Fixed teeth in 24 hours: All-on-4® dental implant

Tooth loss has a significant impact on quality of life. When you are faced with partial or complete tooth loss, you cannot eat properly, which directly affects your general health, and social interactions often become difficult or uncomfortable.

Today, however, there are modern dental implant treatments available for those who need full-mouth rehabilitation, regardless of whether tooth loss has occurred gradually or due to conditions such as periodontal disease.

The ‘Fixed Teeth in 24 Hours’ concept is the answer to this challenge and refers to treatment using the All-on-4® dental implant system, an innovative solution that allows the entire dental arch to be reconstructed in a very short time. By inserting just 4 strategically positioned implants and fitting a fixed temporary restoration on the same day, All-on-4® restores the functionality and aesthetics of the smile quickly, safely and with minimal invasiveness.

“The general perception is that only older people lose their teeth, but the truth is that people over the age of 40 also need implants or complex dental restorations. A study carried out by the Romanian College of Dentists in 2024 showed that the prevalence of unrehabilitated edentulism is 73.3% in our country, an extremely worrying figure. “In the absence of dental implant treatment, the consequences for general health are significant,” explains Dr. Marina Băjinaru, Specialist in Dento-Alveolar Surgery.

According to research, missing teeth can affect general health in many ways:

• it increases the risk of cardiovascular disease;
• increased incidence of gastrointestinal and pancreatic cancer;
• increased risk of diabetes;
• increased risk of high blood pressure, heart failure, ischaemic heart disease, and stroke;
• increased risk of chronic kidney disease;
• sleep-related breathing disorders, including obstructive sleep apnoea.

The solution available to patients with complete edentulism to avoid these systemic conditions is treatment with the All-on-4®dental implant system. By inserting just 4 strategically positioned implants and fitting a fixed temporary restoration on the same day, All-on-4® restores the functionality and aesthetics of the smile in a fast, safe and minimally invasive way.

The All-on-4® oral rehabilitation system is a modern technique whereby an entire dental arch is secured to just four implants. This solution represents one of the greatest breakthroughs in modern dentistry.

Developed by the renowned surgeon Prof. Dr. Paulo Maló, with whom DENT ESTET has been collaborating since 2020, the All-on-4® technique uses just four dental implants to support an entire dental arch. This is made possible by the strategic and precise positioning of the four implants:

• Two front implants are placed vertically, where the bone is denser and more stable;
• Two posterior implants are inserted at an angle to avoid areas with thinner bone and to provide strong support for the entire restoration.

This intelligent distribution allows the implants to distribute chewing forces evenly and provide the same stability as a restoration with multiple implants.

“In just one day, you can go from compromised dentition or a complete lack of teeth to an aesthetic and functional smile. In other words, even if a person has no teeth left, after the All-on-4® procedure is completed, they will go home with fixed, stable and aesthetic teeth. Thanks to the temporary prosthesis being fixed onto the 4 implants, they will be able to eat, speak and smile immediately, without long waiting periods or discomfort. “Once healing is complete and the implants have integrated into the bone, the temporary restoration will be replaced with a permanent one, customised to provide harmony, functionality and long-term durability,” explains Dr. Marina Băjinaru.

The main difference between a conventional dental implant and the All-on-4® implant system is that the technique invented by Prof. Dr. Paulo Malo eliminates the need to insert a large number of implants (more than 6–8) to support a full dental arch. Furthermore, traditional dental implants require a longer osseointegration process, and possibly bone grafting, to ensure success.

The All-on-4® implant system, or ‘Teeth in a Day’ as it is known, is an effective, rapid and long-lasting solution for patients who need to regain functionality quickly but wish to avoid removable dentures or unsightly dental bridges. 

• for patients with complete edentulism (total loss of teeth);
• for those who wear removable dentures and want ‘fixed teeth in 24 hours’. All-on-4® eliminates
• discomforts such as denture mobility and the development of painful sores;
• for patients with chewing or aesthetic problems resulting from tooth loss;
• for patients who have lost all their teeth and do not have sufficient bone for conventional dental implants;
• for patients with advanced bone resorption, to avoid bone augmentation (bone grafting);
• for elderly patients who wear dentures.

Stability and comfort similar to natural teeth

Unlike traditional dentures, which can cause discomfort because they are removable and require adhesives, the All-on-4® system offers a fixed, stable solution that feels much more like natural teeth. By anchoring the prosthesis to four strategically positioned implants, the patient can enjoy fixed teeth in just 24 hours, with a high level of comfort and safety in daily use.

Immediate aesthetics after treatment

One of the major differences from traditional techniques is that, immediately after the procedure, the patient receives a fixed temporary restoration that is perfectly aesthetic and tailored to their smile. This avoids the long waiting period associated with other types of treatment, and the patient can resume their daily activities without feeling self-conscious about the appearance of their smile.

Improved chewing and speech

Patients wearing removable dentures usually experience changes in their sense of taste and voice, as the denture covers important sensory areas in the mouth. Replacing it with a fixed All-on-4® restoration restores natural function, allowing for efficient chewing and clear speech, without slipping or discomfort.

Rapid recovery

The All-on-4® technique was created specifically for patients with bone resorption or who require bone grafting, who wish to enjoy an aesthetic and functional smile once again.

By using a special angle for the posterior implants, the treatment makes the most of the existing bone, reducing the need for additional procedures such as bone grafting or sinus lifts. This leads to a rapid recovery, reduced discomfort and a much simpler treatment plan for the patient.

1. Initial consultation and planning

The first step is a detailed assessment of your oral health. The implantologist from the DENT ESTET team examines your gums, the bone of the upper or lower jaw, and the general condition of your teeth.

Imaging tests (X-rays, CBCT scans) are carried out to determine whether the bone volume and density are sufficient or whether bone grafting is required. At this stage, the optimal treatment plan is established, namely whether the All-on-4 technique or another protocol can be used.

2. Insertion of implants and fitting of the temporary prosthesis

In a single session, any irrecoverable teeth are extracted, if necessary, and then the four dental implants are placed.

Immediately after the implants are placed, a fixed temporary restoration is secured onto the four screws. This means that on the very day of the procedure, you will have a new set of functional and aesthetic teeth. This is the key element that makes the concept of ‘fixed teeth in 24 hours’ possible.

3. The healing period

In the weeks and months that follow, the process of osseointegration takes place, whereby the implants become firmly anchored in the bone. During this time, careful oral hygiene and adherence to the dentist’s instructions are essential to ensure the long-term success of the treatment.

4. The final prosthetic restoration and final adjustments

Once osseointegration is complete, which may take several months, the final prosthetic restoration is fitted, perfectly adapted to the patient’s facial features. This results in a complete, stable, functional and aesthetically pleasing set of teeth.

5. Long-term monitoring and maintenance

Regular monitoring, proper oral hygiene and routine check-ups are important to ensure gum health, implant integration and the longevity of the restoration.

The cost of All-on-4® treatment is influenced by a number of factors, including the complexity of the case and the medical resources required to achieve a safe and long-lasting result. The procedure involves not only the insertion of implants, but also a detailed analysis of the bone structure, digital planning, the fabrication of a temporary restoration to be fitted on the same day, and the subsequent production of the final prosthetic restoration.

Factors influencing the cost of treatment with the All-on-4® system:

• The complexity of the case. The degree of bone resorption, the number of extractions required and any preparatory treatments influence the final cost.
• Digital planning and imaging investigations. X-rays, CT scans and precise digital impressions are essential for a safe and predictable result.
• The experience and specialisation of the medical team. At DENT ESTET clinics, All-on-4® treatment involves a multidisciplinary team comprising an implant surgeon, a prosthodontist, a dental technician and, in some cases, specialists in periodontology or orthodontics. The team’s level of expertise directly influences both the cost of treatment and its success.
• The technology used, immediate loading techniques and premium prosthetic materials can influence the cost of the procedure.
• The type of prosthetic work, both temporary and final, represents a significant part of the treatment cost. This work is carried out by the ASPEN Advanced Dental Technology Laboratory, and the cost is influenced by the materials used, which may be premium or standard.

However, it is important to note that the reduced number of implants and the special rehabilitation technique result in relatively moderate costs compared to situations where multiple bone grafts are required to secure a fixed prosthetic restoration. For this reason, All-on-4® treatment can be more affordable compared to solutions requiring 6 or 8 implants and/or complex bone grafting procedures.

If you would like to find out the cost of an All-on-4® procedure at DENT ESTET clinics, please see the full price list for implants and fixed prosthetic restorations here.

The main problem addressed by the All-on-4® technique is complete edentulism, i.e. the absence of all teeth in the dental arch. By inserting the implants at an angle, the dentist can avoid sensitive areas such as the sinuses or nerves in the upper and lower jaws. In this way, in many cases there is no longer a need for additional procedures, such as bone grafting or sinus lifts, making the treatment safer and less invasive.

A full denture is limited because it adheres only to the mucosa and there are no other retention elements. Attempting to bite or chew solid foods is usually only possible to a limited extent compared to the prosthetic work fixed using the All-on-4® technique.

Fixed implant-supported restorations behave most similarly to natural teeth. They do not move and do not cover the gums, as is the case with conventional dentures. Thus, the patient can enjoy clear speech and a normal sense of taste and sensation in the oral cavity.

Last but not least, one of the most important issues we address with this treatment method is time. A temporary prosthetic restoration significantly reduces treatment time compared to conventional restorations.

1. P. Maló; B. Rangert; Miguel Nobre – "'All-on-Four' immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study", 2003
2. "All-on-4® treatment concept". published on www.NobelBiocare.com, 2021
3. History and evolution of the All-on-4® treatment concept - Paulo Malo on the evolution and history of the All-on-4® treatment concept, 2021
4. S. Dikicier, A. Atay, C. Korkmaz - Health-related quality of life in edentulous patients, 2021
5. E. Emami 1, R. de Souza, M. Kabawat - The Impact of Edentulism on Oral and General Health, 2013