All-on-4 Implants in Turkey

The angled implants are the whole idea. In a jaw that has lost bone at the back, placing implants straight down there is impossible without grafting. Tilting the rear implants forward lets them engage the stronger bone at the front of the jaw while still emerging far enough back to support a bridge of ten to twelve teeth. That is how a technique that would otherwise need bone grafting and eight implants gets done with four.

Because the four implants are splinted together by a rigid bridge, they share load in a way individual implants do not. That is what allows a temporary fixed bridge to be attached on the day of surgery, long before each implant could carry a tooth on its own.

All-on-4, All-on-6 or individual implants?

All-on-6 spreads the load across more implants and is generally preferred where bone quality is good and the budget allows, particularly in the upper jaw where bone is softer. See All-on-6 for the comparison in detail.

What the package includes

• Full examination, panoramic X-ray and 3D CBCT scan
• Any extractions needed on the day
• Four implants and multi-unit abutments
• A fixed temporary bridge the same day
• The permanent bridge at the second trip
• Five nights in a four-star hotel on each trip
• All airport, hotel and clinic transfers
• A personal English-speaking coordinator
• Your implant passport with brand and batch numbers
• Five-year guarantee on the bridge, manufacturer guarantee on the implants

Choosing the final bridge material

Acrylic on a titanium bar is lighter, cheaper and easier to repair, but the acrylic teeth wear and discolour over time and typically need replacing at around ten years. Monolithic zirconia is far more durable and does not stain, but it is heavier, less forgiving if the bite is wrong, and harder to repair if a section fractures. For most patients the zirconia upgrade is worth it.

All-on-4 is usually suitable if

• You are missing all or nearly all the teeth in one or both arches.
• Your remaining teeth are failing and will need removing anyway.
• You wear a denture that moves, rubs or affects what you can eat.
• You have lost bone at the back of the jaw and want to avoid grafting.
• You are a non-smoker, or can stop for four weeks either side of surgery.
• You can commit to two trips and to cleaning under the bridge daily.

You may need something else

• You are missing only a few teeth: individual dental implants or a bridge will serve you better and cost less.
• You have severe bone loss even at the front of the jaw, where angled implants cannot find purchase.
• You have active gum disease that has not been treated.
• You are a heavy smoker: full-arch failure is harder to recover from than a single implant.
• You take bisphosphonates, which needs specialist assessment.
• You grind heavily and will not wear a night guard — a full-arch bridge concentrates that force.

Take the self-check below for an honest starting answer, and send a panoramic X-ray for a free assessment by a Valentmedica implantologist before you commit to anything.

1. CBCT planning: a 3D scan maps bone volume, the nerve canal in the lower jaw and the sinus in the upper. Implant positions and angles are planned on the scan beforehand.
2. Anaesthetic: local anaesthetic, with intravenous sedation if you have chosen it. You remain able to respond but will remember little.
3. Extractions: any remaining teeth in the arch are removed.
4. Shaping the ridge: the bone ridge is levelled so the bridge will seat properly and the join will not show when you smile.
5. Placing the front implants: two implants are placed vertically in the front of the jaw, where bone is densest.
6. Placing the angled implants: two more are placed at the back, tilted up to 45 degrees forward to engage good bone while emerging far enough back to support a long bridge.
7. Multi-unit abutments: angled connectors are fitted so that all four implants present a parallel platform for the bridge.
8. The temporary bridge: a pre-prepared acrylic bridge is adjusted, attached and the bite checked. You leave with fixed teeth.

• Days 1–3: swelling and bruising peak around day two and can be marked, particularly on the lower face. Ice, prescribed painkillers and antibiotics.
• Days 3–7: swelling subsides. You eat soft food on the temporary bridge. Rinse gently; do not use a straw.
• Weeks 2–4: most patients feel normal and are back at work. Still soft food only.
• Weeks 6–8: diet can broaden, but nothing hard or crusty on the temporary bridge — acrylic fractures far more easily than the final zirconia will.
• Months 4–6: integration completes and the gums settle. The gum line recedes slightly as swelling resolves, which is precisely why the permanent bridge is made at this point and not earlier.
• After the permanent bridge: full function. Most patients report eating things they had given up years before.

Valentmedica works with licensed dental clinics in Istanbul whose implantologists are registered with the Turkish Ministry of Health, with in-house CBCT scanning and their own laboratory. You are given your dentist's name and registration number before you pay anything.

Risks you should know about

• Implant failure: under 5%, but the consequence is larger than with a single implant.
• Infection: peri-implantitis around one or more implants, the leading cause of late failure.
• Nerve injury: numbness of the lip and chin in the lower jaw. Rare with proper CBCT planning.
• Sinus perforation: in the upper jaw, which angling the implants is partly designed to avoid.
• Bridge fracture: more likely in acrylic than zirconia, and much more likely if you grind.
• Screw loosening: usually straightforward to retighten, but it needs the right components.
• Speech changes: a full-arch bridge alters tongue space, and most patients adapt within weeks.
• Food trapping: cleaning under the bridge daily is not optional — it is the single biggest determinant of long-term success.

Keep your implant passport and show it to any dentist who treats you. A full-arch bridge needs specific tools and knowledge of the system to service.

All-on-4 is designed to be a single-stage solution, so there is less sequencing than with individual implants. The main decision is whether to treat one arch or both.

Commonly combined with

• Extractions: nearly always, and done in the same sitting.
• The opposing arch: treating both at once adds one night and avoids a second surgical recovery. It also means the bite is designed as a whole.
• Veneers or crowns on the opposing natural teeth: where you are treating one arch and want the other to match in shade.
• Gum treatment: where periodontal disease caused the tooth loss, it is treated as part of the plan.

Usually avoided

Bone grafting and sinus lifts are what All-on-4 is designed to sidestep. If your CBCT scan shows there is not enough bone even for angled implants, your implantologist may recommend grafting first, or zygomatic implants anchored in the cheekbone — a more specialised procedure with its own trade-offs.

• Panoramic X-ray: send one before paying a deposit. Bone height at the front of the jaw determines whether All-on-4 is possible at all.
• Smoking: stop at least four weeks before and four weeks after. Full-arch failure is far harder to recover from than losing a single implant.
• Medication: declare blood thinners and especially bisphosphonates, which need specialist assessment before jaw surgery.
• Plan both trips: book the second provisionally when you book the first, four to six months later.
• Soft food: plan six to eight weeks of it. Soups, eggs, fish, slow-cooked meat and smoothies.
• Time off: two weeks is comfortable for most people after the first trip; the second trip needs almost none.

For most patients the change is larger than any other treatment on this site. Fixed teeth that do not move, no palate coverage, and the return of foods that denture wearers give up — apples, steak, crusty bread. The bone preservation matters too: loading the jaw slows the resorption that gives long-term denture wearers a collapsed lower face.

What determines longevity is cleaning. There is a gap between the bridge and the gum that must be cleaned under daily with a water flosser or superfloss, plus a hygienist every six months who knows how to maintain full-arch work. Patients who do this keep their bridges for decades; patients who do not develop peri-implantitis. You can see cases at both stages in our dental before and after gallery.