Index / Implants
All-on-4 & full-arch
A whole arch,
screwed in,
and yours to keep in.
Where a full set of upper or lower teeth is failing or already gone, four to six implants can carry a fixed arch that you do not take out. In suitable cases a provisional arch goes in the same day as the surgery.
Why people come here
- He teaches occlusion and full-mouth rehabilitation to other dentists
- Fellowships in three academies — FAGD, FACE and FICOI
- The complex cases other practices refer out
- A written, itemized plan before anything is scheduled
How it works
Four implants, angled
to use the bone you have.
The front of the jaw keeps its bone far better than the back, because the back is where bone is lost first once teeth are gone. The All-on-4 approach exploits that: two implants placed vertically at the front, and two angled backward through the denser bone, so that an arch can be supported without grafting the areas where bone is thin.
Angling the rear implants spreads the support further back, which is what lets four implants carry a full arch of teeth. Some cases take five or six for a better load distribution, and that decision comes from the 3D scan rather than from the name of the technique.
The result is screwed into the implants. You do not take it out; it is removed only by the dentist, at maintenance visits.
The timeline
Teeth the same day.
Final teeth in months.
Being precise about this matters, because “teeth in a day” is widely advertised and widely misunderstood.
Planning
3D scan, digital scans, photographs, a design of the finished arch, and a written itemized plan with the full sequence and cost.
Weeks beforeSurgery day
Any remaining teeth removed, the implants placed, and a fixed provisional arch attached the same day in suitable cases. You leave with teeth.
Day oneHealing
Three to six months while the implants integrate. You wear the provisional arch throughout, on a soft then normal diet as directed.
3–6 monthsRefinement
The provisional is the live test of shape, length, speech and bite. What you want changed is recorded and built into the final arch.
During healingFinal arch
The definitive arch is made in its final material, fitted, and the bite measured and verified. This is the one built to last.
Month 4–7Honest comparison
Fixed arch against an implant denture.
Implant-retained denture
Removable, and considerably less expensive
- Two to four implants rather than four to six per arch
- You take it out to clean, which some patients prefer and others dislike
- Covers the palate on an upper, which affects taste and sensation
- A fraction of the cost of a fixed arch
- Attachments wear and need replacing periodically
Fixed full arch
Stays in, and feels closest to teeth
- Four to six implants per arch, angled to use available bone
- Not removable by you — cleaned in place, around and underneath
- No palatal coverage on an upper, so taste and speech are more natural
- The most expensive implant option, and the one most patients prefer
- Requires real commitment to cleaning under the arch, daily
Questions
Full-arch work, answered.
Do I really get teeth on the same day?
In suitable cases, yes — a fixed provisional arch, attached to the implants, that you leave the office wearing. It looks like teeth and functions for a soft diet. It is not the final arch, and the final arch is made months later once the implants have integrated.
Some cases are not suitable, usually because the implants did not achieve enough initial stability to load immediately. In that situation loading would risk losing them, and a removable temporary is used instead. You would be told on the day.
How do I clean under it?
With a water flosser, specialized brushes that pass under the arch, and a technique you are taught before you leave. This is the real commitment of a fixed arch. The arch is also unscrewed and professionally cleaned at maintenance visits, typically once or twice a year.
What if an implant fails?
A failing implant is usually detected at a review visit before it becomes an emergency. Depending on which one it is and where the others sit, it is removed and either replaced after healing or the arch is redesigned around the remaining implants. It is not routine, and it is not a catastrophe.
Will it feel like my own teeth?
Closer than any removable option, and most patients describe it as a transformation. It is still not identical: there is no sensation from the implants the way there is from a tooth root, and the arch is one piece rather than individual teeth. Speech and chewing normalize within a few weeks for most people.
Keep reading
Next step
Start with an examination and a straight answer.
A consultation includes an examination, the records the case needs and a written, itemized plan. If what you are asking for is not the right treatment, Dr. Nosti will say so and tell you what is.