All-on-4: Fixed teeth.
In one day.
Treatment: 1 day
Sedation or general anaesthesia
Statutory subsidy possible
In-house master laboratory
10–15+ years lifespan
Imagine waking up tomorrow and still having removable dentures – but by this evening you leave our practice with a fixed, firmly anchored dental prosthesis that feels like your own teeth.
All-on-4 makes this possible. Four precisely placed implants are enough to give an entire jaw a permanent, fixed restoration on the very same day. No multiple surgeries spread over months. No bone grafting in most cases. One day. One journey home – with fixed teeth.
At z-aesthetic in Mülheim an der Ruhr, every All-on-4 procedure begins and ends in our own in-house master laboratory. Your dental technician is present throughout the entire treatment – not working in some anonymous external lab, but in the same building as your surgeon. That is the decisive difference.
What is All-on-4?
All-on-4 (also written All-on-Four) is a full-arch implant restoration technique in which four titanium implants are placed in the jawbone to support a complete fixed prosthesis. The two posterior implants are angled up to 45 degrees, which allows them to engage the available bone without requiring a sinus lift or extensive bone grafting. Because the implants are distributed strategically across the arch, the prosthesis is immediately loaded the same day – meaning you leave with teeth that are already fixed. All-on-4 is distinct from conventional single-tooth implants, where each missing tooth receives its own implant. With All-on-4, four implants replace an entire jaw of up to twelve to fourteen teeth simultaneously.
Advantages of All-on-4 at a glance
- ✦Fixed teeth already on the day of surgery – no weeks of waiting with a temporary solution
- ✦No bone grafting required in the vast majority of cases, even with existing bone loss
- ✦Only 4 implants for a complete dental arch (upper or lower jaw)
- ✦No palate coverage – full taste sensation and natural speech preserved
- ✦Natural chewing feel – bite hard food, eat normally
- ✦10 to 15 years or more lifespan with correct maintenance
- ✦Premium implant systems (Straumann, Nobel Biocare) – same brands used in leading UK clinics
- ✦In-house master lab crafts the prosthesis on the same day
Your All-on-4 day at z-aesthetic
Morning: 3D precision diagnostics (DVT)
Your day begins with a high-resolution 3D scan (digital volume tomography). Dr. Fuchs-Grote analyses bone volume, bone density and nerve pathways to plan the exact angle and depth of each implant with submillimetre precision. Your dental technician is already present, reviewing the scan alongside your surgeon.
Surgical phase: implant placement
Under local anaesthesia – or general anaesthesia if preferred – the four implants are placed. The angled positioning of the posterior implants allows maximum contact with available bone without the need for bone grafts. The procedure typically takes two to three hours.
Same day: in-house laboratory fabrication
While you rest in our practice, your dental technician begins crafting the provisional fixed prosthesis in our in-house master laboratory on the same floor. There is no courier, no external lab, no overnight wait. Your prosthesis is produced metres away from the treatment room.
Afternoon/Evening: fitting and fine-tuning
The provisional prosthesis is fitted, adjusted for bite and aesthetics, and securely attached to your four implants. You receive detailed care instructions and a direct contact for any questions.
Follow-up: final ceramic restoration
After an integration period of approximately three to six months, the final high-quality ceramic prosthesis is placed. This is also crafted in our own master laboratory – with the same dental technician who accompanied your treatment from day one.
The in-house laboratory advantage
In most dental clinics, the laboratory work happens elsewhere – sometimes in a different city. At z-aesthetic, your dental technician is in the same building as your surgeon, from the first scan to the final ceramic fitting.
This proximity matters enormously for All-on-4. The provisional prosthesis must be ready on the same day. Bite registration, aesthetics and phonetics need to be adjusted in real time. With an in-house master laboratory, your technician can walk into the treatment room, observe the fit directly, and return to the bench to make immediate corrections. No telephone call to an outside lab. No next-day adjustment appointment.
The same technician who crafts your provisional bridge on day one will also produce the final ceramic restoration months later – with full knowledge of your individual anatomy, your bite, and your aesthetic wishes.
Anxious about surgery? We understand.
The prospect of a surgical procedure – even a well-planned one – can feel overwhelming. At z-aesthetic, we offer general anaesthesia as a full option for All-on-4, not only as a last resort. Many of our patients choose this route not because they could not manage with sedation, but because it allows them to experience the procedure in complete comfort, without any sensory memory of the surgical phase.
Our anaesthesiologist works alongside our surgical team. You arrive, fall asleep, and wake up with fixed teeth. The team monitors you throughout and you remain in the practice until you are fully recovered before going home.
If you prefer to remain awake, conscious sedation with midazolam and nitrous oxide is also available. You are deeply relaxed and unconcerned, while remaining able to respond if needed.
Please tell us about any anxieties during your consultation. There is no judgement – only solutions.
Are you a candidate? – Checklist
- ◎You are fully edentulous (all teeth missing in one or both arches)
- ◎You are facing imminent tooth loss and considering your long-term options
- ◎You currently wear a removable denture and find it uncomfortable, loose or socially limiting
- ◎You have been told you have insufficient bone for standard implants
- ◎You want to avoid a bone grafting procedure
- ◎You are generally in good health (controlled diabetes, well-managed systemic conditions are not absolute contraindications)
- ◎You do not smoke heavily – or are willing to quit, as smoking significantly impairs implant osseointegration
Costs and financing
All-on-4 at z-aesthetic typically ranges from approximately €15,000 to €28,000 per jaw, depending on the implant system, the material used for the final prosthesis, and the complexity of the individual case. Both arches (upper and lower) combined are correspondingly higher.
A comparable All-on-4 procedure at a private dental clinic in the United Kingdom typically costs between £18,000 and £32,000 per arch. Patients travelling from the UK, UAE, or other countries often find that the cost difference – combined with premium implant systems (Straumann, Nobel Biocare) and our in-house master laboratory – makes the journey significantly worthwhile.
Statutory health insurance (GKV) contributes a fixed subsidy (Festzuschuss) towards implant-retained full prostheses in cases of complete edentulism. The exact amount depends on your bonus booklet history. Private dental insurance often reimburses a substantial portion – we are happy to advise on documentation for your insurer.
Interest-free instalment plans are available for qualified patients. Treatment can also be planned in phases to distribute costs over time.
A detailed written cost plan is always provided free of charge following your initial diagnostic appointment – before any commitment is made.
Travelling to Mülheim for All-on-4
z-aesthetic is located in Mülheim an der Ruhr, 20 minutes by car from Düsseldorf International Airport (DUS). Düsseldorf is served by direct flights from London Heathrow, Gatwick, Stansted, Manchester, Edinburgh, Birmingham, and many UK regional airports. Dubai (DXB) is served by direct Emirates and Lufthansa flights to Düsseldorf. The clinic is also directly accessible by S-Bahn from Düsseldorf city centre (approx. 25 minutes). We are happy to recommend nearby hotels for patients travelling from abroad.
Reviewed by
Dr. Karolina Efrem
Implantology & Oral Surgery · z-aesthetic
z-aesthetic · Prinzeß-Luise-Straße 195a · 45479 Mülheim an der Ruhr
+49 208 69888869 · Mo–Do 08:00–20:00, Fr 08:00–16:00
You were told no – or not yet?
Some patients come to us having been told by another practice that they do not have sufficient bone for implants, or that a lengthy bone grafting procedure is necessary first. In many of these cases, the angled implant technique used in All-on-4 makes it possible to work with existing bone without grafting. We offer a free, no-obligation second opinion consultation with full 3D diagnostics. Bring your existing X-rays or scans – or we will take new ones here.
Kein Druck. Kein Commitment. Nur kennenlernen.
Questions about All-on-4
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