All-on-4 in Istanbul: fixed teeth in 72 hours, not a denture.

All-on-4 is a way of replacing every tooth in one jaw with a single fixed bridge supported by four dental implants. Two implants are placed upright at the front of the jaw and two are tilted backwards at up to 45 degrees, so their tips sit in the dense bone in front of the sinus (upper jaw) or the nerve canal (lower jaw).⁴ The tilt spreads the four implants along the arch, which lets a 12-tooth bridge be supported without implants at the very back and, in most patients, without bone grafting.²

The concept was developed by Dr Paulo Maló with Nobel Biocare in the late 1990s and now has 10 to 18 years of published follow-up.¹ All-on-6 is the same idea with six implants, used when the bone allows it and the bite demands extra support.

Three parts, two trips

1. Implants. Four titanium screws, usually 10–18 mm long, placed under local anaesthetic or IV sedation through a printed surgical guide. Any remaining failing teeth are removed in the same appointment.
2. A fixed temporary bridge. Within 72 hours a reinforced acrylic bridge is screwed onto the implants. This is immediate loading: you eat soft food with fixed teeth while the bone heals around the implants for 3–4 months.
3. The final bridge. On your second trip a monolithic zirconia bridge, milled from one block of zirconia and fitted to a titanium bar, replaces the temporary. It is screw-retained, so your dentist can remove it for cleaning or repair.

Nothing covers your palate, nothing moves when you talk and chewing force returns to close to that of natural teeth. For implant brands, bone grafting and single-tooth gaps, see our dental implants guide.

Turkey is one of the most common destinations for All-on-4 because the same implants, the same lab materials and a specialist team cost roughly a third of UK private fees. The saving is real. So are the ways a low headline price can mislead you, and UK dental bodies have published advice on exactly this.⁵⁶

Six things to check in any All-on-4 quote

• Is the final bridge included, or only the temporary? Some clinics quote the surgery and acrylic temporary, then charge for the zirconia bridge on visit 2. Our €4,200 per arch covers both.
• Which implant brand, and can a dentist at home get parts? We place Straumann® and Nobel Biocare®, with Osstem® as the economy option. Any UK, Irish, German or Dutch dentist can order components for these.
• Was the quote based on a CT scan? Nobody can confirm All-on-4 from a photo. Bone height, sinus and nerve position decide whether 4 implants are enough, or whether you need 6 or a graft.
• Who does the surgery? An implantologist or oral surgeon named in your plan, not a general dentist you meet on the day.
• What does the guarantee say in writing? Ours: implants for life, bridges for 10 years, and remakes under warranty include flights and hotel.
• Is the price fixed? Ours is, once it is in writing. If the surgeon finds something unexpected on the day, you decide before any extra work happens.

The other worry we hear is 'Turkey teeth', the oversized, over-white smiles that circulated on social media. Those were mostly full crowns on healthy teeth. All-on-4 is a different treatment for a different problem, and the shape, size and shade of your bridge are designed to your face, with a try-in you approve on visit 2 before the final bridge is milled.

Your CT scan decides. All-on-4 is enough for most lower jaws and for upper jaws with reasonable bone density; All-on-6 is our recommendation when the scan or your bite shows the arch needs more support.³

We recommend All-on-6 when

• The upper jaw has soft bone. Upper bone is less dense than lower bone, so six implants share the chewing load across more bone.
• The arch is wide or long. If you want first molars in the bridge, six implants reduce the unsupported overhang at the back.
• You grind or clench. Bruxism can put 2–3 times normal force on a bridge. More implants and a night guard protect it.
• You want a safety margin. If one of six implants fails, the bridge usually stays in place while it is replaced. If one of four fails, it often cannot.

We stay with All-on-4 when

• The lower jaw has dense bone, which it usually does.
• Two more implants would need a sinus lift, and you would rather avoid a graft and a third trip.
• Your bite and bone do not justify the extra cost.

Sometimes the surgeon finds room for a fifth implant on the day. Where bone allows, an extra implant is €550, and we ask you before placing it. For bone grafts and sinus lifts, see the dental implants guide.

Expect 3–7 days of swelling, a soft diet for 8–12 weeks and a full return to normal eating once the final bridge is fitted. This is the timeline we give every patient.

• Days 1–3. Swelling peaks around day 2 or 3. Ice packs 20 minutes on, 20 off. Ibuprofen and paracetamol for 3–5 days; most patients describe the jaw as bruised rather than painful.
• Weeks 1–2. Stitches dissolve or are removed by a partner dentist at home. Soft foods only: soups, scrambled eggs, fish, pasta, yoghurt.
• Weeks 2–12. Bone grows onto the implant surface. This is when the implants are most vulnerable, so keep to soft food, avoid chewing at the very back of the bridge and do not smoke.
• Speech. Most people lisp slightly for 1–3 weeks while the tongue learns the new shape of the bridge. Reading aloud speeds it up.
• Months 3–4. A video review confirms the implants have healed and your second trip is booked.

Cleaning under the bridge

Food collects under a full-arch bridge. Clean it twice a day with a soft brush and a water flosser along the gum line, and once a day with superfloss threaded under the bridge. See a hygienist every 6–12 months, and once a year your dentist unscrews the bridge, cleans it and checks every implant. We send your records to your own dentist or to a partner dentist in the UK, Germany or the Netherlands.

All-on-4 has an implant survival of around 93–98% at 10 years and a bridge survival above 99% in long-term studies, but complications do happen.¹² These are the ones that matter, and what we do when they occur.

• Implant failure (about 2–6% of implants over 10 years). Most failures happen in the first 3 months, before the bone has bonded. Smoking, uncontrolled diabetes and overloading the temporary bridge raise the risk. A failed implant is replaced free under the lifetime guarantee, including flights and hotel. During healing the temporary bridge is adapted to the remaining implants; in rare cases you wear a denture for 2–3 months while the new implant heals.
• Chipped temporary teeth. Acrylic temporaries chip in roughly 1 in 10 patients, usually from biting something hard. A partner dentist repairs them in minutes.
• Chipping of the final bridge. Monolithic zirconia resists chipping far better than layered porcelain, but heavy grinding can still chip it. Chips are polished or repaired; a fractured bridge is remade under the 10-year warranty.
• Peri-implantitis. Gum infection around an implant, driven by plaque. Daily cleaning under the bridge and a yearly professional clean keep the rate low; caught early it is treated with cleaning and antibiotics.
• Nerve or sinus involvement. Rare with guided surgery, because the CT scan maps the nerve canal and sinus floor before the first cut. Temporary numbness of the lip or chin usually settles within weeks.
• Bite adjustments and loose screws. One or two bite adjustments are normal and built into your visits. Bridge screws can loosen after years of chewing; your dentist tightens them at a routine visit.

Aftercare when you are back home

Message your coordinator on WhatsApp with a photo or video; a reply comes within about 10 minutes in opening hours and a video review with your dentist is booked within 48 hours. Minor problems, such as a chipped acrylic tooth or a loose screw, are fixed by a partner dentist near you and we cover the cost. Anything bigger is handled in Istanbul under warranty, with flights and hotel included.

Is it safe to have All-on-4 in Turkey?

Yes, at a licensed clinic where a named implantologist plans the surgery on a CT scan and uses implant brands your home dentist can service.⁶ Denture is licensed and audited by the Turkish Ministry of Health and ISO 9001:2015 certified, and the implant batch numbers are printed on your warranty certificate.

The implants are designed to last for life, and studies with 10 to 18 years of follow-up show that most do.¹ The bridge on top is a wear part. An acrylic bridge typically lasts 5–8 years before the teeth wear down, which is why we fit monolithic zirconia as the final bridge. Zirconia full-arch bridges are expected to last 10–15 years or more, and ours carry a 10-year written warranty.

Three things decide how long yours lasts: hygiene, because plaque under the bridge is the main cause of implant loss after the first year; grinding, so wear the night guard we make for you; and check-ups, a hygienist every 6 months and a bridge removal and clean once a year.

When the bridge eventually needs replacing, the implants stay. A new bridge is made from a scan, without more surgery.