever gives you the better long-term outcome and explain why.

The All-on-4 Procedure: What Actually Happens

All-on-4 is a surgical procedure carried out in two defined stages separated by a healing period. Here is what each stage involves.

Stage 1 — Surgery Day: Extractions, Implants, Temporary Teeth

Everything in Stage 1 happens in a single appointment. Any remaining teeth that need to come out are extracted first. The four implants are then placed according to the pre-planned positions from your 3D scan, with two vertically at the front and two at roughly 45 degrees toward the back. In most cases, computer-guided surgery is used where a surgical template ensures each implant goes exactly where it was planned digitally.

Once the implants are placed and stability is confirmed, a temporary acrylic prosthesis is attached the same day so you leave the clinic with fixed teeth.

ℹ️ Anaesthesia options

The procedure is performed under local anaesthesia. IV sedation is available and commonly chosen for a procedure of this length so you are relaxed throughout and remember little of it. General anaesthesia is also available for patients who prefer to be fully asleep.

Stage 2 — The Permanent Bridge (3 to 4 Months Later)

During the healing period, your temporary prosthesis stays in place while osseointegration happens as the titanium implants fuse with your jawbone. You use the temporary teeth for eating and speaking throughout, following a soft diet for the first 6 to 8 weeks.

When you return for your second visit, we confirm osseointegration through clinical assessment and imaging. If all is well, digital scans are taken and your permanent zirconia bridge is fabricated on-site. The fit, bite, and shade are adjusted until everything is right.

Your All-on-4 Journey in Istanbul

First Visit — approx. 6 to 8 days

Day ما الذي يحدث
Day 1Arrival in Istanbul — VIP transfer from airport to hotel
Day 2CBCT scan + full consultation + written treatment plan + any pre-op tests
Day 3Surgery: extractions + implant placement + temporary prosthesis fitted
Day 4Rest — coordinator available by WhatsApp for any questions
Day 5Post-op review + prosthesis check + any bite adjustments
Day 6Written aftercare instructions + return flight home (with fixed teeth)

Between Visits — 3 to 4 months at home

Osseointegration occurs while the temporary bridge stays in place. You follow a soft diet for the first 6 to 8 weeks and then progress to normal foods. Your coordinator remains reachable throughout. If you have a local dentist monitoring you, we provide them with full clinical documentation.

Second Visit — approx. 4 to 5 days

Day ما الذي يحدث
Day 1Arrival + osseointegration check
Day 2Digital scanning + shade selection + bridge fabrication begins
Day 3Try-in + adjustments
Day 4Permanent zirconia bridge fitted + final bite adjustment + photographs
Day 5Final review + return flight home
✈️ After both visits

Annual check-ups with your local dentist are sufficient for most implant cases. We provide full written records, X-rays, and implant specifications for your local dentist. Your DentAkademi coordinator remains reachable for questions after you are home.

Clinical Note

What Happens When Same-Day Teeth Are Not Possible?

"Same-day loading, which means fitting the temporary bridge on the day of surgery, is possible in the majority of All-on-4 cases. However, it depends on implant stability at the time of placement, which we measure intraoperatively.

If the stability reading is below the threshold we consider safe for immediate loading, we will not attach the temporary bridge that day. The implants are left to heal first, and the prosthesis is fitted at a later appointment. This adds time, but it significantly reduces the risk of early implant failure.

We explain this possibility during every consultation so patients are not surprised. It is not a complication, but rather a clinical decision made to protect the outcome."

— Assoc. Prof. Ahmet Ferhat Mısır, Oral & Maxillofacial Surgeon, DentAkademi

DentAkademi by the Numbers

6,000+
Dental implants placed annually at DentAkademi
43%
International patients
14
Treatment units
2,500 m²
Dedicated dental facility
98.3%
Implant survival rate

Ready to see if All-on-4 is right for your case? Send us your scan and get a personalised treatment plan.

Get My All-on-4 Treatment Plan

الاعتبارات العملية للمرضى الدوليين

How many visits to Istanbul are required?
Most All-on-4 patients need two visits consisting of the first for surgery lasting 6 to 8 days and the second for permanent bridge fitting lasting 4 to 5 days, separated by 3 to 4 months. Complex cases may need an additional visit confirmed in your treatment plan before you commit to anything.

What about aftercare once I am home?
We send every patient home with full written documentation including treatment records, implant specifications, X-rays, and aftercare instructions. Your DentAkademi coordinator remains reachable by WhatsApp throughout recovery.

What if something goes wrong after I return home?
Minor post-operative issues can usually be addressed remotely. For anything requiring physical review, we arrange it promptly either through a return to Istanbul or in some cases a referral to a trusted local provider. We take clinical responsibility for our work.

Can I eat normally between visits?
With the temporary prosthesis in place, you can eat, though you should follow a soft diet for the first 6 to 8 weeks. After the final restoration, most patients return to a completely normal diet.

Will I look and sound different with the temporary teeth?
The temporary prosthesis is functional and presentable. While it is not the final aesthetic result, it is not embarrassing either, and speech usually adapts within a few days. The permanent zirconia bridge provides the final aesthetic result and is designed to look and feel like natural teeth.

الأسئلة الشائعة

During surgery, no. Local anaesthesia is effective and most patients feel pressure rather than pain. IV sedation is widely chosen for All-on-4 because the procedure takes longer than a single implant. The 3 to 5 days after surgery involve swelling and soreness managed with prescribed medication. Most patients tell us it was less painful than they feared.
In the majority of cases, yes. The temporary prosthesis is fabricated in advance using your scan data and fitted on the day of surgery once the implants are placed. Whether same-day loading is possible depends on implant stability measured during surgery. If stability is below the safe threshold, we delay the prosthesis to protect the outcome, which we explain fully during your consultation.
Most patients do not need it. The angled placement of the rear implants is specifically designed to engage denser bone further forward in the jaw, which is often well-preserved even when the back of the jaw has lost volume. We can only confirm this from your CBCT scan, and if bone grafting is needed, we will tell you before you commit to treatment.
From the first appointment to the permanent bridge, it takes approximately 3 to 4 months. The first visit to Istanbul takes 6 to 8 days for surgery and temporary teeth. Healing happens at home over 3 to 4 months, and the second visit takes 4 to 5 days for the permanent zirconia bridge. You are never without teeth at any stage.
All-on-4 uses four implants per arch while All-on-6 uses six. All-on-6 distributes biting load across more points, which can be beneficial for patients with particularly strong bite forces or good bone density throughout. All-on-4 requires less bone, making it more suitable for most patients with bone loss. Neither is universally better, and we recommend one or the other based on your scan and clinical assessment.
The titanium posts in the bone are intended to be permanent, and DentAkademi reports a 98.3% implant survival rate. The prosthetic bridge of visible teeth typically lasts 15 to 20 years before it may need replacement due to normal wear. Long-term success depends significantly on oral hygiene, avoiding smoking, and attending regular professional check-ups.
Smoking substantially increases the risk of implant failure, especially in the critical first months of osseointegration. We do not automatically refuse treatment to smokers, but we have a frank conversation about the elevated risk and strongly recommend stopping for at least 8 weeks before surgery and throughout the healing period. If you are not willing to stop, that changes our clinical recommendation and we will tell you so.
Well-controlled type 2 diabetes is not an automatic barrier. Poorly controlled diabetes impairs healing, increases infection risk, and significantly raises the chance of early implant failure. We ask for a recent HbA1c result and assess current control before confirming suitability, and we will always tell you honestly if we think the risk is too high.
Zirconia is our standard material for All-on-4 permanent bridges. It is metal-free, highly durable, stain-resistant, and produces natural-looking results. Zirconia bridges are fabricated in our in-house dental laboratory, allowing us to control quality and timing while custom-fitting the shade, shape, and bite to your facial structure.
Early implant failure is uncommon but does occur. If it does, the failed implant is removed, the site is allowed to heal, and placement is reattempted once conditions are right while maintaining the temporary bridge throughout. We discuss our protocol for this, including what costs are covered, before treatment begins so you should ask about this at consultation.
The bridge is cleaned in place because it does not come out. You brush twice daily with a soft-bristle toothbrush, paying attention to the junction between the bridge and the gums, and use an interdental brush or water flosser to clean underneath. We provide detailed instructions and a cleaning kit before you leave after surgery, and professional cleaning every 6 months is recommended.
Some food particles can accumulate under the bridge, particularly in the first weeks while you are adapting. Regular cleaning with an interdental brush or water flosser manages this effectively, and most patients adapt to the cleaning routine quickly once it becomes a habit.
The permanent zirconia bridge is custom-designed to match your facial structure with the size, shape, and shade determined together with you before fabrication. Unlike a full denture, the bridge does not cover the palate, which makes it feel significantly more natural, and most patients report that neither they nor others can tell the difference.
Yes, many patients use their first Istanbul visit to address other dental needs alongside All-on-4 surgery, such as treating the opposing arch or combining it for both upper and lower arches. Where this is clinically appropriate and will not compromise the All-on-4 outcome, we coordinate it into a single treatment plan.
This is confirmed in your written treatment plan before surgery. We work with Straumann, Nobel Biocare, BEGO, Notch, and Osstem, which are systems with documented long-term clinical records. We will explain which system has been selected and why it is appropriate for your anatomy and clinical situation.
The difference comes from operational costs rather than clinical standards. Turkish dental clinics have lower overheads, different labour cost structures, and government incentives for health tourism. The implant brands, zirconia materials, and surgical protocols are the same as those used in well-equipped UK or German practices, making the saving real rather than a reflection of lesser care.

الخلاصة

All-on-4 is the most clinically established approach to full-arch tooth replacement for patients with significant bone loss. It is not the right treatment for everyone since suitability depends on a proper assessment, but for the patients it is right for, it offers a fixed, long-lasting restoration in two visits with teeth fitted the same day as surgery in most cases.

Choosing to have this treatment in Istanbul is a practical decision that many of our patients make after weighing cost, quality, and logistics. The clinical standards at DentAkademi are not a compromise, which is why patients from the UK, Germany, Scandinavia, and the UAE choose us over local options costing two to four times as much. Our 98.3% implant survival rate reflects the planning that goes into every case rather than just the surgery itself.

What we ask of every patient is to come to the consultation with your questions ready. Ask about the surgeon experience, the implant brand, what happens if something goes wrong, and what the long-term maintenance involves because we would rather you make the right decision than a fast one.

Ready to Find Out If You Are Suitable?

Send us your X-ray or existing scan and our surgical team will review it and give you a clear, honest assessment with no commitment required. If All-on-4 is not the right approach for your case, we will tell you what is.

Talk to an All-on-4 Coordinator
زراعة الأسنان All-on-6
زراعة الأسنان