Richard J. Walicki, DMD

General & Cosmetic Dentistry in Philadelphia, PA Since 1990


2260 E. Allegheny Avenue
Philadelphia, PA 19134

For an appointment call



2260 E. Allegheny Avenue
Philadelphia, PA  19134

For an appointment call


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The All-on-Four® Fixed Denture is a treatment concept which uses Nobel Biocare implants and components to provide people who have no teeth (the dental term for this condition is “edentulous) -- or are soon to be without all their teeth -- with a non–removable ("fixed") full-arch prosthesis (denture) which is supported by only four implants on the day of surgery. Several unique elements of this system lead to improved patient satisfaction – especially with regard to function, appearance, sensation, speech, and self-esteem.

Many implant procedures require treatment times that can take up to a year (or more!) before the patient is able to enjoy the use of their dentures or bridges.  This methodology has two key elements that significantly reduce treatment complexity, the number of surgeries, and the overall treatment time:

1.     tilting of the posterior implants avoids the need for time-consuming bone grafting procedures

2.     immediate loading, which shortens the time until patients get to use their teeth.

The All-on-4® treatment concept is not only the least time-consuming treatment option, but also the least costly in comparison with conventional implant treatment modalities of the edentulous (having no teeth) and soon-to-be edentulous jaw.

Another advantage is that this system enjoys stability even with minimum bone volume. By tilting the two posterior implants, longer implants can be used. This increases bone-to-implant contact and avoids the need for surgically building up the bone. In addition, the tilted implants can be anchored in better quality bone that is usually found in the front of the jaw. Also, the dentist can reduce cantilevers (unsupported denture teeth, which can break under pressure), and the placement helps to avoid important anatomical structures.

Here are some interesting statistics about tooth loss and why it is important to replace missing teeth:

According to the Centers for Disease Control and Prevention (CDC), one quarter of all adults aged 60 years and older have lost all of their teeth.

More specifically, 20.5% of adults in the U.S. aged 65 and older have lost all of their natural teeth due to tooth decay or gum disease.  So this is not just a little problem.

Loss of all teeth causes serious disabilities for most people who wear conventional dentures because they have difficulty performing two of the most essential tasks of life: eating and speaking. 

Many denture wearers will tell you, they have trouble with relaxation, endure daily pain and distress, as well as simply avoid going out.  Complete and partial tooth loss is associated with reduced physical, psychological, and social function, in addition to decreased chewing ability.  In fact, for full denture wearers, their chewing ability can be cut by as much as half.  This leads to greater disability and handicap as well as a potential detriment to overall health.  The reason is simple: as people loose teeth over time, their intake of nutritious foods decreases.  

It has been shown that the intake of specific foods that are rich in dietary fiber and nutrients, and are known to have anti-cancer and other positive health effects, is lower among denture wearers than among people who have all of their teeth.  For one thing, high fiber foods can be tougher to chew.

It is not surprising, then, that several studies demonstrate complete tooth loss is most definitely associated with illness.  In fact, 17% of edentulous people take medication for gastrointestinal disorders. Also, they require 17% more medications than people the same age who have their teeth.

Fortunately, there are several loose lower denture solutions.  Dental implants can help a patient to achieve immediate stability and improved function with safe, attractive, and comfortable non-removable dentures.

The surgical placement of implants is increasingly becoming a standard treatment option for general dentists, and patient demand is the biggest reason that general dentists are exploring the surgical option. Yet, only a small percentage of people who have lost their teeth and who might benefit from implants ever get them placed.

In practical terms, implant dentistry can date back to prehistoric man.  Fossil evidence suggests people have made attempts to recreate teeth using substances such as stone, ivory, gold, iron, and wood.

When the lower jaw and gummy ridge become thin and start to shrink, dentures won’t fit properly and denture wearers often experience significant problems with their dentures staying in place. Of course, this makes it more difficult to eat and to speak.

Modern dental implants have been around for 40 years and numerous studies show success rates routinely above 95%.  These same studies suggest that patients enjoy a higher quality of life, have greater self-confidence, and enjoy a better nutritional state when conventional dentures are replaced with dentures that are implant-retained.  

This can take one of two forms: either, removable dentures that are supported and retained by implants, or dentures that are secured to the implants (dentists refer to these as “fixed dentures”) and are not removable by the patient. Typically, the dentist removes these types of dentures at least twice a year for cleaning in the dental office.

So, if this solution can make such a huge difference in people’s lives, why don’t we see more people taking advantage of it?  After all, looking at real numbers, there are about 40 million people in the US that are missing their back teeth; 10 million people are completely without any upper teeth; and the number of people without any teeth at all (we call this the "edentulous" population) totals 20 million people.

Fear of surgery, time constraints, inadequate bone, and cost are often cited as the reasons people don’t choose to have implants to support their dentures.  It is estimated that in the industrial world alone, more than 240 million people lack one or more teeth. In Europe, an estimated 10% of the population is fully edentulous (missing all teeth), and 35% to 40% are partially edentulous. In the U.S., the 11% of the population is fully edentulous and 40% are partially edentulous. 

Only 22% of older persons are covered by private dental insurance. As a result, dental care is out of reach for many older people living on a fixed income. Traditional means of securing bridges permanently often required six to eight implants.  Between surgeon’s fees, lab and restoring dentist’s costs, this often put the cost of treatment out of reach for all but a few individuals.  Another solution needed to be developed.  More than ten years of testing has shown that the All-on-Four® system by Nobel works.

 With All-on-Four® Fixed Dentures people can enjoy a:

  • Better quality of life
  • Shorter treatment times
  • Lower costs 
  • Stability even in minimal bone volume

Call our office to learn how you or a loved one suffering with ill-fitting dentures may benefit from this life-changing procedure.