The All-on-4 implant procedure is one of the most transformative options available for patients who have lost most or all of their teeth in one arch. By securing a full set of fixed, non-removable teeth onto just four implants, All-on-4 delivers results that traditional dentures simply cannot match — restoring function, appearance, and confidence in a way that feels permanent and natural.
If you’re considering All-on-4 at Legacy Oral Surgery, understanding the full process from consultation through final restoration will help you prepare and know what to expect at every stage.
Step 1: Comprehensive Evaluation and Treatment Planning
Every All-on-4 journey begins with a detailed evaluation. During your consultation at Legacy Oral Surgery, Dr. Nancy Herbst or a member of our surgical team will review your dental and medical history, examine your mouth, and take advanced imaging — typically a cone beam CT scan — to assess your bone volume, sinus position, nerve anatomy, and overall jaw structure.
This evaluation determines whether you are a strong candidate for All-on-4, whether any preparatory procedures such as extractions or bone grafting are needed, and exactly where the four implants will be positioned for maximum stability. Most patients are pleased to learn that the All-on-4 technique is specifically designed to work with the denser regions of the anterior jaw, often eliminating the need for bone grafting even in patients with some degree of bone loss.
Step 2: Tooth Extractions (If Needed)
For patients who still have compromised or failing teeth remaining, extractions are performed on the day of implant surgery. At Legacy Oral Surgery, extractions and implant placement are coordinated into a single surgical appointment whenever possible, minimizing the number of separate procedures and reducing your overall treatment timeline.
Step 3: Implant Placement and Temporary Prosthesis
The core of the All-on-4 procedure takes place in one surgical appointment. Four titanium implant posts are placed into the jawbone at carefully planned positions and angles — two upright in the front and two tilted toward the back. The angled placement of the posterior implants is the key engineering principle behind All-on-4, allowing the surgeon to maximize contact with available bone without requiring a sinus lift or bone grafting in most cases.
On the same day as implant placement, a temporary fixed bridge is attached to the implants. You leave the practice with a full set of functional, natural-looking teeth — not removable dentures, but a fixed prosthesis anchored securely to your new implants.
Step 4: Osseointegration and the Healing Period
The months following surgery are dedicated to healing. As the implants integrate with the surrounding bone — a biological process called osseointegration — the foundation for your permanent restoration strengthens. This process typically takes four to six months and is closely monitored through follow-up appointments at our office.
During this period, you will follow a modified diet starting with softer foods and transitioning to a broader range as healing progresses. Most patients are comfortable returning to normal daily activities within a week of surgery, though more strenuous physical activities are restricted in the immediate post-operative period.
Ready to Schedule Your Consultation?
Our board-certified oral surgeons are here to help you find the right treatment. Schedule your appointment today.
Step 5: Placement of Your Permanent Restoration
Once osseointegration is confirmed through imaging, your temporary bridge is replaced with the final, custom-fabricated permanent prosthesis. This is the moment the transformation is complete. Your permanent All-on-4 restoration is precisely crafted to match the natural appearance of your gums and teeth, with careful attention to color, contour, and bite function.
The permanent prosthesis is designed for durability and is maintained much like natural teeth — daily brushing, flossing around the implants, and routine professional cleanings are all that’s needed for long-term success.
What Makes All-on-4 Different from Traditional Dentures?
The difference between All-on-4 implants and removable dentures is significant in both function and quality of life:
- Fixed stability — No slipping, no adhesives, no removing them at night
- Natural chewing force — Bite and chew with far greater strength and confidence than removable dentures allow
- Bone preservation — The implants stimulate the jawbone, slowing or stopping the bone resorption that accelerates under dentures
- Easier maintenance — Care mirrors natural tooth hygiene practices
- Improved appearance — Fixed teeth support the facial structure and deliver a more natural aesthetic result than removable prosthetics
Why Choose Legacy Oral Surgery for All-on-4?
Dr. Nancy Herbst brings over 25 years of oral and maxillofacial surgery experience to every procedure. Legacy Oral Surgery is equipped with advanced imaging technology and a dedicated surgical team, allowing us to deliver precise, efficient care at every phase of the All-on-4 process. We serve patients across New Jersey from our locations in Union City, Elizabeth, and Staten Island, and our team is committed to guiding you through every step of your treatment with clarity and support.
Take the First Step Toward a Permanent Smile
If you’re ready to explore whether All-on-4 is right for you, we invite you to schedule a consultation with our team. Call (201) 601-9262 or submit our contact form to get started. Let Legacy Oral Surgery help you understand your options and take the first step toward a permanent, confident smile.
