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- Dr. Atila C. Miranda, DDS -

- Dr. Don M. Preble, DMD -

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All-on-Four Dental Implants

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The health and overall appearance of your teeth can begin to decline with time, leading to pain, missing teeth, and other issues impacting how you feel about your smile. Missing teeth are embarrassing and cause you to try to hide your smile in photos and social situations. Advancements in dental implant technology has led to comfortable, affordable dental implants that can improve the look of your smile without a difficult recovery or painful surgery.

First developed in the 1990s, the All-on-Four dental implant treatment replaces failing teeth or existing dentures with beautiful dental implants. The All-on-Four dental treatment avoids bone grafting and multiple surgeries, painlessly improving your smile in one session. Dr. Miranda has extensive experience with the procedure and has performed many All-on-Four dental implant procedures.


Dental implants are intended for men and women who struggle with serious dental issues. If you’ve been considering All-on-Four dental implants, you’ve come to the right place. Dr. Miranda and the team at Altamonte Implant & Cosmetic Dentistry will help you resolve serious dental problems, including:

  • Missing all or some of the teeth on your top jaw, bottom jaw, or both
  • Embarrassment or lowered self-esteem due to missing or unhealthy teeth
  • Pain or other medical conditions as a result of declining oral health
  • Avoiding pictures or other situations where a smile is appropriate
  • You have dentures, and are tired of the daily routine

Candidates for All-on-Four implants should also be seeking a permanent, natural-looking solution for their teeth or an alternative to dentures or other treatments.

"Knowledge and expertise is evident in Dr. Don Preble's artistic approach to dental implants. He totally personalizes to each individual and creates a 'look' to be proud of. His staff is supportive and creates a caring environment which complements the total experience." - J.B.

The All-on-Four Dental Implant Procedure

To prepare for the procedure, any failing teeth will be removed to make room for the implant. Your mouth and teeth will also be thoroughly cleaned. You’ll be given an anesthetic during the procedure so the procedure is painless and comfortable. The implants are custom-made pieces that include natural-looking teeth and gums that blend perfectly with any natural remaining teeth. Then the implants will be placed in position and secured using four screws, as opposed to a screw on each tooth as is the case with other implants.

The All-on-Four procedure employs four dental implants that attach to the top arch, bottom arch, or both arches of your mouth. Implants used in All-on-Four procedures are uniquely designed to function immediately, without the need for bone grafting surgeries. Unlike ordinary dentures that simply sit on the top of your gums secured by adhesives, our All-on-Four dental implants are secured to the jaw bone within the gum. This makes them a strong, natural looking, and reliable permanent teeth replacement.

Once your implants are in place, your incisions will be sutured and you will rest for a brief time before returning home. Dr. Miranda will review aftercare with you and offer help and suggestions so you have a speedy, painless recovery.

All-on-Four Implants Look and Feel Exactly Like Normal Teeth

Many people who've had denture surgery are left with a "sunken look" caused by loss of bone in the jaw. All-on-Four implants preserve bone by replacing some of the teeth's roots, providing vital support to help preserve facial structure. When the implants are put into place, bone growth around the implant is spurred in a body process called "osseointegration." Osseointegration will not only keep All-on-Four implants secure, but also help to fill out the section of the jaw that may have appeared "sunken" without the support of the bone. This gives All-on-Four smiles the security of a surgical dental implant and the cost-effectiveness of traditional dentures.

Osseointegration takes a few weeks, so a temporary set of dentures is needed until your implants are fully integrated into your natural jawbone structure. When the All-on-Four implants are firmly secured, permanent dentures will be set in place. Dr. Miranda and his team of dental specialists will be with you at every step.

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Advantages of All-on-Four Dental Implants

All-on-Four dental implants help patients to avoid many of the annoying daily issues of removable dentures bring. Long-term denture wearers know that dentures rub and chafe the gums over time, often leading to painful sores and irritation. Dentures that slip or move around can also make speaking or eating uncomfortable, or even embarrassing. All-on-Four implants are just like natural teeth -- the only care involved is brushing and flossing. Here a few more advantages to All-on-Four dental implants:

All-on-Four implants can restore your smile and confidence in a one-day procedure.

All-on-Four implants are only secured in four places instead of each individual tooth.

All-on-Four implants stabilize jaw bone loss.

All-on-Four implants will eventually fuse with the jawbone, making them a more permanent solution than dentures.

All-on-Four implants look like real teeth.

All-on-Four implants fill in the area where a tooth’s root would go, helping you avoid a sunken look in your gums.

All-on-Four implants give you the confidence of knowing you can eat or talk without dentures slipping or clicking.

All-on-Four implants do not require bone graft surgery.

All-on-Four are proven to have successful, long-term results.

Get a Beautiful New Smile in One Day

The All-on-Four dental implant delivers amazing results in a short time, with minimal discomfort. The procedure itself is minimally invasive and relatively quick, providing natural-looking results in only one visit. Replacement teeth and the structural support given by dental implants are so durable you can go home the same day of your procedure with a new set of teeth. Most of Dr. Miranda's patients report only minor soreness the day after the implant.


Recovery after All-on-Four procedure is relatively short. The procedure is minimally invasive, with surface incisions healing quickly. The implants are placed directly onto the bone and secured, leading to less recovery time than other forms of implants that may need months to integrate with the natural bone.

You may need to adopt a light diet of soft foods while your implants settle into place. Strenuous exercise or other activities should be avoided to keep your teeth from moving or shifting during the healing process. Most people will need a couple days off work to recover from the procedure, and soon you will experience an alleviation of any discomfort. Your new teeth will appear straighter and fill in any gaps you had from missing teeth. The implants can be cleaned and maintained the same as your other teeth, and you’ll be able to enjoy your attractive new smile for many years to come.

All-on-Four Dental Implants

With postcard-worthy sunshine and no dreary snow or ice, our patients have plenty to smile about. Let Dr. Miranda and his dedicated dental staff help you gain the confidence and sense of wellbeing that strong, healthy teeth bring. As a board certified prosthodontist, Dr. Miranda is a highly respected dental specialist. For years, he's provided his patients with expert care, making significant difference in the quality of life of people throughout central Florida. Call our office to schedule your appointment today.

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"I am a big chicken when it comes to going to the Dentist. Dr. Miranda and staff allay my fears in every way possible. I will never be a fan of going due to my childhood dentist, but if you are scared, this is the place to go! Also, I receive excellent care and my teeth look amazing!" - T.A.

Frequently Asked Questions about All-On-Four Implants:

How Are All-on-4 Dental Implants Different from Traditional Implants?

The basic concept for All-on-4 Dental implants and traditional implants is the same:

  • - Small titanium posts are embedded into the upper or lower jaw.
  • - The bone grows back around them, so they become the “roots” for the replacement teeth that will be fitted onto them.

The differences can be substantial, however:

  • - All-on-4 are so named because only four implants are needed for even an entire bridge of new upper or lower teeth; whereas six to eight implants are needed to support an entire bridge when traditional implants are used.
  • - Because of the number of posts required for traditional implants, bone grafting may be needed to ensure the bone in the jaw(s) is strong enough and that there is enough of it to accommodate all of them.
  • - Sinus augmentation may also be needed for traditional implants. This is a surgical procedure in which bone is added between the jaw and the sinuses (spaces) on either side of nose.

Because only four posts are need for All-on-4s, as well as where they are placed in the jaw, All-on-4 implants never require either bone grafting or sinus augmentation. This greatly reduces not only the pain and expense but the time, from start to finish, of the entire implant procedure, since the addition of the bone requires additional healing time.

How Long Is the All-on-4 Dental Implant Surgery?

The surgery itself takes about 2½ hours. The initial visit typically takes about three hours. This includes the surgery and the actions needed to create and place the temporary bridge.

Will I Get My Permanent Set of Teeth the Day My Implants Are Placed?

As with any surgery, healing will take some time. Though you will be monitored, it can take up to six months for the jaw to heal and the bone to grow around the posts securely. Immediately after the surgery, there will be some swelling and, over the course of the healing period, there will undoubtedly be changes in the shape of the gum line. Your temporary teeth will be adhered well enough to the posts, so these changes will not be an issue in chewing or speaking or the way your smile looks, but your permanent teeth should be fitted to the final shape and size of your mouth.

Do You Always Use Four Implants?

Four implants are needed to an entire arch (replacing all the teeth on top or replacing all the teeth on the bottom). If you do not need to replace all the teeth on the top or the bottom, you will not necessarily need four implants. Dr. Miranda will determine the optimal treatment program for your needs and discuss the particulars with you.

How Much Do All-on-Four Dental Implants Cost?

The cost of All-on-Four Dental Implants is approximately $10,000 to $25,000, per arch. One of the variables that affects the cost is the number of teeth there will be in both the temporary and the permanent bridges.

Why Don’t All Dentists Use the All-on-4 Procedure?

Dental implant surgery is a highly specialized field. While any general dentist can take a few additional courses and call himself or herself a “cosmetic dentist,” becoming a dental implant specialist or a prosthodontist requires three to four additional years of rigorous study in an American Dental Association-approved program. There are 170,000 general dentists in the US and only 3200 prosthodontists. Additionally, besides the ADA-approved program, there are specific courses for the All-on-4 procedure, which not all practitioners are willing to commit to—as has Dr. Miranda.

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