All-on-4 or Full Arch?

What All-on-4 Means

All-on-4 is a registered trade name for a specific treatment concept: a full arch of teeth fixed to four implants, with the two back implants angled backwards to make the most of the bone that's there. The angle lets the implants reach solid bone without touching the nerve in the lower jaw or the sinus in the upper, and it often means no bone grafting. The concept was developed in the 1990s and is now used, under various names, by implant dentists worldwide.

Because the name is well known, people use it loosely to mean any fixed full set of teeth on implants. That's the source of most of the confusion.

What Full-Arch Means

Full-arch implants is the general term for replacing every tooth in the upper or lower jaw with one fixed bridge carried on implants. The bridge is screwed to the implants, stays in your mouth, and is only removed by the dentist. All-on-4 is one version of it; a bridge on five or six implants is another.

At St Vincent Smile the Healed Foundation and Staged pathways use four MegaGen AnyRidge implants per arch, and the Same-Day and Premium pathways use four to six. Within that, the number isn't a sales tier, it's what your bone needs: a dense lower jaw often does well on four, while a softer upper jaw may be better spread across five or six. Dr Davinder Kalsi, who has placed more than 2,000 implants over ten years with a success rate above 99%,⁵ decides on the CT scan, and your pathway fee is the same whichever it is.

Four Implants or Six?

Both work. The question is where the load goes.

• Four implants spread the bite across a wide base using the two angled back implants. It's the most common design and suits most lower jaws and many upper jaws.
• Six implants share the load across more points. We tend to use six where the upper bone is softer, where you have a strong bite, or where it gives a safer margin if one implant ever had a problem.
• Five is a sensible middle ground when the scan says four is marginal but six isn't needed.

Nobody can tell you the number from a photograph or a quick look in the mouth. The CT scan shows the height, width and density of the bone, and that decides it. If a practice quotes a number before scanning you, ask how they know.

What All-on-4 Costs in Glasgow

Each fee pays for your consultation and CBCT scan, the digital records and 3D planning that follow, a written plan, the implant surgery that pathway needs, its final bridge, and reviews of both the surgery and the bridge until you're finished. Routine grafting, where needed, costs nothing extra on Staged, Same-Day and Premium. Sinus procedures, larger-scale bone augmentation and long-term maintenance are charged separately, and IV sedation, if you'd like it, is £500 per session.²

Both jaws means two arch fees, so the lowest starting point for both is £18,600. Treatment of £1,500 or more can be spread with Chrysalis Finance: interest free over 6 or 12 months, or up to 60 months at 14.9% APR representative, subject to status. Over 12 months interest free, a Healed Foundation arch works out at about £775 a month. Our implant cost guide has the full price list and how it compares locally.

Which Pathway, and Which Bridge?

The pathway depends on where you're starting from. A jaw that has already healed suits Healed Foundation; teeth that need to come out suit Staged Treatment, or Same-Day Fixed Teeth if you'd like to leave with fixed teeth; Premium Guided Zirconia adds guided surgery and zirconia. The bridge is what you see, chew on and clean, so it's the part that matters most day to day.

• Acrylic / PMMA teeth are the final bridge on the first three pathways. Lighter, and easy to repair if a tooth chips, but they can wear and discolour over the years, so expect to replace the teeth eventually.
• Zirconia on a titanium bar is included on Premium and a +£2,500 upgrade on Healed Foundation. Very strong, stain resistant and the most natural looking, with a milled bar underneath for strength across the arch, which suits heavy bites and longer bridges.

Our guide to full-arch bridge materials goes through each in detail.

How Long It Takes

• Consultation and CT scan: one visit, free.
• Planning: the implant positions are set on the scan; for Premium, we also 3D print a custom surgical guide. On the same-day pathways, the temporary bridge is often made ahead of surgery.
• Surgery day: any remaining teeth come out and the implants go in (on Staged Treatment the extractions come first and the implants follow a healing period). Same-Day and Premium patients usually have the temporary bridge fitted that day;¹ on the other two you heal in a denture. Most people choose IV sedation.
• Healing: about three months on softer foods while the implants bond to the bone.
• Final bridge: made from a digital scan and fitted once the implants are solid.
• Afterwards: hygiene visits every three months, which the guarantee depends on.

Our guide to teeth in a day explains what the same-day bridge is and isn't.

All-on-4 or a Clip-in Denture?

If the cost of fixed teeth is the sticking point, there's a middle option. An implant-retained denture clips onto two implants in the lower jaw or four in the upper. It doesn't move when you eat or talk, but it comes out for cleaning and it's a denture rather than a bridge. From £8,500 per jaw. Our guide to full-arch implants versus dentures compares all three honestly.

Questions to Ask Any Clinic

• How many implants, and how was that decided?
• Which implant system, and does it have a long published record?
• Is a CT scan and a surgical guide used?
• Who places the implants, and who makes the bridge?
• What exactly is included: extractions, grafting, the temporary bridge, the final bridge, reviews?
• What is the final bridge made of?
• What's the guarantee, and what does it depend on?

Our written plan answers all of these before you decide.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.