Is All-on-4 Safe? Who Is a Candidate and Who Is Not

All-on-4 is a well-established treatment, and it is not suitable for everyone. Whether it is safe for you depends on your health, your bone and what you do after the surgery. This is how a dentist decides.

Is All-on-4 safe?

It is a routine implant procedure done under local anaesthesia, with sedation available. Like any surgery it has risks: infection, an implant that does not integrate, swelling and bruising. Most of them are reduced by the same things: a CT scan for planning, a surgeon who places implants regularly, and the patient following the aftercare. The main risk factors are smoking, uncontrolled diabetes and poor oral hygiene, not the technique itself.

Who is a good candidate

• You have lost most or all of the teeth in one jaw.
• Your remaining teeth are loose, broken down or failing and would need extraction anyway.
• You wear a removable denture and want fixed teeth.
• You have enough bone in the front of the jaw, or the angled implants of All-on-4 can reach it. This is confirmed by a CT scan.
• You are in general good health and prepared to clean under the bridge every day.

When it needs a different plan

• Little bone. The plan can change to six implants (All-on-6) or include bone grafting.
• Heavy grinding. More implants and a protective night guard are advised.
• Active gum disease or infection. Treated first. Implants are not placed into an infected site.
• Smoking. Not an absolute bar, but the biggest single risk for failure. Stopping for the healing period is strongly recommended.
• Uncontrolled diabetes, certain bone medications, radiotherapy to the jaw. These do not automatically rule you out, but they change the plan and your doctor should be involved.
• Blood thinners. Managed with your doctor around the surgery date. Do not stop them yourself.

What we need to tell you yes or no

1. A panoramic X-ray (a 3D CT scan if you have one).
2. Photos of your teeth and smile.
3. A list of medications and medical conditions.

From these Dr Bojan Perduv tells you whether All-on-4 is realistic, whether All-on-6 is the better fit, and whether extractions or grafting are needed. The consultation is free and comes with an itemised price: €4,500 per jaw for All-on-4.

Risks and how they are handled

• Implant failure: a small percentage do not integrate. The implant is removed and, after healing, replaced. Each implant comes with a passport recording the system and size.
• Infection: prevented with antibiotics when indicated and hygiene instructions. Reported early, it is treated early.
• Bridge fracture: the temporary acrylic bridge can chip under hard food. It is a repair, not a failure.

Frequently asked questions

Is All-on-4 safe if I live abroad?

The safety comes from the planning and the aftercare. We send written aftercare instructions and the implant documentation, and a local dentist can handle routine checks. See the day-by-day guide.

Am I too old for All-on-4?

There is no upper age limit. Health and bone matter more than age.

What if I have no bone left?

Many patients with shrunken bone are still candidates, because the angled implants use denser bone at the front. When that is not enough, grafting or a different implant plan is discussed after the scan.

Next step

Send your X-ray through the free online consultation to find out whether you are a candidate.