All on 4: what it is, who it is suitable for and how long it lasts
Going back to biting an apple after years of wearing dentures. Smiling in the photo without thinking about it. The technique All on 4 — an entire fixed arch on just 4 implants — is today the most requested solution by those who have lost all the teeth in an arch or are about to lose them.
In this guide you will find everything that our surgeons explain during the first visit: how it works, who it is suitable for (and who not), how it takes place day by day and how long it lasts over time. With the real numbers on costs, in Italy and Tirana.
What is the All on 4 technique
All on 4 literally means "all on four": an entire arch of fixed teeth — 10–12 elements — anchored on only 4 titanium implants. The secret is in the geometry: the two front implants are straight, the two rear ones are inclined up to 45° to exploit the bone where it is densest and avoid delicate anatomical structures (maxillary sinus above, alveolar nerve below).
This inclination allows two fundamental things: in most cases no bone graft is needed even with reduced bone, and the implants are stable immediately for the immediate loading — that is, a temporary fixed prosthesis screwed in within 24–72 hours of surgery. Leave the clinic with teeth, not dentures.
The moment the patient looks at their new smile in the mirror, 48 hours after surgery, is the reason why we do this work. Every time.
All on 4 vs dentures vs All on 6
How does the All on 4 compare to the alternatives? Here is the honest comparison we make on the first visit:
| Denture (removable prosthesis) | All on 4 | All on 6 | |
|---|---|---|---|
| Stability | Low: stickers, movement | Fixed, screwed | Fixed, screwed |
| Comfort | Covered palate, sore gums | Free palate, like one's own teeth | Free palate |
| Chewing efficiency | ~20–30% of natural | ~80–90% | ~90–95% |
| Bone required | None (but it reabsorbs) | Reduced, often without grafts | Medium-good |
| Maintenance | Periodic relining | Hygiene + annual checks | Hygiene + annual checks |
| Expected duration | 5–7 years (relines) | Decades with maintenance | Decades with maintenance |
The All on 6 adds two implants and distributes loads better: we recommend it when the bone allows it and the patient has particularly strong chewing skills. In most cases, however, All on 4 is the solution with the best balance between result, invasiveness and cost. The decision is made on the 3D CT scan — never "in sense".
Are you a good candidate?
The good news: Most patients who are edentulous or have compromised teeth are good candidates. The criteria that we evaluate during the visit (and already on the CT scan that you can send us from home) are these:
- Sufficient bone in the anterior area — the cone beam CT measures it to the millimeter. With very little bone we evaluate grafts or alternatives.
- General health checked. Advanced age is not a problem; we evaluate heart disease and ongoing therapies on a case-by-case basis.
- Diabetes compensated. With glycata under control you can operate safely; with decompensated diabetes we postpone until stabilization.
- Smoke. Smoking reduces osseointegration: we ask you to stop at least in the weeks around surgery. Better: forever.
- Hygiene and consistency. The All on 4 requires daily cleaning and periodic checks. Those who accept this commitment obtain results that last decades.
Remember: If you've been told "you don't have enough bone for implants," ask for a second evaluation. With the inclination of the posterior implants, the All on 4 solves many cases that traditional implantology excluded.
How it unfolds, day by day
This is how an All on 4 path with Tirana Dental Implants in Tirana takes place. The typical stay is 5–7 days, with 4-star hotels, private transfers and Italian coordinator included:
Day 1 — Reception and diagnosis
The driver is waiting for you at the airport with the welcome sign. Check-in at the hotel, visit to the clinic: cone beam CT scan, intraoral scan, photos and final digital planning with the surgeon. Confirmation of plan signed before departure.
Day 2 — Surgery
The operation lasts 2–3 hours per arch, under local anesthesia (conscious sedation available). Extractions if necessary, positioning of the 4 implants, digital impression. Rest in the hotel in the afternoon, with the Italian contact person always available.
Days 3–4 — The fixed temporary prosthesis
The internal laboratory creates your screw-retained resin provisional: within 24-72 hours of surgery we try it on and fix it. From this moment you smile and chew with set teeth — soft foods for the first few weeks. Daily checks and, in free time, a walk around Tirana.
Day 5 — Last checks and return
Final check-up, personalized hygiene instructions, follow-up plan via WhatsApp. Return to Italy with complete documentation: treatment plan, plant certificates, written guarantee.
After 3-4 months of osseointegration, the definitive prosthesis (reinforced, zirconium or premium composite): a second short trip of 2–3 days, or — depending on the case — with a remotely agreed protocol.
Do you want to understand if All on 4 is for you?
Send us your overview or book a free video call with the team: honest evaluation, without obligation.
How long does it last and how to maintain it
Titanium implants, osseointegrated and properly maintained, can last decades: scientific literature speaks of success rates of over 95% at 10 years. The prosthesis has a longer average life than any denture and can be replaced without touching the implants.
- Daily hygiene: toothbrush, pipe cleaners and water flosser — we'll teach you the routine, 5 minutes a day.
- Periodic checks: follow-up via WhatsApp and video visit; for physical checks we collaborate with affiliated dentists in Italy.
- Professional hygiene 1–2 times a year, as for natural teeth.
- 10 year written guarantee on systems: covers device defects, with clear and signed conditions.
How much does it cost
In Italy a complete All on 4 rehabilitation (surgery + temporary + definitive) costs on average €8,000–€15,000 per arch. In Tirana, with the same Straumann® or Nobel Biocare® implants and the internal laboratory, the price is on average a third — with hotel, transfer and Italian coordinator included.
What influences the price: number of arches, need for extractions or grafts, material of the definitive prosthesis (premium composite vs zirconium) and brand of implants. This is why the estimate is always personalized on the CT scan — but it is written, signed and blocked before departure.
Remember: be wary of "All on 4 for €X" prices without a CT scan and without specifying the brand of the implants and the material of the prosthesis. The serious price comes from the diagnosis, not from advertising.
Take the first step: it's free
Send your overview or book a video call with our Italian team: in 24 hours you will know if All on 4 is the right solution for you and how much it would cost in your case. Without obligation.
Written by
Tirana Dental Implants Team
The Italian team that has been accompanying patients since 2014 from the first consultation to the follow-up, in collaboration with the doctors of the Sanitadental clinic in Tirana.
