All-on-4
Also known as: All-on-four, All on 4, Four-implant full-arch protocol
A full-arch protocol in which four implants — two placed axially at the front of the jaw and two tilted distally — carry an immediately loaded fixed prosthesis, avoiding grafting of the posterior jaw.
Key facts
| Trademark status | Nobel Biocare Services AG lists "All-on-4® treatment concept" among its trademarksVerified spec[1] |
|---|---|
| Classification | The protocol uses four implants in the anterior part of a completely edentulous jaw to support a provisional, fixed and immediately loaded prosthesis; the two anterior implants are placed axially and the two posterior implants are placed distally and angled to reduce cantilever lengthVerified spec[2] |
| Clinical evidence | A systematic review of 24 articles covering 11,743 implants reported survival of 99.8% beyond 24 months, with the lowest reported survival at 36 months being 97.6%Clinical evidence |
| Limitations | The authors of that review describe the evidence as limited by the scarcity of information on methodological quality, inadequate follow-up and sample attrition, with sample size calculation reported by only one study; biological complications such as peri-implantitis were reported after a mean follow-up of about two yearsClinical evidence |
| Terminology | Two things share the name. "All-on-4" is a registered trademark of Nobel Biocare for a specific treatment concept using its components; the same phrase is also used generically by clinics and in conversation for any four-implant full-arch protocol, whatever system is used. A quotation for "All-on-4" therefore does not by itself tell a patient which implants, components or prosthetic materials are included. |
| Typical use | Discussed for a completely edentulous jaw, or one where the remaining teeth are not restorable, where posterior bone is insufficient for upright implants but the anterior bone is adequate. |
Overview
All-on-4 places four implants in the front part of the jaw, angling the back two so they reach further along the arch without entering the sinus or the nerve canal, and loads a fixed temporary bridge on them straight away. It may be considered for someone losing or having lost all the teeth in a jaw, where the back of the jaw has too little bone for upright implants but the front still has enough; that judgement needs an examination and a three-dimensional scan. The name is worth understanding precisely: All-on-4 is a registered trademark of Nobel Biocare for its own treatment concept, while the phrase is used far more loosely in the market for any four-implant full-arch case, so two quotations bearing the same name may describe different implants, components and materials. Reported survival in the published review is very high, but the same authors are explicit that the evidence rests largely on retrospective work with short follow-up and attrition, so it should be read as promising rather than settled. The prosthesis is also a maintenance commitment — it is cleaned around, reviewed and eventually remade.
This is general information. Whether any treatment suits you depends on clinical examination, including imaging — no website can determine that.
Sources
Numbers match the citations beside each claim above.
Primary sources
- [1]Trademarks — Nobel Biocare — Nobel Biocare Services AG. Accessed 2026-07-21.
Clinical evidence
- [2]The all-on-four treatment concept: Systematic review — Journal of Clinical and Experimental Dentistry (PMC), 2017. Accessed 2026-07-21.