Fixed teeth in just one day: Reality or marketing promise? (The All-on-4® concept)

For many patients, the idea of a removable full denture (the classic “false teeth in a glass”) is a nightmare. The fear of loose teeth when speaking, reduced sense of taste due to a palatal plate, and painful pressure points is widespread.

For a long time, the path to fixed teeth was complex and demanding: extensive bone augmentation procedures and months of healing without teeth were often required. The All-on-4® treatment concept has revolutionized implantology by making it possible to restore a completely edentulous jaw with fixed teeth in just one day.

But how does it work from a biological perspective? And is it suitable for everyone? Here is the medical fact check.

The biomechanical principle: angled instead of vertical

Under normal circumstances, dental implants are placed vertically into the bone. However, when a jaw has been edentulous for a long time, the bone gradually resorbs (atrophy) — particularly in the posterior regions, where the maxillary sinus in the upper jaw and the mandibular nerve in the lower jaw are located. In the past, this often required surgical bone augmentation.

The All-on-4® concept makes use of an ingenious biomechanical principle:

1. The two anterior implants are placed vertically, where sufficient bone volume is usually still available.
2. The two posterior implants are intentionally inserted at an angle ( approximately 30–45 degrees ).

The advantage: By angling the posterior implants, critical anatomical structures such as the nerve and maxillary sinus can be avoided while making optimal use of the existing bone. In addition, the posterior support area is extended, providing excellent primary stability — often without the need for bone augmentation.

The procedure: a gap in the morning, fixed teeth by evening

The term “Fixed teeth in one day” refers to what is known as immediate loading.

1. Diagnostics & 3D planning: Before the procedure, a three-dimensional X-ray scan (CBCT/DVT) is taken. Using digital planning software, the exact position of the four implants is planned down to the millimeter to protect nerves and blood vessels.
2. The procedure: In a single surgical session, any remaining teeth that cannot be preserved are removed, and the four implants are placed.
3. Immediate restoration: On the very same day, a fixed provisional bridge is securely screwed onto the implants.
   • The psychological benefit: You do not leave the practice with a removable denture or a visible gap, but with fixed, screw-retained teeth. You can immediately smile, speak, and interact socially again.

IMPORTANT: the rules for a proper healing

Here we need to correct a common misconception often found online: While the teeth are fixed immediately, the bone still needs time to bond to the titanium implant surface (a biological process known asosseointegration).

• Diet: For the first 6 to 12 weeks, a strict soft-food diet is essential (e.g. pasta, fish, scrambled eggs). Excessive chewing forces (nuts, crusty bread, tough meat) can disrupt healing and may lead to implant failure.
• Oral hygiene: Because the bridge is firmly fixed, we will show you specific cleaning techniques — such as the use of super floss and oral irrigators — to keep the areas beneath the bridge clean and free from inflammation.

The final step: the definitive restoration

After approximately 3 to 6 months, biological healing is complete. At this stage, the provisional bridge is replaced with the definitive restoration. This final bridge is usually made of a high-strength titanium framework or zirconia and is designed to be so natural in appearance that it is virtually indistinguishable from real teeth.

Who pays for what? Understanding the costs

Within the German healthcare system, cost coverage is clearly regulated — though often confusing for patients:

1. Implants (surgery): The placement of the artificial tooth roots is considered a private service. As a rule, statutory health insurance (GKV) does not cover the costs of implant surgery.
2. Dental prosthetics: Statutory health insurance provides a fixed subsidy. This subsidy is based on the so-called standard treatment (usually a removable denture). However, this fixed amount is also credited toward an

Conclusion: All-on-4® is a well-established and scientifically well-documented treatment concept that allows patients to regain quality of life immediately. Compared to conventional approaches, it is often more cost-efficient, as fewer implants are required and bone augmentation can frequently be avoided. However, it does require discipline during the healing phase, particularly with regard to diet.

Would you like to know whether your bone structure is suitable for this treatment? We would be happy to clarify this in a non-binding diagnostic consultation.