Full Arch · Maló Protocol · Teeth in a Day · Same-Day Fixed Bridge

All-on-4 Dental Implants in Turkey — Full-Arch Fixed Teeth in 24 Hours at Eyeglow Istanbul

All-on-4 is the full-arch fixed-bridge protocol developed by Paulo Maló and Nobel Biocare in 1998 — 4 implants per jaw (2 anterior vertical plus 2 posterior tilted at 30 to 45 degrees) support a complete set of fixed teeth. A temporary acrylic bridge is fitted within 24 hours of surgery; the final monolithic zirconia bridge follows 3 to 6 months later. Most edentulous cases avoid bone grafting. Delivered at our partner accredited dental clinic by a DDS board-certified dental specialist.

Get a written All-on-4 plan Compare with All-on-6

Procedure time3–5 hours per arch

AnaesthesiaLocal + IV sedation

Implants per arch4 (2 vertical + 2 tilted 30–45°)

Temporary teethFitted within 24 hours

Final zirconia bridgeAfter 3–6 months of healing

Bone graftAvoided in most edentulous cases

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What it is

What are All-on-4 dental implants?

All-on-4 is a full-arch fixed dental-bridge protocol that supports a complete set of teeth — typically 10 to 14 teeth — on just 4 dental implants per jaw. The 2 anterior implants are placed vertically; the 2 posterior implants are tilted at 30 to 45 degrees to engage dense anterior bone and avoid the sinus and inferior alveolar nerve. A temporary fixed acrylic bridge is fitted within 24 hours ("teeth in a day"); the final monolithic zirconia bridge follows 3 to 6 months later.

At Eyeglow Health in Istanbul, All-on-4 is performed at our partner accredited dental clinic by a DDS board-certified dental specialist using original Nobel Biocare, Straumann or Mega Gen implants — the same brands used in implant clinics across Switzerland, Sweden and Germany. The Turkish Ministry of Health International Health Tourism Authority Certificate is held by both Eyeglow and the partner dental clinic. We follow American Dental Association (ADA) implant guidelines and FDI World Dental Federation standards on the original Maló protocol (Maló 2003 — Clinical Implant Dentistry and Related Research; Maló 2012; Maló 2018).

All-on-4 is the right protocol for edentulous patients (or those with failing remaining teeth) who want fixed (not removable) teeth, who want to avoid bone grafting where possible, and who can commit to two visits to Istanbul separated by 3 to 6 months. The decision between All-on-4, All-on-6 or conventional implant rehabilitation belongs to a DDS who has personally reviewed your CBCT scan and discussed your priorities.

How it works

From first consultation to final zirconia bridge

01
Online consultation + CBCT review
You share a panoramic X-ray or 3D cone-beam CT (CBCT) plus a brief dental history. Our partner DDS reviews bone volume in the anterior (front) jaw, identifies whether All-on-4 is feasible without bone grafting (yes in most edentulous cases), confirms candidacy and selects implant dimensions. A written treatment plan with itemised pricing is sent before any payment is requested.
02
Pre-operative assessment in Istanbul
On day 1 in Istanbul: clinical examination, fresh CBCT if needed, full-mouth digital scan, blood tests (CBC, INR, hepatitis B/C, HIV per Turkish Ministry of Health protocol), informed consent. If you still have failing remaining teeth, these are atraumatically extracted at this visit or in combination with implant surgery. Digital implant planning is finalised on a surgical guide.
03
All-on-4 implant surgery (3 to 5 hours per arch)
Under local anaesthetic and intravenous sedation, 4 implants are placed per arch: 2 in the anterior jaw (vertical, between the natural canine positions) and 2 in the posterior jaw (tilted at 30 to 45 degrees to avoid the sinus on the upper jaw and the inferior alveolar nerve on the lower jaw). The tilted-implant biomechanical principle was developed by Paulo Maló and Nobel Biocare in 1998 and allows full-arch rehabilitation without bone grafting in most edentulous cases.
04
Same-day temporary bridge fitted ("teeth in a day")
On the same surgical day or within 24 hours, a fixed temporary acrylic bridge is screwed onto multi-unit abutments connected to the 4 implants. You leave the clinic with a full set of fixed temporary teeth on each treated arch — no removable denture, no toothless period. The temporary bridge is functional for soft to medium foods immediately; gradual food re-introduction is guided over 3 to 6 months while bone integration completes.
05
Healing + osseointegration (3 to 6 months)
You return home with the temporary bridge in place, antibiotics, anti-inflammatory and oral-rinse instructions. During this period the 4 implants fuse biologically with the surrounding bone. Eyeglow coordinator schedules a remote 1-month and 3-month review by photo and video; any soreness or bite issue is addressed by the partner DDS through the coordinator without delay.
06
Final zirconia bridge delivery (visit 2)
You return to Istanbul after osseointegration is confirmed by CBCT. The temporary acrylic bridge is removed, multi-unit abutments are checked, a final digital scan is taken and the partner laboratory crafts a monolithic zirconia bridge (or zirconia with porcelain layering on the front teeth) over 4 to 6 working days. The final bridge is screw-retained for serviceability and can be unscrewed by your home dentist for cleaning every 1 to 2 years.

Full-arch options

All-on-4 vs conventional implants vs dentures vs All-on-6

For patients missing most or all of their teeth, the right full-arch protocol depends on bone volume, bite force, budget and willingness to commit to implant maintenance. Here is how the four main options compare:

Aspect	All-on-4	Conventional implants	Denture	All-on-6
Implants per arch	4 (2 vertical + 2 tilted)	6 to 10 per arch (one per missing tooth area)	0 (gum-supported)	6 per arch
Bone graft needed	No in most cases (tilted implants avoid sinus / nerve)	Yes in 60–80% of cases	No	Sometimes (depends on posterior bone)
Time to fixed teeth	Same day (24 hours)	3–6 months minimum	Same day (but removable)	Same day (24 hours)
Long-term cost	Lower (fewer implants)	Higher (more implants + grafts)	Lower upfront, higher long-term	Slightly higher than All-on-4
Maintenance	Interdental brush + water flosser daily	Same as natural teeth + special floss	Remove + clean nightly	Interdental brush + water flosser daily
Bite force	Strong (~80% of natural teeth)	Excellent (~90% of natural teeth)	Reduced (~30% of natural teeth)	Slightly stronger than All-on-4

Pricing

Personalised pricing

Every treatment plan is priced individually after your consultation. Request a written, all-inclusive quote — clear, itemised, and with no obligation.

Request a written quote

Package transparency

What's included in your All-on-4 package

Included in package

Pre-op consultation + clinical examination + CBCT review
Implant-planning software analysis + surgical guide where indicated
Atraumatic extraction of any remaining failing teeth (if needed) on the surgical day
Blood tests (CBC, INR, hepatitis B/C, HIV — Turkish Ministry of Health protocol)
All-on-4 implant placement at partner accredited dental clinic by DDS board-certified dental specialist
Local anaesthetic + intravenous sedation included
4 dental implants per arch (Mega Gen standard / Straumann or Nobel Biocare on premium tier)
Multi-unit abutments + same-day fixed acrylic temporary bridge
5-star hotel — 4 nights surgical visit + 5 nights final-bridge visit
VIP airport transfers (return) for both visits
All post-op medications + antibiotics + oral-rinse + soft-diet aftercare kit
Final monolithic zirconia bridge (or zirconia with porcelain front-teeth layering on premium tier)
1, 3, 6 and 12-month photographic video follow-up
Implant manufacturer warranty documentation
Multilingual dental coordinator — 24/7
Complication insurance — covers eligible post-operative medical complications during the recovery period at our partner accredited clinic (issued in line with the Turkish Ministry of Health International Health Tourism Authority Certificate)

Paid separately

Items below are not part of the medical package — your coordinator helps you arrange them at no markup.

Flights to/from Istanbul (two visits required)
Personal expenses
Bone grafting or sinus lift if needed (a separate quote is provided at consultation; All-on-4 typically avoids bone grafting but a small proportion of cases still need it)
Replacement final bridge if the original needs replacement after 10+ years (warranty covers the implant fixtures, not the bridge superstructure beyond standard warranty period)
Treatment of remaining natural teeth on the opposite arch (separate dental plan if needed)
Travel insurance (flight cancellation, baggage, general trip cover) — separate from the medical complication policy above; your coordinator can recommend a provider at no markup

Candidacy

Are you a candidate for All-on-4 dental implants?

You may be a good candidate if

You are missing most or all of the teeth in one or both jaws — or your remaining teeth are failing and need extraction.
You have adequate anterior (front) jawbone volume — All-on-4 needs minimum 5 mm bone height in the front jaw; tilted posterior implants avoid sinus and nerve constraints.
You are a non-smoker or willing to stop from 2 weeks before surgery to 3 months after — nicotine reduces osseointegration in all implant cases.
You can commit to two visits to Istanbul (4 to 5 nights surgical visit + 5 nights for the final bridge) separated by 3 to 6 months.
You want fixed (not removable) teeth and understand the maintenance requirement is daily interdental brushing plus 6-monthly hygiene visits.

A different approach may suit you better if

You have uncontrolled diabetes (HbA1c above 8%) or active oral infection — these must be stabilised first.
You are taking high-dose intravenous bisphosphonates (osteoporosis medication) — osteonecrosis risk is elevated; a removable denture may be safer.
You have had radiotherapy to the head and neck within the last 12 months — implant healing in irradiated bone is significantly impaired.
You only have 1 to 3 missing teeth — individual implants or a fixed bridge are more conservative; All-on-4 is not appropriate when most natural teeth are healthy.
You are unable or unwilling to maintain daily interdental cleaning — peri-implantitis around full-arch bridges is particularly damaging and difficult to treat.

Disclaimer. Information on this page is consistent with American Dental Association (ADA) implant guidelines, FDI World Dental Federation standards and Turkish Ministry of Health International Health Tourism Authority Certificate requirements. The choice between All-on-4, All-on-6 or conventional implant rehabilitation is a clinical decision based on bone volume, bite force, edentulous timeline and patient priorities — not a marketing-driven default.

Risks & outcomes

Realistic outcomes — the risks that actually matter

Every All-on-4 procedure has measurable risks. We list them here in the same plain language our DDS uses in your consultation:

Implant failure in the first 6 to 12 months

Individual All-on-4 implants fail to integrate in approximately 2 to 5% of cases over the first year, similar to single-tooth implants. When one of the 4 implants fails, the temporary bridge is removed, the failing implant is replaced (often with a slightly larger fixture in the same position), and healing restarts. The other 3 implants usually continue to integrate normally. Eyeglow coordinator manages return travel logistics under warranty.

Prosthetic complications (more common than implant failure)

In long-term All-on-4 follow-up studies (Maló 2012, Maló 2014), implant survival exceeds 95% at 10 years — but prosthetic complications (acrylic temporary fracture, abutment screw loosening, opposing-arch wear) occur in 20 to 40% of cases over 10 years. These are correctable in-chair at modest cost and do not threaten the implants themselves. Annual professional review with a dentist trained in implant prosthetics is essential.

Nerve injury (lower jaw)

The inferior alveolar nerve runs through the lower jaw and supplies sensation to the lip and chin. The posterior tilted implants in lower All-on-4 must avoid this nerve. CBCT 3D planning and surgical guide use reduce the risk of permanent nerve injury to under 1%; transient numbness for a few weeks is reported in 2 to 3% of cases and almost always resolves. We perform 3D digital planning on every All-on-4 lower-jaw case.

Hygiene-related peri-implantitis (long-term)

Bacterial inflammation around full-arch bridge implants is particularly destructive because all 4 implants must support the same bridge — if peri-implantitis affects one or two implants, the entire bridge may need to come off for treatment. Daily interdental brushing, water flossing under the bridge and 6-monthly professional cleaning are non-negotiable for All-on-4 patients. We discuss this at length in consultation and provide a written aftercare protocol.

FAQ

Frequently asked questions about All-on-4 dental implants

What is All-on-4 dental implants?

All-on-4 is a full-arch fixed dental-bridge protocol developed by Paulo Maló and Nobel Biocare in 1998. It uses just 4 implants per jaw (instead of one implant per missing tooth) to support a full set of fixed teeth — typically 10 to 14 teeth — on a single bridge. The clinical innovation is the angled placement of the 2 posterior implants at 30 to 45 degrees, which uses the dense bone available in the anterior (front) jaw and avoids the maxillary sinus on the upper jaw and the inferior alveolar nerve on the lower jaw. This means most patients avoid bone grafting even after years of being toothless. A temporary fixed acrylic bridge is fitted within 24 hours of surgery ("teeth in a day"); the final monolithic zirconia bridge replaces the temporary 3 to 6 months later. The protocol has 20+ years of published follow-up data (Maló 2003, 2012, 2018) with implant survival exceeding 95% at 10 years.

How is All-on-4 priced in Turkey?

At Eyeglow Health every treatment plan is priced individually after a consultation with our partner DDS — pricing depends on the number of arches treated, implant brand tier, and any additional procedures (extractions, bone work). You will receive a written, all-inclusive, itemised quote before any payment is requested. Request your personalised quote using the form on this page.

How long do All-on-4 dental implants last?

Long-term published data on All-on-4 (Maló 2012 and 2018 — 10 to 18 year follow-up cohorts) shows implant survival exceeding 94 to 96% at 10 years. Many All-on-4 cases continue functioning at 15 to 20 years. The implant fixtures themselves typically outlive the bridge superstructure: the temporary acrylic bridge is designed to last 3 to 6 months; the final monolithic zirconia bridge is designed for 10 to 15 years of service before potential replacement of the superstructure (the implants remaining in place). Long-term outcome depends on three factors: daily oral hygiene (peri-implantitis prevention), occlusal management (avoiding excessive bite forces and grinding without a night guard), and 6-monthly professional hygiene visits with a clinician trained in implant maintenance.

What are the problems with All-on-4 dental implants?

Real and honestly-discussed challenges with All-on-4: (1) Prosthetic complications — acrylic temporary fracture, abutment screw loosening and opposing-arch wear occur in 20 to 40% of cases over 10 years; these are correctable but require professional attention. (2) Hygiene-sensitive — daily interdental brushing and 6-monthly professional cleaning are essential; patients who cannot or will not maintain hygiene have significantly increased peri-implantitis risk. (3) One bridge across all 4 implants — if peri-implantitis affects one implant, the entire bridge may need to come off for treatment. (4) Adaptation period — speech and chewing feel different for 2 to 6 weeks; most patients adapt fully, a small minority continue to feel the bridge as "foreign". (5) Cost — although significantly less than individual implants per missing tooth, All-on-4 is still a substantial investment compared to a conventional denture. These are not reasons against All-on-4 — they are reasons for honest consent and clear aftercare commitment.

How is All-on-4 different from conventional dental implants?

Conventional implant rehabilitation places one implant per missing tooth — for a full toothless arch this typically means 6 to 10 implants, often requiring bone grafting in 60 to 80% of cases to build up bone where teeth have been missing for years. All-on-4 uses just 4 implants per arch by tilting the posterior implants 30 to 45 degrees so they engage dense anterior bone without entering the sinus or nerve canals. This avoids bone grafting in most edentulous cases, reduces total cost, and allows a same-day fixed temporary bridge to be fitted. Conventional implants give slightly stronger bite force and more independent dental crowns; All-on-4 gives faster treatment time, lower cost and avoidance of bone grafting. The DDS recommends the right protocol for your bone volume, edentulous timeline and budget — not what is most profitable for the clinic.

How is All-on-4 different from All-on-6?

All-on-6 uses 6 implants per arch instead of 4 — typically arranged with 2 in the anterior, 2 in the mid-arch and 2 in the posterior. The additional 2 implants provide greater biomechanical stability for patients with strong bite forces, suit longer-term durability and may be preferred when adequate posterior bone allows. All-on-4 uses 4 implants per arch with the posterior 2 tilted 30 to 45 degrees — the simplest protocol that achieves immediate fixed teeth and avoids bone grafting. Decision factors: bone availability (limited posterior bone may force All-on-4; adequate bone allows All-on-6), bite force (heavy bruxers may benefit from 6 implants), and overall treatment scope. See our All-on-6 page for the longer comparison.

What is "teeth in a day"?

"Teeth in a day" refers to the same-day temporary bridge fitted within 24 hours of All-on-4 surgery. After the 4 implants are placed at controlled torque, multi-unit abutments are connected and a pre-prepared or chairside-fabricated acrylic bridge is screwed onto the abutments. You leave the clinic the same day or the next day with a full set of fixed teeth on the treated arch — no removable denture, no toothless period. The temporary bridge is fully functional for soft to medium foods; full hard-food capability returns when the final zirconia bridge is fitted 3 to 6 months later. The biomechanical principle that allows immediate loading is the high primary stability achieved with tilted implants engaging dense anterior bone — this is why the Maló protocol specifies tilted posterior implants.

How many visits to Turkey are needed for All-on-4?

All-on-4 typically requires two visits to Istanbul separated by 3 to 6 months. Visit 1 (4 to 5 nights): pre-operative assessment day 1, surgical day for implant placement day 2, same-day or 24-hour temporary acrylic bridge fitting, recovery review day 3, departure day 4 or 5. You return home with the temporary bridge in place. Visit 2 (5 to 6 nights): final digital scan day 1, laboratory fabrication of the final monolithic zirconia bridge over 4 to 6 working days, try-in and screw delivery, bite check and polish, departure. Your coordinator manages flight and hotel scheduling so both visits align with surgical and laboratory milestones. Some patients prefer to combine the second visit with a longer Istanbul or Turkey holiday.

Is All-on-4 painful?

The All-on-4 surgery is performed under local anaesthetic plus intravenous sedation — included in the package — and is generally not painful during the procedure. After the anaesthetic wears off, moderate discomfort for 3 to 7 days is typical and is managed with prescribed pain medication. Swelling and bruising peak at 48 to 72 hours and resolve within 1 to 2 weeks. Soft-diet eating for the first 6 to 12 weeks is recommended to protect the temporary bridge during osseointegration. Once the temporary bridge is comfortable (usually after 2 to 4 weeks), there is no significant pain — the temporary bridge functions like fixed teeth, although the bite force is moderated by the soft-diet recommendation during bone integration.

Can All-on-4 be done if I have no teeth left?

Yes — patients with no remaining teeth (fully edentulous) are the original target population for All-on-4. The protocol was specifically developed by Maló and Nobel Biocare for edentulous patients who would otherwise have needed extensive bone grafting before conventional implants. Even patients who have been wearing dentures for many years and have significant bone resorption can usually be treated with All-on-4 because the anterior jaw retains adequate bone for the 2 vertical anterior implants in most cases. CBCT 3D imaging at consultation confirms anterior bone volume; in the small percentage of cases where anterior bone is also insufficient, alternative protocols such as zygomatic implants (anchored in the cheekbone) may be discussed. For edentulous patients who currently wear ill-fitting dentures, All-on-4 is often a life-changing transition from removable to fixed teeth.

What is the difference between All-on-4 and a denture?

A denture is a removable plate of acrylic teeth that rests on the gum and is held in place by suction (upper) or muscle contour (lower). All-on-4 is a fixed bridge of zirconia or acrylic teeth that is screwed onto 4 implants permanently anchored in the jawbone — it cannot be removed by the patient. Functional differences: (a) Bite force — All-on-4 delivers about 80% of natural-tooth bite force; a denture delivers about 30% (significantly reduced chewing capability). (b) Stability — All-on-4 is rock-solid during eating, laughing and speaking; dentures can dislodge unexpectedly. (c) Bone preservation — All-on-4 implants stimulate the underlying jawbone and prevent further bone loss; dentures do not stimulate bone and resorption continues over years. (d) Taste — dentures cover the palate and dull the sense of taste; All-on-4 bridges do not cover the palate. The right choice depends on your clinical situation, priorities and willingness to commit to implant-maintenance — your coordinator will discuss both options honestly.

Why choose Eyeglow Health for All-on-4 in Turkey?

At Eyeglow Health your All-on-4 surgery is performed at our partner accredited dental clinic by a DDS board-certified dental specialist with documented All-on-4 case volume. Both Eyeglow and the partner clinic hold the Turkish Ministry of Health International Health Tourism Authority Certificate. We are honest that Eyeglow is primarily an eye-care specialist clinic — dental treatments are delivered through our partner dental clinic network with full transparency, the same care coordination and the same complication insurance as our eye procedures. We use only original-component implants (Nobel Biocare, Straumann, Mega Gen) with verifiable lot numbers and full manufacturer warranty documentation. One named coordinator from first message to 12-month follow-up; written treatment plan with itemised pricing before any payment; honest discussion of whether All-on-4 or All-on-6 is the right protocol for your bone anatomy and priorities.