All On Four Dental Implants vs. Saving your teeth: Which to chose?

Some of my patients ask themselves if they should repair their teeth or perhaps remove them and replace them with implants with an all-on-four (Nobel) or pro arch solution (Straumann).

In this post, I would like to address what one must take into consideration before making this decision.




In this picture we can see finished case of a full arch on implant. Notice that the gum and the teeth are made in porcelain and make for a very uniform smile.




There are four main things to keep in mind when choosing between full arch dental implants and saving your teeth:

The first is the long-term prognosis of your existing teeth. If most of your teeth can be repaired in a way that will last for many years to come, then keeping your teeth is the ideal treatment. Yes, replacing all teeth with zirconia on four or five implants is a good treatment, but not necessarily better than your initial teeth. Teeth that mother nature gave us have some advantages that implants don't, such as us such as proprioception, and better protection against gum disease. Proprioception allows the body to feel pressure on teeth and determine if too much force has been placed on them and gum disease results in tooth or implant loss. Also, natural teeth are individual and so if one has an issue it can be replaced. With a full arch on implant solution, if one implant fails, then the whole treatment becomes problematic.


The second consideration is aesthetics. Can we realistically achieve your desired smile with your existing dentition? Modern dentistry came a long way and we can give patients the smile they want. However, sometimes there are limitations especially when the gum is lost and black spaces appear in between teeth (black triangles). In that situation, a full arch on implant solution could yield more aesthetic results because both teeth and gum are recreated in aesthetic porcelain over strong zirconia.



The third conideration is cost. Sometimes repairing a heavily damaged mouth costs more than a full arch solution due to the amount of work required to repair the gum, roots and teeth. I advise my patients for big decisions like this to consider what's best for them but cost plays a role.


Forth consideration is time. Redoing a smile and repairing very damaged teeth can take a lot of appointments versus a full arch that is accomplished in one main appointment and a couple of appointments 4-6 months later to change the temporary prosthesis for a permanent one.

Keeping your good teeth and replacing only those missing with implants is most of the time the best treatment solution but in cases where teeth are very compromised and the patient wants a great aesthetic result a full arch on implants is the preferred treatment.


I hope this article helped you understand further the difference between these treatments and what to expect. As always, if you have any questions please reach out to us. We are here to help!

Dr. Dan Munteanu, DMD


3 views0 comments