⭐ 700+ Five-Star Reviews · Since 1998
All-on-4 Dental Implants
in North Hollywood, CA
Permanent fixed teeth — often in a single day. From $16,000 per arch.
Dr. Fadi Elzayat — USC-trained, ICOI Fellow, 20+ years performing All-on-4 in-house. No referrals. No outside surgeons.
Your Free Consultation Includes
Oral evaluation & Digital imaging
Bone density assessment, medical history, often using Cone Beam 3D imaging
Complete treatment plan
Personalized — no obligation, no pressure
Transparent pricing
All options reviewed, including financing
In-house, same day
No referrals. Dr. Elzayat performs every procedure personally
Same-day appointments
Call before noon and we almost always get you in today
★★★★★
4.9
Google Rating
★★★★★
700+
Five-Star Reviews on Google & Yelp
25+
Years in NoHo
USC
School of Dentistry
ICOI Fellow
Top 5% of Implant Dentists
Same
Day Appointments Available
WHAT IS ALL-ON-4?
All-on-4 is a full-arch dental implant procedure that replaces an entire upper or lower set of teeth using four strategically placed titanium implants that support a permanent fixed prosthetic bridge.
Two implants are placed vertically at the front of the jaw, and two are angled at 30–45 degrees at the rear, maximizing bone contact with available jaw structure and eliminating the need for bone grafting in most patients.
The implant-supported prosthesis is attached the same day as surgery, allowing most patients to leave A-Dental Center with functional temporary teeth within hours of arriving. After osseointegration, the process by which titanium implant posts fuse with living jawbone, a permanent fixed hybrid denture or zirconia full arch is placed, typically 3–6 months later.
All-on-4 is also referred to as All-on-X, immediate load implants, or full-arch implant restoration. It is the most efficient full-arch tooth replacement solution available in modern implant dentistry.
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“After years of hiding my smile, I finally feel confident again. Dr. Elzayat and his team were caring, thorough, and made the entire process smooth and stress-free.”— S.R.
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“Dr. Elzayat made my implant procedure much easier than I expected. He explained everything clearly, the staff was incredibly kind, and my new smile looks amazing.”— M.R.
Meet Your Dentist
Meet Dr. Fadi Elzayat, DDS, FICOI
A-Dental Center has been a trusted part of the North Hollywood community since 1998. Dr. Fadi Elzayat has led the practice since 2008, bringing over 20 years of clinical experience in dental implants, All-on-4, full arch restorations, and comprehensive family dentistry.
A graduate of the USC Herman Ostrow School of Dentistry, one of the top dental schools in the country, Dr. Elzayat holds a Fellowship from the International Congress of Oral Implantologists (FICOI) — a distinction held by fewer than 5% of implant dentists worldwide, making it one of the most prestigious credentials in the field of implant dentistry.
He focuses on cosmetic dentistry, with a strong emphasis on dental implants and advanced full-arch solutions. He performs every implant case personally and in-house, often utilizing Cone Beam 3D imaging for precision planning.
No referrals. No outside oral surgeons. Every phase of your treatment, from consultation to final restoration, is handled or supervised by Dr. Elzayat at A-Dental Center.
Beyond clinical skill, Dr. Elzayat is known throughout North Hollywood as “The Friendly Dentist” for his calm, straightforward approach, gentle technique, and zero-pressure consultations. A strong focus on comfort and clear communication ensures that each visit feels personalized and supportive.
Whether you haven’t seen a dentist in years or are facing a complex full arch case, patients from North Hollywood, Burbank, Studio City, and the greater San Fernando Valley are welcomed into a setting designed for a relaxed, judgment-free experience.
Credentials:
USC School of Dentistry Graduate
FICOI Fellow, International Congress of Oral Implantologists
20+ Years Placing Dental Implants
Bilingual, English & Spanish team
ADA, CDA & San Fernando Valley Dental Society Member
Real Results
Real Patient Results — All-on-4 at A-Dental Center
Every photo on this page is a real patient treated by Dr. Elzayat at A-Dental Center — no outside surgeons, no referrals. What you see is what we do.
This patient had been turned away at another practice due to insufficient bone. All-on-4 angled placement with tilted posterior implants allowed full arch restoration without grafting. Final restoration is a fixed FP1 (without gums) upper zirconia full arch — the strongest, most natural-looking material available for full arch implant restorations.
This patient had been edentulous for over two years and was wearing an ill-fitting conventional denture. Extractions, implant placement, and temporary restoration completed in a single surgical visit. Final restoration is a fixed FP1 (without gums) lower zirconia full arch — the strongest, most natural-looking material available for full arch implant restorations.
This patient presented with four severely failing lower teeth and significant gum recession across the full lower arch. All remaining teeth were extracted, implants placed, and a temporary restoration delivered in a single surgical visit. The final fixed hybrid denture shown was placed approximately 5 months later.
The top photo shows the upper arch 3 weeks after All-on-6 surgery — six titanium implants placed with gold abutment connectors visible at the surface. The bottom photo is the final milled upper zirconia full arch FP1 (without gums) restoration permanently screwed into place. This is the strongest, most natural-looking restoration option available. Treatment time: 5 months from surgery to final smile.
This is the actual prosthetic arch before final placement — a custom-milled full arch restoration with a titanium substructure and individual zirconia teeth. The pink gum-colored acrylic replicates natural gum contour. The abutment connection points are visible at the rear. Once placed, this arch is permanently screwed to the implants and functions like natural teeth.
The top photo shows the lower arch on 3 weeks from surgery day — implants placed and gold abutment connectors seated, ready to receive the temporary prosthetic. The tissue is healing around each connector. The bottom photo is the final fixed arch restoration — permanently attached and fully functional. This patient went from no lower teeth to a complete fixed smile in a single surgical visit, with the final result shown 5 months later.
Sound Familiar?
Does Any of This Sound Familiar
These are the conversations that happen in our office every week. If one of them is yours, you’re not alone — and you likely have more options than you think.
I can't eat steak anymore. Or apples. Or corn. Half the menu is off-limits.
Failing teeth and unstable dentures dramatically limit chewing ability — often without patients realizing how much their diet has shrunk over the years. Malnutrition risk increases significantly with prolonged poor dental function.
My dentures move when I talk. I'm terrified they'll fall out in public.
As bone shrinks beneath an edentulous arch, dentures loosen. Adhesives stop working. The anxiety of a denture slipping mid-conversation is something no one should have to live with — and it is entirely solvable.
I avoid smiling in photos. I haven't smiled naturally in years.
Missing teeth and ill-fitting dentures cause patients to hide their smile — in photos, at dinner, in meetings. It affects confidence at every level, in ways patients often don't fully recognize until it's restored.
I feel embarrassed eating in restaurants. I order around what I can chew.
Patients with terminal dentition quietly restructure their social lives around food limitations — skipping dinners, avoiding certain restaurants, eating before going out. Most don't mention it to anyone.
I was told I don't have enough bone. That I'm not a candidate. I gave up.
This is one of the most common things we hear — and one of the most common misconceptions. All-on-4 was specifically engineered for patients with bone loss and atrophic maxilla. The tilted posterior implants maximize contact with available bone, which is exactly why most patients who were turned away elsewhere qualify here.
I'm spending a fortune on denture adjustments that never actually fix the problem.
Patients often spend $5,000–$12,000 over several years on relines, replacements, and adhesives — approaching the total cost of a permanent implant-supported prosthesis without any of the permanence. Every dollar spent re-fitting dentures is a dollar toward what could have been fixed once.
I've been putting this off for years. I don't even know where to start.
This is the most common call we receive. Most patients have been living with this problem for 3–7 years before picking up the phone. The first step is a free 45-minute conversation — no commitment, no pressure, no obligation. Just a clear picture of your options and what treatment would actually cost. That's it.
If you recognized yourself in any of the above — a conversation with Dr. Elzayat costs nothing and takes less than an hour. Same-day consultations available.
THE A-DENTAL CENTER DIFFERENCE
Why Patients Choose A-Dental Center for All-on-4
Here’s what makes All-on-4 at A-Dental Center different from a referral to an outside oral surgeon — and why patients from Burbank, Glendale, Studio City, Sherman Oaks, and Toluca Lake make the drive.
You Leave With Teeth
You arrive in the morning and leave by afternoon with a complete, natural-looking temporary smile. No gap. No waiting weeks. Immediate load implants mean the same day as surgery.
Most Patients Qualify — Even With Bone Loss
The tilted posterior implants used in All-on-4 maximize contact with available bone. Most patients with atrophic maxilla or significant bone loss proceed without bone grafting — even those told they don't qualify elsewhere.
From $349/Month
Full arch restoration starts from $16,000 per arch with financing from $349/month through CareCredit and Cherry. Fewer implants and procedures than traditional full-arch solutions — more affordable than most patients expect.
One Surgery. Done.
Extractions, implant placement, and your temporary restoration completed in a single surgical visit — minimizing total procedures and getting you to your new smile faster.
Stops the Aging Your Dentures Are Causing
Titanium implant posts stimulate the jawbone and prevent the facial sagging and hollowed appearance that accelerates with long-term denture use. All-on-4 stops the progression — and often partially reverses it.
Never Think About Your Teeth Again
Your fixed hybrid denture or zirconia full arch is permanently anchored to your jawbone. No slipping, no adhesives, no removing at night. Brush like natural teeth. Eat what you want after healing. Complete confidence — for life.
All of this — in one office, with one doctor, no referrals, from consultation to final smile.
The Process
Conditions All-on-4 Is Designed to Treat
From your first consultation to your final permanent smile, here is exactly what to expect at A-Dental Center.
Loose or ill-fitting dentures
Stabilize permanently with an implant-supported prosthesis — fixed or snap-in
Terminal dentition
Failing teeth beyond individual restoration; full arch extraction and same-day immediate load implant placement
Advanced periodontal disease
Teeth lost or failing due to bone destruction from chronic gum disease
Severe decay across multiple teeth
Full arch extraction and implant restoration in a single surgical visit
Failed dental bridges
Implant-supported replacement eliminates reliance on neighboring teeth as anchors
Bite collapse
Loss of vertical dimension from multiple missing teeth; restored with full arch prosthetic
Bone loss — atrophic maxilla or mandible
Tilted posterior implants maximize bone contact without grafting in most cases
Edentulous arch
Fully toothless upper or lower jaw; the most common All-on-4 indication
Peri-implantitis revision cases
Failed implants from prior treatment replaced with comprehensive full arch restoration
Dental tourism revisions
Patients returning from overseas treatment requiring correction or completion
Cost of All-on-4 Dental Implant
All-on-4 at A-Dental Center starts at $12,000 per arch for Phase 1 surgery and $16,000–$25,000 total depending on your restoration choice. Here is exactly what is included
There are Two Steps
Two-Phase Treatment Approach
(Includes Placing the Implants, Extractions and a Temporary Denture)
Phase 1: Surgical Treatment - $12,000 per Arch (Savings exceeding $15,000)
This phase includes all necessary procedures to prepare and place implants while providing a temporary restoration.
Included services:
Comprehensive exam and consultation (valued at $150)
Panoramic and/or CT imaging (valued at $400)
Diagnostic planning and case design (valued at $800)
Removal of remaining teeth if needed (valued at $4,000)
Bone reshaping procedure (valued at $2,500)
Placement of 4 – 6 titanium implants (valued at $9,000)
Bone grafting and sinus lift procedures if required (valued at $3,000)
Impressions and fabrication of temporary teeth or denture (valued at $7,000)
Coverage during the healing period (valued at $3,000)
Limited-time pricing. Additional costs may apply depending on individual treatment needs.
Optional sleep sedation is available for an additional fee.
Restorative Part (3 OPTIONS)
Choose Your New Teeth
Option 1
Denture Stabilization
$4,000 per Arch
Total with Surgery $16,000
*Over $11,000 in Savings
- Removable High Quality Prosthetic Denture
- 4 Housing Abutments
- 4 Locators
- Snaps or “Clicks” in
- 2-Year Warranty on teeth
- 2 Maintenance Visits
Demonstration model illustrating blue housings on Denture that snap into golden locators on model.
**Limited time offer. We offer affordable 3rd party financing up to 120 months. Monthly rate depends on approval.
Fixed Resin Teeth
Permanently Screwed on to Implants
$8,000 per Arch
Total with Surgery $20,000
*Over $16,000 in Savings
- Non-removable Permanent Teeth
- Custom Smile Design
- High Quality Resin Prosthesis and teeth with titanium frame.
- Strong and Durable. 5-year Warranty on Teeth, Implants and Titanium Bar
- Cordless Water Flosser
Demonstration Model Illustrating Abutment Screws that Attach to the Titanium Frame and Dental Implants.
Option 3
Fixed Zirconia Teeth
Permanently Screwed on to Implants
$13,000 per Arch
Total with Surgery $25,000
*Over $21,000 in Savings
- Non-removable Permanent Teeth
- Recommended for Patients with Heavy Biting/Chewing Habits
- Custom Smile Design
- Milled Zirconia (Porcelain) Framework often with Custom Titanium Substructure and Zirconia Teeth.
- The Ultimate in Strength. 7-year Warranty on Teeth and Implants.
- Cordless Water Flosser
Milled Zirconia (Porcelain) Framework often with Custom Titanium Substructure and Zirconia Teeth.
**Limited time offer. We offer affordable 3rd party financing up to 120 months. Monthly rate depends on approval.
How All-on-4 Compares — Honest Side-by-Side
Every patient’s situation is different. Here is how All-on-4 compares to the most common alternatives — so you can make an informed decision at your consultation.
All-on-4 vs Traditional Dentures
| All-on-4 implants | Traditional dentures | |
|---|---|---|
| Fixed or removable | Permanently fixed | Removable |
| Stability | Anchored to jawbone | Adhesives and suction |
| Bone preservation | Stimulates bone | Accelerates bone loss |
| Facial structure | Maintains fullness | Sagging over time |
| Diet | Eat normally after healing | Significant restrictions |
| Longevity | 20+ years | 5 to 8 years |
| Adhesives needed | Never | Daily |
| Starting price | From $16,000/arch | From $3,400/arch |
All-on-4 vs Snap-In Dentures (Denture Stabilization)
| All-on-4 fixed | Snap-in dentures | |
|---|---|---|
| Removable | No — permanently fixed | Yes — snaps in and out |
| Stability | Maximum | Better than traditional |
| Cleaning routine | Water flosser in-mouth | Remove nightly for cleaning |
| Cost | From $20,000/arch | From $16,000/arch |
| Best for | Patients wanting permanent fixed teeth | Patients preferring familiar removal routine |
All-on-4 vs Individual Implants (Full Arch)
| All-on-4 | Individual implants (full arch) | |
|---|---|---|
| Implants required | 4 per arch | 6 to 8 per arch |
| Bone grafting | Rarely needed | Often required |
| Surgical visits | 1 | Multiple |
| Cost | From $16,000/arch | $40,000 to $60,000/arch |
| Same-day teeth | Yes | Rarely |
| Best for | Full arch replacement | Single or multiple tooth replacement |
All-on-4 vs All-on-6
| All-on-4 | All-on-6 | |
|---|---|---|
| Implants | 4 per arch | 6 per arch |
| Prosthetic | Acrylic hybrid or zirconia | Zirconia full arch preferred |
| Bone requirements | Lower — tilted implants compensate | Moderate |
| Stability | Excellent | Maximum |
| Best for | Most full arch patients | Heavy biters, bruxism, maximum aesthetics |
| Starting price | From $20,000/arch | From $25,000/arch |
All-on-4 vs Dental Tourism (Mexico/Turkey)
| A-Dental Center | Overseas | |
|---|---|---|
| Follow-up care | In-house, same doctor | Return flights required |
| Complication management | Same day, no extra cost | International travel for any revision |
| Continuity of care | Dr. Elzayat throughout | Often different doctors each visit |
| Language | English and Spanish | Variable |
| Hidden costs | None — all-inclusive pricing | Travel, hotels, multiple trips |
| Warranty enforcement | 2 to 7 years, honored in-house | Difficult to enforce internationally |
Many patients return from overseas treatment requiring corrective procedures at significantly higher total cost. Dr. Elzayat has treated revision cases from international dental tourism. Distance is a complication multiplier — not a risk worth taking for a procedure of this complexity.
For patients in Glendale, Burbank, and greater Los Angeles weighing All-on-4 against overseas dental tourism, the calculus changes significantly when follow-up care, peri-implantitis management, and warranty enforcement require an international flight.
Who May Not Be a Candidate for All-on-4?
We believe in honest consultations. All-on-4 is not right for everyone — here is when we may recommend a different path or require additional preparation before surgery.
Uncontrolled Diabetes
Uncontrolled blood sugar impairs osseointegration and dramatically increases infection and implant failure risk. Patients with well-controlled diabetes qualify regularly — but stabilization is required before surgery. We coordinate with your physician when needed.
Active, Untreated Gum Disease
Active periodontal disease must be treated and controlled before implants are placed. Placing implants into an infected environment significantly increases peri-implantitis risk and implant failure. We treat gum disease in-house before proceeding.
Heavy, Uncontrolled Smoking
Smoking is the single most controllable risk factor for implant failure. It impairs healing, reduces bone blood supply, and dramatically increases peri-implantitis risk. Patients must abstain from smoking through the entire healing period.
Severe, Uncontrolled Bruxism
Heavy grinding places excessive occlusal force on implants during osseointegration and can cause implant failure. A nightguard and bruxism management plan may be required before or alongside treatment.
Certain Medications and Medical Conditions
Bisphosphonates for osteoporosis, certain blood thinners, active chemotherapy, and some autoimmune conditions require medical clearance before implant surgery. Dr. Elzayat reviews your full medication list at consultation.
Active Infection Requiring Stabilization
Any active oral infection — abscess, spreading pericoronitis, or active decay — must be treated and resolved before implants are placed. In most cases this is handled in-house before scheduling surgery.
Important:
Not qualifying today does not mean never. Most contraindications are manageable with proper preparation. The only way to know your status is a free consultation with Dr. Elzayat.
COST OF WAITING
The Real Cost of Waiting
Bone loss doesn’t pause while you think it over. Here’s what we see in patients who delay 6, 12, or 24 months — and what it means for your treatment options.
You Stop Showing Up
Patients with loose dentures or terminal dentition stop smiling in photos, avoid speaking in groups, skip restaurants, and pull back from social life entirely. Most don't realize how much it's affecting them until it stops.
→ The psychological cost of delay is measurable — and reversible with the right treatment
Your Jaw Is Shrinking Right Now
Once teeth are lost, the jawbone begins to shrink — up to 25% in the first year alone. The longer you wait, the more atrophic the maxilla or mandible becomes and the less bone remains to support implants without grafting.
→ Waiting converts a simple case into a complex, more expensive one
Your Face Changes Without You Noticing
Without tooth roots stimulating the jaw, the lower third of the face gradually sinks inward — creating a hollowed, aged appearance that no denture can reverse. All-on-4 stops this progression and often partially restores facial structure.
→ All-on-4 stops facial collapse — dentures accelerate it
Your Diet Gets Smaller Every Year
Loose teeth and unstable dentures gradually eliminate foods from your life — first hard foods, then chewy foods, eventually leaving patients eating only soft meals. Malnutrition risk increases significantly with prolonged poor dental function.
→ Most patients don’t realize how restricted their diet has become until they eat normally again
The Reline-Refit-Repeat Cycle Never Ends
As bone shrinks beneath an edentulous arch, dentures become loose, require more adhesive, need more relines, and eventually stop fitting entirely — no matter how many adjustments are made.
→ Every dollar spent re-fitting dentures is a dollar toward a permanent implant-supported prosthesis you could have today
The Procedure Gets More Expensive the Longer You Wait
Waiting typically means more extractions, bone grafting, and sinus lifts before implants can even be placed — significantly increasing total treatment cost and time. A case that qualifies for immediate load implants today may not qualify on the same terms in a year.
→ The psychological cost of delay is measurable — and reversible with the right treatment
Most patients leave their first consultation saying the same thing: "I wish I'd come in sooner." Find out where you stand — free consultation, same day, no pressure.
Why Patients Leave Corporate Implant Chains and Come Here
If you’ve visited a high-volume implant center and felt like a number — you’re not alone. Here’s what’s different at A-Dental Center.
| Corporate implant centers | A-Dental Center |
|---|---|
There is nothing wrong with choosing a specialist center for a complex case. But if you’ve felt rushed, oversold, or handed off between providers — you deserve a second opinion.
The Process
Your All-on-4 Treatment Timeline — Step by Step
From your first call to your final smile — here is exactly what to expect at A-Dental Center.
Step 1 — Free Consultation
Digital imaging assessment, full oral evaluation, bone assessment, medical history review, and personalized treatment plan. Complete treatment cost presented before you leave. No obligation to proceed. Timeline: Same day or next day in most cases
Step 2 — Surgery Day
Remaining teeth extracted if needed. Four titanium implants placed using advanced digital imaging guidance. Temporary fixed hybrid denture attached same day. You leave with a complete, functional smile. Timeline: Single surgical visit, typically 3–5 hours
Step 3 — Early Healing (Week 1–2)
Soft food diet. Swelling peaks at 48–72 hours then resolves. Pain managed with prescribed or over-the-counter medication. Most patients return to normal daily activity within a few days. Timeline: 1–2 weeks
Step 4 — Osseointegration (Month 1–6)
Titanium implant posts fuse with living jawbone — the biological process that makes All-on-4 permanent. Dr. Elzayat monitors healing at scheduled checkpoints throughout this phase. You continue wearing your temporary teeth normally. Timeline: 3–6 months depending on bone density and health
Step 5 — Final Impressions
Once osseointegration is confirmed, final impressions are taken for your custom permanent prosthetic arch — designed specifically for your facial structure, tooth color, and bite alignment. Timeline: 1–2 appointments
Step 6 — Final Restoration Placed
Your permanent fixed hybrid denture or zirconia full arch is permanently attached to your implants using precision abutment screws. This is the appointment patients describe as life-changing. Timeline: 1 appointment, approximately 5–6 months after surgery
Step 7 — Ongoing Maintenance
Professional cleanings every 4–6 months using specialized instruments that clean beneath the prosthetic arch. Annual implant assessment. Water flosser used daily at home. Implants monitored for peri-implantitis at every visit. Timeline: Ongoing — decades of stable function with proper care
Ready to Restore Your Smile?
Get a Real Answer Today
✓ Free consultation
✓ Same-day appointments available
✓ No obligation, no pressure
✓ Se habla español
✓ Most PPO insurance accepted
Frequently Asked Questions — All-on-4
How long do All-on-4 implants last?
Can I eat steak with All-on-4?
Yes. After osseointegration is complete, most patients eat foods that were difficult or impossible with dentures — including steak, apples, corn, and crusty bread. This is consistently the outcome patients describe as the most life-changing.
Is All-on-4 painful?
Most patients report significantly less discomfort than expected. Local anesthesia eliminates pain during surgery. Oral sedation and nitrous oxide are available. Post-operative soreness typically resolves within 3–5 days and is managed with over-the-counter medication.
Do I sleep with All-on-4 teeth?
Fixed All-on-4 and All-on-6 restorations are permanently screwed in — they do not come out. You sleep with them, eat with them, and care for them exactly like natural teeth. Denture stabilization options snap out for nightly cleaning.
Can food get under All-on-4?
Some food debris can collect beneath the prosthetic arch. A water flosser used daily removes debris effectively. Professional cleanings every 4–6 months are essential — our hygienists clean beneath the arch with specialized instruments.
Are All-on-4 implants removable?
In most cases, no. Dr. Elzayat performs All-on-4 entirely in-house — including complex cases involving bone loss, atrophic maxilla, multiple extractions, and full arch surgical placement. The best way to confirm is a free consultation — digital imaging is available in-house, including Cone Beam 3D when clinically indicated.
Can implants get infected?
In most cases, no. Dr. Elzayat performs All-on-4 entirely in-house — including complex cases involving bone loss, atrophic maxilla, multiple extractions, and full arch surgical placement. The best way to confirm is a free consultation — digital imaging is available in-house, including Cone Beam 3D when clinically indicated.
Why is All-on-4 cheaper than individual implants for a full arch?
In most cases, no. Dr. Elzayat performs All-on-4 entirely in-house — including complex cases involving bone loss, atrophic maxilla, multiple extractions, and full arch surgical placement. The best way to confirm is a free consultation — digital imaging is available in-house, including Cone Beam 3D when clinically indicated.
Can smokers get All-on-4?
Smoking significantly increases implant failure risk and slows osseointegration. It is not an absolute disqualifier but patients must abstain completely during the healing period. Dr. Elzayat discusses this in detail at your consultation.
Can diabetics get All-on-4?
Patients with well-controlled diabetes are frequently successful candidates. Uncontrolled diabetes impairs osseointegration and increases peri-implantitis risk — medical clearance and blood sugar stabilization are required before surgery.
What is osseointegration?
Osseointegration is the biological process by which titanium implant posts fuse directly with living jawbone — creating a permanent, load-bearing foundation as strong as natural tooth roots. It takes 3–6 months and is the reason All-on-4 provides decades of stable function.
What is peri-implantitis?
Peri-implantitis is a bacterial infection affecting the tissue and bone surrounding a dental implant. It is the implant equivalent of gum disease and the primary cause of late implant failure. It is largely preventable with consistent home care and professional maintenance.
All-on-4 Questions — Answered Honestly
I've been told I need to see an oral surgeon. Do I really need a referral?
In most cases, no. Dr. Elzayat performs All-on-4 entirely in-house — including complex cases involving bone loss, atrophic maxilla, multiple extractions, and full arch surgical placement. The best way to confirm is a free consultation — digital imaging is available in-house, including Cone Beam 3D when clinically indicated.
CANDIDACY
I have severe bone loss — can I still get All-on-4?
In most cases, yes. All-on-4 was specifically engineered for patients with bone loss. The tilted posterior implants maximize contact with available bone — allowing most patients with atrophic maxilla or mandible to proceed without bone grafting.
I grind my teeth — am I a candidate?
Bruxism is a risk factor but not an automatic disqualifier. A nightguard and bruxism management plan may be required before or alongside treatment to protect implants during osseointegration.
I take blood thinners — can I get implants?
Certain blood thinners require medical clearance and possible temporary adjustment before surgery. Dr. Elzayat coordinates with your physician to ensure safe surgical conditions.
I had implants fail elsewhere — can they be replaced?
Yes. Dr. Elzayat treats implant revision cases in-house, including patients returning from overseas dental tourism with failed or incomplete treatment.
I have osteoporosis — does that disqualify me?
Not necessarily. Osteoporosis and bisphosphonate medications require careful evaluation. Medical clearance is required. Dr. Elzayat reviews your full medication history and coordinates with your physician.
I've had radiation to my jaw — can I get implants?
Prior jaw radiation significantly affects bone healing capacity and is evaluated carefully on a case-by-case basis. A consultation with full medical history review is required.
THE PROCEDURE
How many implants does All-on-4 use?
Four titanium implants per arch — two placed vertically at the front, two tilted at 30–45 degrees at the rear to maximize bone contact.
Are extractions and implants done the same day?
Yes. In most cases extractions, implant placement, and temporary restoration are all completed in a single surgical visit at A-Dental Center.
What sedation options are available?
Local anesthesia is standard. Nitrous oxide and oral conscious sedation are available for anxious patients. Dr. Elzayat discusses sedation options at your consultation.
How long does the surgery take?
Typically 3–5 hours per arch depending on complexity, number of extractions, and bone preparation required.
What happens if I need a sinus lift?
A sinus lift may be required if upper posterior bone is insufficient. Dr. Elzayat performs sinus lifts in-house. In many cases All-on-4’s tilted posterior implants avoid the sinus entirely — eliminating the need for this procedure.
What is osseointegration and how long does it take?
Osseointegration is the process by which titanium implant posts fuse with living jawbone. It typically takes 3–6 months and is the biological foundation that makes All-on-4 a permanent solution.
What is peri-implantitis and how is it prevented?
Peri-implantitis is a bacterial infection around the implant post — the leading cause of late implant failure. It is prevented through daily water flossing, regular professional cleanings, and not smoking.
RECOVERY
What can I eat immediately after surgery?
Soft foods only for the first 3–5 days — yogurt, mashed potatoes, scrambled eggs, soup, smoothies. A soft food diet continues throughout osseointegration.
How long before swelling goes down?
Swelling typically peaks at 48–72 hours and resolves within 5–7 days. Ice packs during the first 24 hours significantly reduce swelling.
When can I return to work?
Most patients return to desk work within 2–3 days. Physical labor or strenuous activity should be avoided for 1–2 weeks.
What medications are prescribed after surgery?
Antibiotics to prevent infection, anti-inflammatories for swelling, and pain management medication. Dr. Elzayat provides a complete post-operative care kit at your surgery appointment.
How do I clean implants during healing?
Gentle warm salt water rinses for the first week. A water flosser is introduced after initial healing. Dr. Elzayat provides detailed written aftercare instructions at your surgery appointment.
FINAL RESTORATION
What is the difference between a fixed hybrid denture and a zirconia full arch?
Nitrous oxide (laughing gas) for mild anxiety — wears off in minutes, drive yourself home. Oral conscious sedation for deeper relaxation — little to no memory of the procedure. Both used alongside local anesthesia so you feel no pain.
Can my final teeth be whitened?
No. Prosthetic materials — both acrylic hybrid and zirconia — do not respond to bleaching agents. Your tooth color is selected at the time of fabrication and remains consistent permanently.
How do I clean under my final arch?
A water flosser used daily cleans effectively beneath the prosthetic arch. Professional cleanings every 4–6 months with specialized instruments are essential for long-term implant health.
Do I need a nightguard with All-on-4?
Patients with bruxism are typically prescribed a nightguard to protect the prosthetic arch and reduce implant stress during sleep.
What happens at my maintenance visits?
Professional cleaning beneath the prosthetic arch, implant health assessment, peri-implantitis screening, bite evaluation, and prosthetic inspection. Dr. Elzayat personally monitors every maintenance checkpoint.
COST & INSURANCE
Does Medicare cover All-on-4?
Standard Medicare does not cover dental implants. Some Medicare Advantage plans include partial dental benefits — verify your specific plan before your consultation. We help patients review their coverage.
What PPO plans cover implants?
Most major PPO plans provide partial coverage for implant procedures. A-Dental Center accepts Delta Dental, Cigna, Aetna, MetLife, Guardian, BlueCross BlueShield, United Healthcare, and most major PPO carriers. We verify your benefits before your consultation.
Can I use FSA or HSA for All-on-4?
Yes. Flexible Spending Accounts and Health Savings Accounts can be applied toward dental implant treatment. Contact your plan administrator to confirm your specific benefits.
What is included in A-Dental Center's all-inclusive price?
The surgical phase including implant placement, extractions if needed, temporary restoration, and final prosthetic are all included. No separate surgeon fee. No hidden lab coordination fees. One price, one doctor, one office.
What happens if an implant fails — is there a warranty?
Implant failure is rare — under 5% globally. All restorations at A-Dental Center include warranty coverage: 2 years on denture stabilization, 5 years on fixed resin, 7 years on fixed zirconia. Dr. Elzayat monitors healing at every checkpoint to identify and address issues early.
COMPARISONS
Is All-on-4 better than dentures?
For patients who qualify, yes — in almost every clinical and quality-of-life measure. All-on-4 preserves jawbone, eliminates adhesives, restores full chewing function, and lasts 3–4 times longer than traditional dentures. The upfront cost is higher but the long-term value is significantly greater.
Is All-on-4 permanent?
The titanium implant posts are designed to last a lifetime. The prosthetic arch — fixed hybrid denture or zirconia full arch — is designed to last 15–20+ years with proper care. No other full-arch solution offers comparable longevity.
Can All-on-4 be reversed or removed?
The implant posts are permanent — they are not designed to be removed. The prosthetic arch can be removed by a dentist for repair or replacement if needed. This is not a reversible procedure.
What happens if I don't replace missing teeth at all?
Jawbone loss accelerates, facial structure changes, remaining teeth shift, chewing function declines, and nutrition suffers. The longer an edentulous arch goes untreated, the more complex and expensive restoration becomes.