all-on-4 with Dr. Maria Avis

All-on-4 is a specific surgical procedure designed for people with no teeth: someone who is sick and tired of wearing removable dentures; or someone who is told “we can no longer save these teeth and we have to remove them”.

Often by this stage bones and gums inside the mouth shrink due to teeth missing for a long time or multiple chronic infections, and it becomes very difficult to restore these cases with implants, because generally implants require a good amount of bone and gums to survive long term and look good.

The All-on-4 procedure was invented by a brilliant Portuguese surgeon Paolo Malo specifically to avoid extensive bone reconstructive procedures (also known as grafting) in cases where remaining bone and gums were insufficient to receive conventional implants. Although the treatment is certainly not cheap, it is a huge saving compared to the alternative of rebuilding bone and remodelling gums, in what often becomes a journey of multiple surgical procedures over a few years.

It involves removing all the remaining teeth, placing 4 implants in the jaw bone which can then be fitted with a non removable (screwed in) prosthesis, often on the same day.
Depending on the prosthesis type (the chosen material: porcelain, acrylic, zirconia) the cost in Australia starts at about 20-25K and can run as high as 50-60K per jaw, inclusive of all surgical and laboratory costs but not the maintenance costs over lifetime.

Unlike popular belief this procedure is not new, it has been performed successfully since the nineties. However, it is becoming increasingly popular as more surgeons and dental prosthetists around the world get trained to perform the treatment. It gets advertised widely and rather aggressively in the national radio campaigns and there is marketing materials to be found in just about every dental clinic around the country today. This can be both good and bad at the same time.

Good because more and more people become aware of the treatment options available to them in the way of improving their dental health, comfort and lifestyle. Bad because marketing materials are not designed to inform of all the intricacies and potential benefits or pitfalls of a medical procedure and people often become confused, overly excited or the opposite, scared of what a treatment may entail. As a result some will end up with unrealistic expectations, while others may become frightened of exploring their options.


All-on-4 is a fantastic treatment alternative for the right patient. It can be truly life altering, allowing people to smile again confidently, eat anything they want without the fear of losing their denture at the dinner table, widening the social and lifestyle choices and possibilities….
What it is NOT is a quick fix option for people with poor teeth, requiring a lot of maintenance or unsightly teeth, wanting an immediate “permanent” solution.

The treatment is invasive, involves significant risks and should not be taken lightly.

If you think this procedure is something you would like to consider, please seek professional opinions. Perhaps more than one would be good. Seek a surgeon who performs a variety of implant treatments, not necessarily the one who performs only one type of treatment. This will insure a balanced view of your individual needs.