All-on-4 is the full-arch implant solution most commonly considered by dental tourists — and with good reason. The cost differential between the US or Australian market and Turkey or Vietnam on a bilateral All-on-4 case can reach $30,000 to $50,000. Before evaluating destinations and clinics, this guide addresses the prior question: are you a clinically appropriate candidate?
What All-on-4 is
All-on-4 is a specific implant technique, developed by Nobel Biocare in collaboration with Portuguese surgeon Paulo Maló, in which four implants per arch support a fixed full-arch prosthetic bridge. The design uses:
- Two anterior (front) implants: placed vertically in the better bone volume near the front of the jaw
- Two posterior (back) implants: angled 30 to 45 degrees to maximise bone contact and reach denser bone regions, avoiding the sinus or the inferior alveolar nerve
The angled posterior implants are what make All-on-4 work in patients with significant bone loss — they avoid the areas of worst resorption and engage denser, better-preserved bone.
On the same day as implant placement, a temporary full-arch bridge is attached — hence the marketing term “teeth in a day.” The temporary bridge is worn during osseointegration (3 to 6 months), then replaced with the final prosthetic arch.
Who qualifies: the primary candidates
Missing most or all teeth in an arch: All-on-4 is designed for full-arch restoration. It is not appropriate for patients who are missing just a few teeth.
Patients with multiple failing teeth: Patients with severe decay, periodontitis, or fractures affecting the majority of remaining teeth are often better served by a planned full-arch extraction and All-on-4 than by attempting to save compromised teeth one by one.
Denture wearers seeking a fixed solution: This is the largest single demographic. Removable dentures cause ongoing bone resorption by not transmitting functional load to the jaw. They also impair chewing efficiency and quality of life. All-on-4 restores fixed function, halts further bone loss at the implant sites, and is reported to dramatically improve quality of life in this patient group.
Patients with bone loss who cannot support conventional implants without extensive grafting: All-on-4’s angled implant design was specifically developed to circumvent the need for sinus lifts and extensive bone augmentation in atrophic (bone-resorbed) arches.
The bone assessment: what you actually need
Unlike conventional implants, which require specific bone volume at each implant site, All-on-4 is designed around the available bone in the anterior jaw. The practical requirement is:
- Anterior (front) bone: Sufficient height and width for the two straight anterior implants — typically 10 to 12 mm height and 5 to 6 mm width at the implant site
- Posterior bone access: Sufficient bone distal to (behind) the mental foramen (lower jaw) or anterior to the sinus (upper jaw) for the angled implants — the design specifically works around these anatomical structures
In cases of extreme bone resorption where even All-on-4 cannot achieve adequate primary stability, a pre-surgical bone graft stage may be required — but this is less common than with conventional implants. The CBCT scan determines whether the available bone is sufficient.
Health requirements
All-on-4 is a significant surgical procedure involving multiple implant placements and, typically, multiple extractions in the same appointment. The health requirements are similar to but more stringent than for single implant placement.
Well-controlled diabetes: Same threshold as single implants (HbA1c below 7.5 to 8.0), but with greater importance given the larger surgical scope. Poorly controlled diabetes significantly impairs wound healing across a full-arch procedure.
No bisphosphonate contraindications: The ONJ risk is more significant with multiple surgical sites across a full arch than with a single implant. Bisphosphonate status must be reviewed with your prescribing physician before proceeding.
No uncontrolled periodontal disease: Any remaining teeth with active periodontal infection should be extracted or treated before All-on-4 placement — implant sites adjacent to infected tissue are at higher risk.
Blood pressure control: Surgical procedures at this scale require controlled blood pressure. Severe hypertension may need medical management before proceeding.
Non-smoking or cessation: Smoking during the osseointegration period significantly increases implant failure risk. The stakes are higher with full-arch All-on-4 — a single implant failure in a 4-implant system is more consequential than failure of one of eight conventional implants.
Who does not qualify
- Patients missing only a few teeth: All-on-4 is full-arch. It is not a solution for 2 to 5 missing teeth with otherwise healthy dentition.
- Active bone infection or untreated periodontitis in the full arch: Must be resolved first.
- Severe, uncontrolled systemic disease: Same absolute contraindications as any major oral surgery.
- Patients with insufficient anterior bone even for angled placement: Rare, but possible in extreme cases of long-term bone resorption — pre-surgical bone augmentation may be required.
- Patients expecting the same density as natural teeth: All-on-4 typically supports 10 to 14 prosthetic teeth on 4 implants, which is slightly less biting surface and load-distribution than natural dentition. Expectations should be set accordingly.
All-on-4 vs All-on-6 vs implant-retained dentures
All-on-4 (4 implants per arch): Designed for reduced bone volume; angled posterior implants; one of the most studied full-arch protocols globally; Nobel Biocare holds the trademark but many clinics offer equivalent “4-implant full arch” protocols.
All-on-6 (6 implants per arch): Six implants provide better load distribution, particularly in the upper arch where bone is typically softer. Some prosthodontists prefer 6 implants for greater long-term stability. Requires slightly more bone volume than 4-implant protocols. Costs more.
Implant-retained (snap-on) dentures (2–4 implants): A cost-effective middle ground. The denture attaches to implant locators and snaps in/out for cleaning. More stable than conventional dentures but removable. Not as functional as a fixed arch. Cost is lower; bone requirements are more modest. Appropriate for patients who are not good fixed-arch candidates or for whom cost is the primary constraint.
The right choice between these depends on your bone volume, budget, and preference for fixed versus removable. An experienced All-on-4 surgeon will advise on the most appropriate protocol after reviewing your CBCT scan.
What All-on-4 costs abroad vs at home
All-on-4 cost comparison (per arch, 2026, USD)
Full-arch treatment including implants, temporary bridge, and final prosthetic. Single arch. USD.
| Location | Per arch | Bilateral (both arches) |
|---|---|---|
| US (private practice) | $18,000–35,000 | $30,000–60,000 |
| UK (private) | £12,000–20,000 | £20,000–36,000 |
| Australia | AUD $22,000–38,000 | AUD $38,000–65,000 |
| Turkey | $5,000–9,000 | $9,000–15,000 |
| Vietnam | $5,500–9,500 | $10,000–16,000 |
| Mexico | $4,500–8,000 | $8,000–14,000 |
| Hungary | $6,000–11,000 | $10,000–19,000 |
For bilateral All-on-4, dental tourism delivers savings of $20,000 to $50,000 versus US domestic pricing — in a category where the domestic alternatives (continued dentures or conventional implants with extensive grafting) do not close the gap meaningfully.
Related guides
- All-on-4 procedure guide
- Bone grafts and sinus lifts
- Am I a candidate for dental implants?
- Dental implant costs by country
- Dental tourism in Turkey
- Dental tourism in Vietnam
This guide is for informational purposes only. Consult a qualified implantologist for assessment specific to your jaw anatomy, bone volume, and health history.