The All-on-4® treatment concept is a fixed full-arch dental restoration that replaces an entire row of missing or failing teeth with just four strategically placed implants — eliminating the need for individual implants at every tooth position and, in most cases, eliminating the need for bone grafting before treatment. Patients leave the office on the day of surgery with a fixed, non-removable set of teeth, with a permanent final prosthesis placed once healing is complete. For patients who have lost most or all of their teeth, who are tired of removable dentures, or who have been told they lack the bone density for traditional implant-supported restorations, All-on-4 is often the most life-changing procedure available in modern dentistry.
Dr. David Salehani is a board-certified oral and maxillofacial surgeon — a specialist who has completed dental school, medical school, a hospital-based surgical residency, and a general surgery internship, the highest level of training available for surgical implant placement. He earned his Doctor of Dental Surgery with honors from State University of New York at Stony Brook, his Doctor of Medicine from Stony Brook School of Medicine, and completed his oral and maxillofacial surgery residency at Long Island Jewish Medical Center. Dr. Salehani serves as faculty at UCLA Medical Center, has held a seat on the peer review board of the Los Angeles Dental Society for over seven years, and is past president of the Beverly Hills Academy of Dentistry — credentials that allow him to plan and place full-arch restorations with the precision required for a result that will function for decades.
How All-on-4 Dental Implants Work
The technique uses four implants per arch — two placed vertically in the front of the jaw, where bone density is typically highest, and two placed at an angle in the back to maximize contact with the available bone. This angled placement is what allows most patients to bypass bone grafting and proceed directly to implant placement, even when bone volume is limited. A temporary fixed prosthesis is attached on the day of surgery so the patient leaves with functional teeth, with a permanent custom prosthesis placed three to six months later once the implants have fully integrated with the bone.
Benefits of Full-Arch All-on-4 Restoration
- Same-Day Fixed Teeth: Patients leave the office with a complete, non-removable arch of teeth on the day of surgery.
- Graftless in Most Cases: Angled implant placement avoids the need for bone grafting in the majority of patients.
- Permanent and Stable: Unlike removable dentures, All-on-4 prostheses do not slip, click, or require adhesives.
- Preserves Jawbone: Implants stimulate the jawbone the way natural tooth roots do, preventing the bone loss that accompanies long-term denture wear.
- Cost-Effective Compared to Individual Implants: Four implants per arch deliver full-arch function at a fraction of the cost of replacing every tooth individually.
Who Is a Candidate for All-on-4 Implants?
Most adults with significant tooth loss, failing dentition, or ill-fitting dentures qualify for All-on-4, including many patients who have been told they lack the bone density for traditional implants. Candidacy is confirmed with a 3D CT scan and clinical examination during the initial consultation, where Dr. Salehani evaluates bone volume, sinus anatomy, bite alignment, and overall medical health to determine whether All-on-4 — or an alternative such as traditional dental implants with bone grafting — is the right approach.
Frequently Asked Questions About All-on-4 Implants
How long does the All-on-4 procedure take?
Surgery typically takes two to four hours per arch, performed under IV sedation or general anesthesia for patient comfort, with the temporary prosthesis placed the same day before the patient leaves the office.
Is All-on-4 painful?
The procedure is performed under sedation or general anesthesia, so there is no discomfort during surgery — most patients manage post-operative discomfort with prescription medication for the first few days and report less pain than they expected.
How long do All-on-4 implants last?
The implants themselves are designed to last a lifetime with proper care, while the prosthetic teeth typically last 10 to 20 years before replacement may be needed due to normal wear.
Will I need bone grafting before All-on-4?
The majority of patients do not — the angled placement of the posterior implants takes advantage of denser bone in the front of the jaw, eliminating the need for grafting in most cases — though some patients with severe bone loss may still require bone grafting before treatment.
How do I clean All-on-4 teeth?
The fixed prosthesis is cleaned with a regular toothbrush, water flosser, and specialty floss threaders for the area beneath the prosthesis — Dr. Salehani’s team provides detailed home-care instructions and recommends professional cleanings every six months.
What is the difference between All-on-4 and traditional dentures?
Traditional dentures rest on the gums, can slip during eating or speaking, and accelerate jawbone loss over time — All-on-4 is permanently anchored to the jawbone, functions like natural teeth, and preserves jawbone structure long-term.
Schedule Your All-on-4 Consultation in West Hollywood
To learn whether All-on-4 dental implants are the right full-arch solution for you, contact Sunset Oral and Facial Surgery at (310) 275-3635 to schedule a consultation with Dr. David Salehani at our West Hollywood office, conveniently located on Sunset Boulevard for patients across Beverly Hills, Los Angeles, and the surrounding communities.
