Patients often ask us about the available options for replacing one or more missing teeth. Dental implants are widely considered the best solution. Although they may seem like a modern innovation, dental implants are not new—the history of modern implantology dates back more than 50 years.
Over time, oral surgery and implant technology have significantly advanced, making dental implants a safe and routine procedure today. They are successfully used to rehabilitate partially or completely edentulous jaws.
In cases where a patient has lost all teeth, or when the remaining teeth are too weak to be restored with high-quality prosthetic solutions (such as bridges or crowns) and must be extracted, three treatment options are available:
In cases where a patient has no remaining teeth, or when the existing teeth are too weak to be restored with high-quality prosthetic solutions (such as bridges or crowns) and must be extracted, three treatment options are available:
1) Complete Dentures
Complete (full) dentures replace missing teeth; however, many patients find them difficult to tolerate because they are often unstable during eating and speaking (they may move or slip). Their construction is relatively bulky, they reduce the sensation of food, and they do not always look completely natural.
Their main advantage is that they are the most affordable option.
2) Implant-Supported Dentures
This solution is significantly superior to conventional dentures, as the prosthesis is supported by two or four dental implants, providing excellent stability. The denture structure is reduced in size, allowing patients to better perceive the taste of food and speak more comfortably.
These dentures are removable, making them easy to clean. They are a good choice for patients who have difficulty maintaining oral hygiene (e.g., due to chronic degenerative diseases) and are also cost-effective compared to fixed implant solutions.
3) all-on-4 ili all-on-6
The All-on-4 concept involves the placement of four dental implants at specific angles, supporting a fixed implant-supported prosthesis (fixed denture or dental bridge). This system is particularly indicated in cases where there is severe bone loss in the posterior regions (back teeth), making conventional implant therapy difficult or impossible (such as placing 6 or 8 implants with a fixed metal-ceramic bridge).
In traditional implant therapy, insufficient bone often requires bone grafting and sinus lift procedures, followed by several months of healing before implant placement—and additional months of waiting before the final restoration. This process can be long, uncomfortable, costly, and sometimes unpredictable.
The All-on-4 (or All-on-6) method is based on implant placement in the anterior part of the jaw, where sufficient bone is usually present. This approach eliminates the need for bone grafting and sinus lift procedures. In a single visit, under anesthesia, it is possible to place the implants and provide a temporary fixed prosthesis.
In practice, this means that the patient undergoes surgery in the morning and receives new teeth the very same day, allowing them to eat, smile, and speak normally. After approximately 4–6 months, once the bone and soft tissues have fully healed and remodeled, the final permanent restoration is fabricated.
The All-on-4 construction is fixed, meaning it cannot be removed by the patient and is only taken off in the dental office for professional check-ups, cleaning, or repairs. However, a fixed restoration also carries significant responsibility—proper oral hygiene is essential. If the prosthesis is not cleaned adequately and regular dental check-ups are neglected, there is a high risk of inflammation and potential implant failure.
Cost of All-on-4 Treatment
The cost of All-on-4 treatment depends on the implant brand used and the dental clinic itself. There are many implant brands on the market that offer All-on-4-compatible systems. Some of the most well-known and reputable brands include Straumann, Nobel Biocare, MIS, and Ankylos.
These manufacturers have placed hundreds of thousands of implants worldwide, supported by long-term clinical studies, continuous innovation, and patented technologies. As a result, they are generally more expensive than so-called “low-cost” implant systems.
Below, you can read a case example of All-on-4 treatment performed in our clinic.
Case Example
A patient presents to the clinic after having the remaining teeth in the upper jaw extracted due to severe damage caused by chronic periodontitis. The previous dentist at a public health clinic suggested conventional removable dentures, but the patient is seeking a fixed solution in the shortest possible time. Due to the nature of his work—which involves daily social interaction and frequent travel—he does not want to remain without teeth.
Additionally, the patient had avoided dental treatment for a long time because of dental anxiety and now wishes to resolve the issue as quickly as possible.
Evaluation of a 3D CBCT scan reveals a significantly compromised bone condition in the posterior region of the upper jaw, with both reduced bone height and width. Conventional implant therapy (a fixed bridge supported by 6–8 implants) would therefore require bilateral sinus lift procedures and extensive bone augmentation using artificial bone.
Only after 6–8 months of healing would implant placement be possible, followed by an additional 3–4 months of waiting for osseointegration (the process of implants bonding with the bone) before new teeth could be fabricated in the form of a metal-ceramic implant-supported bridge.
This prolonged treatment timeline was not acceptable to the patient. He did not wish to undergo multiple complex surgical procedures, and the financial cost of such therapy was also less favorable compared to the alternative—All-on-4. As a result, the All-on-4 system was proposed as the ideal solution tailored to the patient’s needs.
Within a single day, four dental implants are placed to support a fixed prosthetic construction (dental bridge), allowing the patient to leave the clinic with new teeth the same day. From implant placement to receiving new teeth, no more than 12 hours pass.
After approximately 6 months, once the oral situation has stabilized and tissues have fully adapted, the final permanent restoration is fabricated based on a new dental impression.
The All-on-4 concept is based on four strategically positioned implants, planned using precise CBCT 3D analysis, combined with multi-unit abutments designed to withstand immediate loading. The temporary teeth provided are made of high-quality aesthetic acrylic material and are fully customized according to the patient’s facial features and personal preferences.
The prosthesis is fixed with screws to the implants and can only be removed by a dentist in the clinic, typically once or twice a year for professional cleaning and check-ups.
With this solution, the patient can speak, eat, and smile normally immediately after implant placement, regaining both function and confidence without delay.
U jednom danu će mu biti ugrađena 4 implantata koji će nositi fiksnu konstrukciju (zubni most), a pacijent iz ordinacije izlazi s novim zubima, dakle od ugradnje implantata do novih zuba će proći maksimalno 12 sati! Za 6 mjeseci kada se promijeni i stabilizira situacija u ustima izraditi će se definitivni rad po novom otisku. All on 4 se temelji na 4 posebno pozicionirana implantata (prema analizi precizne CBCT 3D snimke kosti) te spojkama (multi-unit abutment) koje su dizajnirane da odmah po implantaciji podnesu opterećenje fiksnog rada. Zubi koje pacijent dobiva su izrađeni od estetskog akrilatnog materijala te su potpuno individualizirani sukladno pacijentovoj fizionomiji i željama. Skidaju se samo u ordinaciji od strane stomatologa (fiksirani su vijkom za implantat), a za potrebe čišćenja i kontrole, jednom ili dva puta godišnje. S ovim nadomjestkom pacijent može najnormalnije govoriti, jesti i izgledati, odmah po ugradnji implantata.
