10 questions · orientation

All-on-4 Suitability Check

Are fixed teeth on four implants an option for you? A first assessment in two minutes.

Ten short questions about your situation and health. Afterwards you will see whether fixed teeth on implants following the All-on-4 concept are basically an option, what should be clarified first – or whether a different solution fits better.

What is your situation in the affected jaw?

Which jaw is affected?

What would you like?

Do you smoke?

Do you have diabetes?

Do you take, or have you taken, bisphosphonates or denosumab?

Medicines for osteoporosis or bone metastases, e.g. alendronate, zoledronate, Prolia® or Xgeva® – as tablets, infusion or injection.

Have you had radiotherapy to the head or neck?

For example as part of cancer treatment.

Do you take blood thinners?

For example aspirin, clopidogrel, warfarin/phenprocoumon or newer anticoagulants such as apixaban or rivaroxaban.

Do you have untreated gum inflammation or periodontitis?

Typical signs: bleeding gums, receding gums, loose teeth.

Have you been told that there is too little bone for implants?

For example at an earlier consultation.

I would like the treatment under twilight sedation or general anaesthesiaDoes not change suitability – we will show you matching information.

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Your assessment

Answer all questions to see your assessment here.

This check is a non-binding orientation aid, not a medical clearance or diagnosis.

Who is All-on-4 suitable for?

With the All-on-4 concept, a fixed bridge on four (or six) implants replaces the teeth of a whole jaw. The back implants are placed at an angle to make the best use of the existing bone – so bone grafting is often not needed. Good candidates are people who have no teeth in the upper or lower jaw and struggle with their denture, or whose remaining teeth are loosened by periodontitis or so badly damaged that they can no longer be saved.

We explain the concept in detail on the page Fixed teeth in one day.

What should be clarified first

Some factors do not rule out All-on-4, but increase the risk or change the process:

Smoking – implants are lost more often in smokers (systematic reviews covering more than 100,000 implants).
Diabetes – no exclusion if well controlled; with poor control, immediate loading should be considered critically according to the S3 guideline.
Bisphosphonates or denosumab – individual risk assessment because of possible jaw osteonecrosis (S3 guideline, 2026).
Head and neck radiotherapy – implants possible, but no prosthetic loading before three months (S3 guideline).
Blood thinners – the approach is coordinated with your GP or cardiologist.
Untreated periodontitis – treated before implant placement.

Why the check does not replace an examination

Whether All-on-4 is possible for you depends mainly on bone height and width, the position of the maxillary sinus and the mandibular nerve, and your general health. Only an examination with a three-dimensional X-ray (CBCT) shows this. The check helps you prepare for that conversation.

Frequently asked questions

Is All-on-4 possible with diabetes?

Yes, well-controlled diabetes is not an exclusion criterion. The German S3 guideline recommends knowing blood sugar control beforehand and considering immediate loading critically in poorly controlled diabetes.

Can smokers get All-on-4?

Smoking does not rule out implants, but it increases the risk of implant loss and infection. A break from smoking around surgery, or quitting, improves the chances.

Do I need bone grafting for All-on-4?

Often not, because the back implants are placed at an angle. With very severe bone loss, especially in the upper jaw, bone grafting or another solution may still be needed in individual cases.

Is All-on-4 possible while taking bisphosphonates?

That depends on the individual case: the underlying condition (e.g. osteoporosis or cancer), the drug, the dose and the duration. The S3 guideline requires an individual assessment of the risk of jaw osteonecrosis.

Do I have to stop blood thinners before surgery?

Not on your own. Whether and how the medication is adjusted is decided jointly by the dentist and your GP or cardiologist.

What happens after the check?

At a consultation we examine you, take a 3D X-ray and discuss whether All-on-4 or another solution suits you best.