Full-Arch Implant Reconstruction · Led by Dr. Hung Le Ba Gia (Dr. Evans) · Last reviewed May 2026
All-on-4 That Restores
a Full Arch.
Picasso Dental places All-on-4 full-arch implant reconstructions in Vietnam with Osstem, Neodent, Nobel Biocare and Straumann, every fixture covered by the manufacturer's original warranty. All-on-5, All-on-6 and All-on-X variants also available, with two of our six branches operating inside accredited hospitals for complex cases.
What is All-on-4?
All-on-4 is a full-arch dental implant reconstruction in which four titanium implants are placed in one jaw, typically with the rear two angled to take maximum advantage of available bone, to support a complete fixed bridge of 12–14 teeth. Unlike a removable denture, the bridge is anchored permanently. The protocol often allows immediate loading, meaning a provisional fixed bridge can be fitted on the day of surgery.
Why Picasso for All-on-4
Genuine Brand Implants Only
Osstem, Neodent, Nobel Biocare and Straumann, every fixture comes with the manufacturer's original warranty and a serial number you can verify. No grey-market, no off-brand substitutions.
Hospital-Based Options
Two of our six branches operate inside accredited hospitals: Vinmec International Hospital Da Nang and Link General Hospital Da Lat. Hospital-based surgery is recommended for full-arch cases with on-site emergency medical support.
CBCT-Guided Surgical Planning
Cone Beam CT imaging maps your jawbone in 3D before any surgery. We plan implant position, angle and depth digitally, reducing surgical risk and improving long-term outcomes.
Lead Implant Specialist
Full-arch cases at Picasso are led by Dr. Hung Le Ba Gia (Dr. Evans), our dedicated implant specialist with 200+ All-on-4 cases completed, focused on surgical placement, full-arch reconstruction and complex cases requiring grafting or sinus augmentation.
Immediate-Load Where Suitable
For most patients, a provisional fixed bridge can be fitted on the day of surgery or the following day, meaning you do not leave the clinic without teeth.
Bone Grafting If Needed
Bone autograft, Bio-Oss with collagen or Bio-Gide membranes, and closed or open sinus augmentation, all available as part of the same treatment plan, decided after CBCT review.
Itemised All-on-X Pricing
For published rate cards across All-on-4, 5, 6 and X with Osstem, Neodent, Nobel Biocare and Straumann, plus prosthetic upgrades (titanium and BioHPP full-arch bars, acrylic bridges), see the dedicated implant cost guide. Bone grafting and sinus augmentation are quoted separately after CBCT review.
See single dental implants for non-full-arch options.
All-on-4, 5, 6 or X: How to Choose
Different anatomical situations call for different implant counts. Your CBCT scan tells us which configuration is right for you.
All-on-4
When: Full arch missing or failing, with limited posterior bone.
What's involved: Four implants per arch, two front vertical and two rear angled to use available bone.
Best for: Patients with reduced bone volume who want the lowest implant count and fastest treatment.
Lowest implant count, fastest treatment
All-on-5
When: Slightly more bone volume than All-on-4 candidates, additional anchorage preferred.
What's involved: Five implants per arch, with one additional anchor distributed in the front segment.
Best for: Patients between All-on-4 and All-on-6 candidacy.
Extra anchorage in the front segment
All-on-6
When: Adequate bone volume across the full arch.
What's involved: Six implants per arch, improved load distribution vs All-on-4.
Best for: Patients with sufficient bone wanting maximum stability and longevity.
Maximum stability and longevity
All-on-X
When: Patient-specific anatomy or load requirements call for more than six anchors.
What's involved: Custom implant count above six, planned per case.
Best for: Heavy-bite patients, complex anatomical cases, maximum redundancy.
Maximum redundancy, planned per case
The All-on-4 Procedure, Step by Step
From CBCT planning to final fixed bridge, total timeline approximately six months for a standard case.
Consultation + CBCT
Clinical exam, medical history, blood tests, and CBCT 3D scan to map jawbone density and plan implant position digitally.
Day 1 · 90 minSurgical Planning
Digital plan reviewed, implant brand, position, angle, and need for any bone grafting or sinus augmentation.
Pre-surgerySurgery + Provisional
Failing teeth extracted, four implants placed under local anaesthetic with optional sedation. Provisional fixed bridge fitted same or next day.
Surgery · 2–3 hoursOsseointegration
Approximately six months of healing during which the implants fuse with the jawbone. Provisional bridge worn during this period.
~6 monthsFinal Fixed Bridge
Digital impressions taken, final fixed bridge of 12–14 teeth fabricated and fitted. Case file and implant serial numbers handed over.
2–3 visits · 2 weeksWho Is, and Isn't, a Good Candidate?
All-on-4 is the right answer for patients with a full failing arch or already missing all teeth in one jaw. It is not the right answer for everyone.
You're a Strong Candidate If
You are missing all the teeth in one or both arches, or facing the loss of the remaining few.
You are an adult in generally good health with a healed surgical site or are willing to have remaining teeth extracted.
You have adequate bone in the front of the jaw, the All-on-4 protocol is designed for cases with limited posterior bone.
If diabetic, your HbA1c is well-controlled (ideally below 7%).
You do not smoke, or are willing to stop at least 2 weeks before surgery and 8 weeks afterward.
You are willing to attend 6-month recall visits for life.
All-on-4 May Not Be Right If
You only have one or two missing teeth, single implants or a bridge are the right tool.
You have uncontrolled diabetes, failure and infection risk are significantly higher.
You have active untreated gum disease, must be resolved first.
You have recently received IV bisphosphonate therapy.
You are a heavy smoker unwilling to stop or significantly cut down.
Your jaw is still growing (typically under 18) or you are pregnant.
Risks & Success Rates: Honestly
No surgery is risk-free. Here is what the literature reports, what can go wrong, and how Picasso minimises every avoidable risk.
Documented Success Rate
Long-term clinical literature consistently reports dental implant survival rates in the 95–98% range over 10 years for healthy patients placed by experienced clinicians, confirmed by the systematic review of Moraschini et al. (2015) covering more than 14,000 implants across 23 studies.
What Can Go Wrong
Failure to integrate (an implant doesn't fuse with the bone). Peri-implantitis (gum disease around the implants). Mechanical bridge fracture (rare, usually from grinding). Nerve injury (rare, mitigated by CBCT planning).
How We Minimise Risk
CBCT 3D imaging before every case. Genuine brand fixtures with serial numbers. Hospital-grade sterilisation. Medical history screening (diabetes, smoking, bisphosphonate use are flagged). Surgical planning reviewed before any incision.
If an Implant Fails to Integrate
If an implant fails to integrate within 6 months of placement, we re-place it at no additional cost. The All-on-4 protocol's redundancy means a single failed implant rarely jeopardises the whole arch, though re-placement is still warranted.
Smoking & Implants
Smoking roughly doubles implant failure risk and significantly increases peri-implantitis. We require honest disclosure, it doesn't disqualify you, but it changes our protocol and aftercare advice. Stopping at least 2 weeks before surgery markedly improves outcomes.
Long-Term Maintenance
Daily brushing under the bridge with interdental brushes and water flossers. 6-month hygiene visits. Annual X-ray review. The bridge itself does not decay, but peri-implant tissue health requires consistent care.
Frequently Asked Questions
What is All-on-4?
All-on-4 places four titanium implants in one jaw, typically angled at the back to take maximum advantage of available bone, and uses them to support a complete fixed bridge of 12–14 teeth. The result is a full arch anchored permanently in the bone, not removable like a denture.
How much does All-on-4 cost in Vietnam?
The fee depends on the implant brand chosen (Osstem, Neodent, Nobel Biocare or Straumann), case complexity, whether bone grafting or sinus augmentation is needed, and your prosthetic option (acrylic bridge, titanium or BioHPP full-arch bar). After your free consultation we provide a written, itemised quote. For published rate cards, see the implant cost guide.
What is the difference between All-on-4 and All-on-6?
All-on-4 uses four implants per arch; All-on-6 uses six. All-on-6 distributes chewing load across more anchor points and is recommended where bone volume permits. Picasso offers All-on-6 with Osstem, Neodent, Nobel Biocare and Straumann. For itemised pricing, see the implant cost guide.
How long does All-on-4 treatment take?
From surgery to final fixed bridge typically takes around six months, surgical placement on day one (often with a provisional bridge fitted the same or next day), followed by an osseointegration period during which the implants fuse with the bone, then final bridge fitting.
Will I leave the clinic with teeth on the day of surgery?
In most cases, yes. Picasso fits a provisional fixed bridge on the day of surgery or the following day for immediate-load cases. The final, definitive bridge is fitted after osseointegration is complete.
Will I need bone grafting for All-on-4?
Often no. The All-on-4 protocol was specifically designed to use available bone by angling the rear implants, meaning many patients who would otherwise need extensive grafting can proceed without it. CBCT scanning on day one tells us definitively.
Which implant brand should I choose for All-on-4?
Osstem (Korea) and Neodent (Brazil, Straumann Group) are well-documented mid-tier options. Nobel Biocare and Straumann (both Switzerland) are the premium choice with the most internationally recognised long-term documentation. We recommend after seeing your CBCT and discussing your priorities.
Can I have All-on-4 as an international patient?
Yes, this is a common dental tourism procedure. Most international patients split treatment across two trips: surgery and provisional bridge on trip one, then final bridge on trip two after osseointegration. Some patients with longer availability complete both phases in a single extended stay in Vietnam.
Where is All-on-4 surgery performed?
At any of our six branches, including two hospital-based locations: Vinmec International Hospital Da Nang and Link General Hospital Da Lat. Hospital-based surgery is recommended for full-arch cases where on-site emergency medical support is preferred.
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Tell us what you need. Our implant team reviews every full-arch request and responds with a recommended brand, treatment plan and written, itemised quote, at no cost and with no obligation.