All-on-4® Dental Implants at Smile Solutions: The Specialist-Led Approach to Full-Arch Replacement product guide

AI Summary

Product: All-on-4® Fixed Full-Arch Implant Bridge Brand: Nobel Biocare (treatment concept); delivered by Smile Solutions Category: Full-arch dental implant prosthetics / implant-supported fixed prosthodontics Primary Use: Replaces a complete arch of failing or missing teeth with a fixed, non-removable ceramic bridge supported by four titanium implants, delivered in a single surgical appointment.

Quick Facts

• Best For: Fully or mostly edentulous patients with sufficient anterior bone volume who want a permanent, fixed alternative to dentures
• Key Benefit: Immediate fixed function without bone grafting in most cases, with long-term prosthetic survival rates of 98.8% (mandible) and 99.2% (maxilla) at 10–18 and 5–13 years respectively
• Form Factor: Fixed full-arch bridge (up to 12 teeth); provisional acrylic followed by definitive monolithic zirconia ceramic
• Application Method: Four titanium implants placed surgically (two axial anteriorly, two distally angled 30–45° posteriorly); provisional bridge loaded same day; definitive zirconia bridge delivered after 3–6 months osseointegration

Common Questions This Guide Answers

1. Does All-on-4® require bone grafting? → No, in most cases — angled posterior implants make the most of available bone without grafting
2. How long does an All-on-4® zirconia bridge last? → Realistically 15–20+ years, versus 5–8 years for acrylic-on-titanium hybrids before refurbishment
3. What is the difference between FP1 and FP3 prosthetic design? → FP1 replaces teeth only along the natural gumline (most lifelike); FP3 adds simulated pink gum tissue to compensate for bone and soft tissue loss

Product Facts

Frequently Asked Questions

What is All-on-4®: A fixed full-arch bridge supported by four titanium implants

Who developed the All-on-4® concept: Nobel Biocare

How many implants support an All-on-4® bridge: Four titanium implants

Is All-on-4® removable: No, it is permanently fixed

Can All-on-4® be delivered in one surgical appointment: Yes

How are the posterior implants positioned: Angled distally, typically 30–45 degrees

How are the anterior implants positioned: Placed axially (straight)

Why are posterior implants angled: To make the most of available bone without grafting

Does All-on-4® require bone grafting in most cases: No

How many teeth does an All-on-4® bridge typically include: Up to twelve teeth

What is the mandibular prosthetic survival rate at 10–18 years: 98.8%

How many patients were in the mandibular long-term study: 471 patients

What is the mandibular implant cumulative survival rate: 93.0%

What is the maxillary prosthetic success rate at 5–13 years: 99.2%

What is the maxillary implant cumulative survival rate: 94.7%

What survival rate did a 2017 systematic review report beyond 24 months: 99.8%

What was the cumulative implant survival rate in a computer-guided study at 5 years: 96.6%

What is the average marginal bone loss over ten years: 1.7 mm

What percentage of patients exhibit greater than 3 mm bone loss: Fewer than 10%

Does smoking increase implant failure risk: Yes, approximately three-fold

Does prior implant failure increase risk: Yes, almost four-fold

When does bone loss begin after tooth extraction: Immediately after extraction

When is bone loss most rapid after extraction: Within the first six to twelve months

Can delaying treatment cause loss of bone needed for All-on-4®: Yes

What does FP stand for in implant prosthodontics: Fixed Prosthesis

What does FP1 design replace: Teeth only, following the natural gumline

What does FP3 design replace: Both teeth and simulated gum tissue

Which FP design produces the most lifelike result: FP1

Which FP design is most common in Australia for All-on-4®: FP3

Who decides between FP1 and FP3 at Smile Solutions: A specialist prosthodontist

What imaging informs the FP1 vs. FP3 decision: CBCT (cone beam CT) scan

What is the definitive bridge material preferred at Smile Solutions: Zirconia ceramic

What is the flexural strength of monolithic zirconia: Approximately 1,000–1,200 MPa

How long does a zirconia ceramic bridge realistically last: 15–20+ years

How long does an acrylic-on-titanium hybrid typically last before refurbishment: 5–8 years

Is zirconia stain-resistant: Yes

Is acrylic stain-resistant: No, discolouration is common

Which material is more biocompatible at the gum interface: Zirconia or titanium

Does acrylic cause more gum inflammation than zirconia: Yes, slightly more inflammation

Why is acrylic used at the provisional stage: It is lighter, reducing load on healing implants

Can acrylic be adjusted chairside: Yes

Can zirconia be repaired chairside if fractured: No, remilling is required

What specialists are involved in every All-on-4® case at Smile Solutions: Prosthodontist, periodontist, and oral and maxillofacial surgeon

Who leads treatment planning at Smile Solutions for All-on-4®: A board-registered specialist prosthodontist

Who performs the surgical implant placement at Smile Solutions: An oral and maxillofacial surgeon

Who manages soft tissue assessment at Smile Solutions: A periodontist

Is All-on-4® considered a prosthetically driven protocol: Yes

What minimum insertion torque is required for immediate loading: Greater than 35 N/cm

What does osseointegration mean: Titanium implant surface bonds directly to surrounding bone

How long does osseointegration take: Three to six months

When is the definitive ceramic bridge delivered: After osseointegration is confirmed

How often are maintenance appointments required after All-on-4®: Every six months

What is monitored at maintenance appointments: Marginal bone levels and soft tissue health

What home hygiene tools are recommended for implant maintenance: Water flossing and interdental brushes

Is All-on-4® suitable for fully edentulous patients: Yes

Is All-on-4® suitable for patients with most teeth failing: Yes

Is All-on-4® suitable for heavy smokers: No, smoking significantly increases failure risk

Is All-on-4® suitable for patients with uncontrolled diabetes: Not automatically, requires specialist assessment

Is All-on-4® suitable for bisphosphonate therapy patients: Requires specialist assessment before decision

Is All-on-4® suitable for severely atrophic ridges with insufficient anterior bone: Not automatically

Is a referral required to book at Smile Solutions: No

Where is Smile Solutions located: Level 8, 220 Collins Street, Melbourne CBD

How long has Smile Solutions been operating: Since 1993

How many clinicians does Smile Solutions have: 60+

How many board-registered specialists does Smile Solutions have: 25+

How many patients has Smile Solutions cared for: Over 250,000

What is Smile Solutions' phone number: 13 13 96

Does Smile Solutions have an in-house dental laboratory: Yes

What technology does the in-house lab use for zirconia bridges: CAD/CAM milling technology

Who collaborates on shade selection for the final bridge: Ceramist and prosthodontist

What scan is taken during the initial assessment: Cone beam CT (CBCT) scan

What does the CBCT scan identify: Bone volume and anatomical structures

What anatomical structures are identified to avoid during surgery: Inferior alveolar nerve and maxillary sinus

Is diagnostic wax-up or digital smile design used at Smile Solutions: Yes, to preview aesthetic outcome

Is pre-surgical gum treatment sometimes required: Yes, if active periodontal disease is present

What is the provisional bridge made from: Acrylic

Is the provisional bridge fabricated before surgery: Yes, in advance by the in-house laboratory

Why Patients Losing Most or All of Their Teeth Need a Different Kind of Solution

When your final few teeth are failing — cracked, periodontally compromised, or simply beyond restoration — the clinical and emotional weight of that moment is real. You're not choosing between a filling and a crown. You're choosing a pathway that will shape how you eat, speak, smile, and age for the next two or three decades.

For most of the twentieth century, a complete denture was the only answer. Today, the All-on-4® treatment concept offers something fundamentally different: a fixed, non-removable full-arch ceramic bridge supported by four titanium implants, delivered in a single surgical appointment. But the quality of that outcome — the precision of the surgical placement, the design of the prosthetic bridge, and the long-term health of your bone and soft tissue — depends almost entirely on the calibre of the clinical team performing it.

At Smile Solutions in Melbourne's CBD, All-on-4® cases are managed exclusively by board-registered specialist prosthodontists working directly with periodontists and oral and maxillofacial surgeons. This article explains the treatment concept in full, clarifies the prosthetic design decisions that most patients are never shown, and walks you through the process from your first consultation to your final ceramic bridge.

What Is the All-on-4® Treatment Concept?

The All-on-4® concept, developed and commercialised by Nobel Biocare, is a surgical and prosthetic protocol for immediate function — using four implants to support a fixed prosthesis for patients with completely edentulous arches.

The protocol was designed to make the most of available remnant bone in atrophic jaws, allowing immediate function and avoiding regenerative procedures that add cost and patient discomfort. Four implants are placed in the anterior part of completely edentulous jaws to support a provisional, fixed, immediately loaded prosthesis. The two most anterior implants are placed axially, whilst the two posterior implants are angled distally to reduce cantilever length — allowing prostheses with up to twelve teeth and better chewing efficiency.

That posterior angulation, typically between 30 and 45 degrees, provides excellent implant anchorage, a short cantilever, and a large inter-implant distance — all of which contribute to a predictable outcome.

The key clinical advantage is that tilted implants make the most of your available bone without grafting. This contrasts with traditional implant treatment, where insufficient posterior bone requires grafting procedures that add chair time, cost, and recovery.

Why Bone Loss Makes This Decision Urgent

One of the most consequential facts many patients are never told: bone loss after tooth extraction is not a slow, distant process. It begins immediately and accelerates in the first year.

When tooth roots are removed, the mechanical loading that maintains alveolar bone disappears. Over six to twelve months, significant loss of jawbone density and ridge height is common — particularly on the thin facial side. Width loss can actually exceed height loss, reducing the bone available for implants.

Alveolar ridge resorption is a natural consequence of extraction. Once the socket heals, the strain stimulus needed to maintain bone mass is gone. In practical terms, delaying full-arch implant treatment — even by one to two years — can cost you the very bone volume that makes the All-on-4® graft-free protocol possible.

Inadequate ridge height or width remains one of the main obstacles to successful implant outcomes. Bone loss can also be accelerated by the effects of periodontal disease, infection, or trauma.

This is central to how Smile Solutions approaches All-on-4® timing. The sooner failing teeth are replaced with implant-supported prostheses, the more bone is preserved — and the more predictable the surgical outcome.

The Clinical Evidence for All-on-4®

All-on-4® has one of the most thoroughly documented evidence bases in modern implantology, and the long-term data holds up well.

After ten to eighteen years of follow-up in mandibular rehabilitation patients, the cumulative prosthetic survival rate was 98.8% — only four of 471 patients lost their prostheses due to implant failures. Implant cumulative survival and success rates were 93.0% and 91.7% respectively, across 1,884 implants.

For the maxilla, outcomes are similarly strong: at five to thirteen years, the prosthetic success rate was 99.2%, with only nine of 1,072 patients losing their prostheses. Implant cumulative survival and success rates were 94.7% and 93.9% respectively, across 4,288 implants.

A 2017 systematic review published in the Journal of Clinical and Experimental Dentistry (Soto-Penaloza et al.) found a survival rate beyond 24 months of 99.8%. A separate prospective study using computer-guided surgery reported a cumulative implant survival rate of 96.6% at five years.

Systematic reviews and meta-analyses confirm these findings, with tilted posterior implants in immediate function regarded as a safe procedure — survival rates exceeding 93.9% and average marginal bone loss of 1.3 ± 0.4 mm from twelve to sixty months.

Over ten years, average marginal bone loss was 1.7 mm. Fewer than 10% of patients showed more than 3 mm of bone loss around their implants. The two most significant risk factors were smoking (roughly three times the failure risk) and prior implant failure (almost four times the risk).

The Prosthetic Design Distinction: FP1 vs. FP3

This is the clinical decision that most All-on-4® providers either skip over or oversimplify — and it's arguably the most consequential design choice in full-arch implant treatment.

In implant prosthodontics, fixed full-arch prostheses are classified by how much anatomical structure they replace. FP stands for Fixed Prosthesis, and the numbers describe how much of your natural oral structure the prosthesis replaces. FP1 is used when gum and bone levels are healthy — the teeth follow your natural gum line and produce the most lifelike result. FP2 addresses uneven gum levels, with prosthetic teeth extending slightly below the gumline. FP3 includes artificial gum tissue made of acrylic or zirconia, and is typically needed for patients with major tissue or bone loss requiring full-arch restoration.

FP3 — a bridge that replaces both teeth and a portion of the pink gum tissue — has been the most common choice in Australia for All-on-4® restorations.

The distinction matters both clinically and aesthetically:

• FP1 requires adequate residual bone and soft tissue height, so prosthetic teeth appear to emerge naturally from the gumline without any pink ceramic or acrylic. This produces the most anatomically lifelike result but demands precise bone management and careful surgical planning.
• FP3 compensates for bone and gum loss by adding pink ceramic or acrylic to simulate missing gum tissue. It's appropriate — and often necessary — when significant bone resorption has already occurred.

At Smile Solutions, the choice between FP1 and FP3 is made by your specialist prosthodontist during diagnostic planning, informed by CBCT imaging, ridge measurements, and your aesthetic expectations. This is not a decision that can be delegated to a treatment coordinator or made chairside on the day of surgery.

Ceramic Over Acrylic: Why Material Selection Matters

A frequently misunderstood aspect of All-on-4® treatment is the material used for your definitive bridge. Many providers — particularly high-volume "teeth in a day" clinics — deliver acrylic-on-titanium hybrid bridges as the final prosthesis. Smile Solutions' specialist team advocates for ceramic (zirconia) as the definitive material wherever clinically appropriate, for the following reasons:

Zirconia is one of the strongest ceramic materials available — highly resistant to fractures and chips, and translucent enough to closely mimic natural teeth. It's the material of choice for patients who want a genuinely lifelike result.

From a biocompatibility standpoint, the best materials to contact gums are unglazed zirconia or titanium. When acrylic contacts gum tissue, slightly more inflammation is observed at regular reviews compared with zirconia and titanium.

Acrylic works well at the provisional stage because it's lighter than zirconia, which reduces load on healing implants, and can be adjusted chairside if the bite settles differently during healing. That makes it a sensible transitional material — but not an ideal permanent one.

Smile Solutions' in-house dental laboratory (see our guide on The Role of Smile Solutions' In-House Dental Laboratory in Prosthodontic Outcomes) mills definitive zirconia bridges using CAD/CAM technology, with the ceramist and prosthodontist collaborating on shade, contour, and emergence profile before final delivery.

The Specialist Team Model: Why It Differs from Volume Clinics

The growth of All-on-4® clinics across Australia has created a real quality gap in how these cases are planned and executed. Many practices delegate surgical and prosthetic phases to general dentists who have completed a short-course implant training programme. That's legal — but it's not the same as specialist-led care.

At Smile Solutions, every All-on-4® case involves:

• A board-registered specialist prosthodontist, who leads treatment planning, designs your prosthetic outcome, and delivers both the provisional and definitive restorations
• A periodontist, who assesses and manages the soft tissue environment, including any pre-surgical gum treatment required before implant placement
• An oral and maxillofacial surgeon, who performs the surgical implant placement, extractions, and any necessary alveolar ridge preparation

This model reflects the genuine clinical complexity of full-arch rehabilitation. Fixed implant-supported prostheses provide more stability, comfort, and chewing efficiency than removable dentures — but predictable outcomes require careful case selection, detailed treatment planning, and genuine interdisciplinary collaboration.

Your prosthodontist's role goes well beyond fitting the final bridge. Prosthetic planning drives every surgical decision: the angulation and position of each implant, the height of the multi-unit abutments, and the vertical dimension of occlusion are all determined by the prosthetic design before the first incision is made. This is what clinicians mean when they describe All-on-4® as a "prosthetically driven" protocol.

(For more on the specialist credentialling framework behind this model, see our guide on Board-Registered Specialist Prosthodontist vs. General Dentist: What the Difference Means for Your Treatment.)

Step-by-Step: The All-on-4® Process at Smile Solutions

Stage 1: Comprehensive assessment and diagnostic planning

Your journey begins with a full clinical examination, digital radiographs, and a cone beam CT (CBCT) scan of both jaws. Your prosthodontist and oral surgeon review the imaging together to assess bone volume, identify anatomical structures (including the inferior alveolar nerve and maxillary sinus), and determine ideal implant position. Diagnostic wax-ups or digital smile design software may be used to preview your aesthetic outcome before any treatment begins.

Stage 2: Pre-surgical preparation

If active periodontal disease is present, your periodontist will complete any necessary gum treatment before surgery. Remaining hopeless teeth are identified, and you'll be thoroughly briefed on the full treatment sequence, timeline, and prosthetic design — so you know exactly what to expect at every stage.

Stage 3: Surgery and provisional bridge delivery

On the day of surgery, your oral surgeon extracts any remaining teeth, prepares the alveolar ridge, and places four titanium implants — two axial anteriorly and two posteriorly tilted. All implants must achieve an insertion torque greater than 35 N/cm to confirm primary stability sufficient for immediate loading. Multi-unit abutments are connected, and the provisional acrylic bridge — fabricated in advance by the in-house laboratory — is delivered the same day.

Stage 4: Osseointegration period

Over the following three to six months, your titanium implants undergo osseointegration — the process by which the implant surface bonds directly to surrounding bone. This direct integration with bone tissue is what gives implants their long-term structural stability, and it's why the provisional period matters: the bone needs time to consolidate before the definitive restoration is placed.

Stage 5: Definitive ceramic bridge

Once osseointegration is confirmed clinically and radiographically, impressions or intraoral scans are taken for your definitive zirconia bridge. The in-house ceramist fabricates the restoration, your prosthodontist verifies fit, occlusion, and aesthetics at a try-in appointment, and the final ceramic bridge is delivered and torqued to the implants.

Stage 6: Long-term maintenance

Ongoing peri-implant health requires professional maintenance every six months. Your prosthodontist monitors marginal bone levels radiographically, assesses soft tissue health, and checks the integrity of the prosthetic components. You'll also receive personalised guidance on implant-specific home hygiene — including water flossing and interdental brushes. (See our guide on How to Care for Crowns, Bridges & Dentures: A Prosthodontist-Approved Maintenance Guide for detailed home care protocols.)

Who Is a Suitable Candidate for All-on-4®?

All-on-4® is appropriate for patients who:

• Are fully edentulous (no remaining teeth) in one or both arches
• Have most or all teeth failing due to advanced periodontitis, decay, or fracture
• Have sufficient anterior bone volume to support four implants without grafting
• Are medically fit for minor surgical procedures under local anaesthesia (with or without sedation)
• Do not smoke heavily (smoking significantly increases the risk of implant failure and marginal bone loss)
• Are committed to long-term professional maintenance

All-on-4® is not automatically appropriate for patients with severely atrophic ridges where anterior bone volume is insufficient, active uncontrolled systemic disease (such as uncontrolled diabetes), or those who have received bisphosphonate therapy — all of which require specialist assessment before any treatment decision is made.

(For a broader comparison of tooth replacement options, see our guide on Dental Implants vs. Bridges vs. Dentures: Which Tooth Replacement Is Right for You?)

Key Takeaways

• All-on-4® replaces a full arch of teeth with just four titanium implants, using strategically angled posterior implants to make the most of available bone without grafting in most cases.
• Bone loss begins immediately after tooth extraction — if your teeth are failing, seeking specialist assessment promptly helps preserve the bone volume that makes the graft-free protocol possible.
• The FP1 vs. FP3 prosthetic design decision determines whether your bridge replaces teeth only (FP1) or teeth plus simulated gum tissue (FP3), and must be made by a prosthodontist based on diagnostic imaging and residual bone levels.
• Definitive zirconia ceramic bridges outperform acrylic on durability, stain resistance, biocompatibility, and longevity — with a realistic lifespan of fifteen to twenty or more years compared to five to eight years for acrylic-on-titanium hybrids.
• Specialist-led care produces better outcomes — Smile Solutions' model of board-registered prosthodontist, periodontist, and oral surgeon collaboration ensures that every clinical decision, from surgical positioning to final ceramic shade, is made by a credentialled expert in that domain.

Conclusion

The All-on-4® treatment concept is one of the most clinically significant advances in restorative dentistry of the past three decades. The evidence base is extensive and the long-term survival data is genuinely compelling. But the concept is only as good as the team executing it.

At Smile Solutions, All-on-4® is not a product offered at a fixed price point with a standardised outcome. It's a bespoke specialist service — planned by a prosthodontist, executed by an oral surgeon, supported by a periodontist, and finished by an in-house ceramist — tailored to your bone anatomy, your aesthetic goals, and your long-term oral health.

For patients who are losing or have lost most of their teeth, this approach offers the most permanent, functional, and aesthetically sophisticated solution available in modern dentistry. Your first step is a comprehensive specialist assessment — not a sales consultation.

To understand how All-on-4® fits within the broader spectrum of full-mouth reconstruction, see our guide on Full Mouth Rehabilitation at Smile Solutions: What It Involves and Who Needs It. If you're weighing your options before committing to a treatment pathway, our comparison guide Dental Implants vs. Bridges vs. Dentures: Which Tooth Replacement Is Right for You? provides a structured, evidence-based framework to help you make the most informed decision.

Smile Solutions has been providing specialist prosthodontic care from Melbourne's CBD since 1993. Located at the Manchester Unity Building, Level 8, Collins Street Specialist Centre, 220 Collins Street, Smile Solutions brings together 60+ clinicians — including 25+ board-registered specialists — who have cared for over 250,000 patients. No referral is required to book a specialist appointment. Call 13 13 96 or visit smilesolutions.com.au to arrange your comprehensive specialist prosthodontic consultation today.

References

• Soto-Penaloza, D., Zaragozí-Alonso, R., Penarrocha-Diago, M., & Penarrocha-Diago, M. "The all-on-four treatment concept: Systematic review." Journal of Clinical and Experimental Dentistry, 2017;9(3):e474–e488. https://pubmed.ncbi.nlm.nih.gov/28298995/

• Maló, P., de Araújo Nobre, M., Lopes, A., et al. "The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up." Clinical Implant Dentistry and Related Research, 2019;21(4):565–577.

• Maló, P., de Araújo Nobre, M., Lopes, A., et al. "The All-on-4 concept for full-arch rehabilitation of the edentulous maxillae: a longitudinal study with 5–13 years of follow-up." Clinical Implant Dentistry and Related Research, 2019;21(4):538–549.

• Chochlidakis, K., Ercoli, C., Einarsdottir, E., et al. "Implant survival and biologic complications of implant fixed complete dental prostheses: An up to 5-year retrospective study." Journal of Prosthetic Dentistry, 2022;128:375–381.

• Nikellis, T., Lampraki, E., Romeo, D., et al. "Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: a 12-month prospective study." Journal of Prosthodontics, 2023;32:214–220.

• Toia, M., et al. "Fixed Full-Arch Maxillary Prostheses Supported by Four Versus Six Implants: 5-Year Results of a Multicenter Randomized Clinical Trial." Clinical Oral Implants Research, 2024. https://onlinelibrary.wiley.com/doi/10.1111/clr.14383

• Kanode, S.J., & Wankhede, A.N. "Changes in Alveolar Bone Dimension after Extraction Sockets and Methods of Ridge Preservation." Journal of Research in Medical and Dental Science, 2022;10(11):191–194.

• Lindhe, J., et al. "Alveolar ridge resorption after tooth extraction: A consequence of a fundamental principle of bone physiology." PMC / Clinical Oral Implants Research, 2012. https://pmc.ncbi.nlm.nih.gov/articles/PMC3425398/

• Nobel Biocare. "All-on-4®: up to 18 years of documented clinical success." Nobel Biocare Science Blog, 2019. https://www.nobelbiocare.com/en-int/blog/science-first/all-on-4-treatment-concept-high-rates-of-long-term-clinical-success

• Karl, M., & Albrektsson, T. "Clinical performance of dental implants with a moderately rough (TiUnite) surface: A meta-analysis of prospective clinical studies." International Journal of Oral and Maxillofacial Implants, 2017;32(4):717–734.

Label Facts Summary

Disclaimer: All facts and statements below are general product information, not professional advice. Consult a qualified dental specialist for clinical guidance specific to your circumstances.

Verified Label Facts

• Treatment concept: All-on-4® fixed full-arch implant bridge
• Developed by: Nobel Biocare
• Implants per arch: 4 titanium implants
• Prosthesis type: Fixed, non-removable full-arch bridge
• Teeth per bridge: Up to 12
• Anterior implant placement: Axial (straight)
• Posterior implant placement: Distally angled, typically 30–45°
• Bone grafting required: No, in most cases
• Surgical appointments: Single appointment
• Minimum insertion torque: >35 N/cm for immediate loading
• Osseointegration period: 3–6 months
• Provisional bridge material: Acrylic (fabricated pre-surgery)
• Definitive bridge material: Monolithic zirconia ceramic
• Zirconia flexural strength: ~1,000–1,200 MPa
• Zirconia bridge lifespan: 15–20+ years (realistic)
• Acrylic bridge lifespan: 5–8 years before refurbishment
• Prosthetic design options: FP1 (teeth only) or FP3 (teeth + simulated gum tissue)
• Mandibular prosthetic survival (10–18 yrs): 98.8% (471 patients, 1,884 implants)
• Mandibular implant cumulative survival rate: 93.0%
• Maxillary prosthetic success (5–13 yrs): 99.2% (1,072 patients, 4,288 implants)
• Maxillary implant cumulative survival rate: 94.7%
• Systematic review survival rate (>24 months): 99.8% (Soto-Penaloza et al., 2017)
• Computer-guided implant survival (5 yrs): 96.6% cumulative
• Average marginal bone loss (10 yrs): 1.7 mm
• Patients with >3 mm bone loss: Fewer than 10%
• Specialist team: Prosthodontist, periodontist, oral & maxillofacial surgeon
• Diagnostic imaging: Cone beam CT (CBCT) scan
• Bridge fabrication: In-house CAD/CAM milling (zirconia)
• Maintenance schedule: Every 6 months
• Suitable candidates: Fully or mostly edentulous patients with sufficient anterior bone
• Not automatically suitable: Heavy smokers, uncontrolled diabetes, bisphosphonate therapy patients
• Provider: Smile Solutions
• Location: Level 8, 220 Collins Street, Melbourne CBD
• Operating since: 1993
• Clinicians: 60+ (including 25+ board-registered specialists)
• Patients treated: 250,000+
• Referral required: No
• Contact: 13 13 96

General Product Claims

• All-on-4® offers a fundamentally different outcome to complete dentures, providing a fixed, non-removable full-arch ceramic bridge in a single surgical appointment
• Angled posterior implant placement makes the most of available bone without grafting, leading to successful clinical outcomes
• Delaying full-arch implant treatment — even by one to two years — may result in loss of the bone volume required for the graft-free protocol
• FP1 design produces the most anatomically lifelike result but demands precise bone management and careful surgical planning
• FP3 design is appropriate — and often necessary — when significant bone resorption has already occurred
• Zirconia closely mimics the appearance of natural teeth and is preferred for patients seeking a lifelike result
• Zirconia is more biocompatible at the gum interface than acrylic; acrylic contact with gum tissue produces slightly more inflammation at regular reviews
• Acrylic is appropriate as a transitional material due to its lighter weight and chairside adjustability, but is not an ideal permanent prosthetic material
• Specialist-led multidisciplinary care (prosthodontist, periodontist, oral and maxillofacial surgeon) produces more predictable outcomes than general dentist-delivered All-on-4® treatment
• All-on-4® is a "prosthetically driven" protocol in which prosthetic planning determines all surgical decisions
• Fixed implant-supported prostheses provide more stability, comfort, and chewing efficiency than removable dentures
• Osseointegration provides long-term structural stability through titanium's direct integration with bone tissue
• The sooner failing teeth are replaced with implant-supported prostheses, the more bone is preserved and the more predictable the surgical outcome
• Smile Solutions' All-on-4® service is a bespoke specialist service tailored to individual bone anatomy, aesthetic goals, and long-term oral health — not a standardised fixed-price product