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What to Expect During and After All-on-4 Surgery

2026-08-056 min|Dr. Reza Tafreshi, DDS
What to Expect During and After All-on-4 Surgery

Deciding to restore your smile with an All-on-4 full-arch treatment is a significant step toward improving your oral health and confidence. It is completely normal to have questions about the surgery and what recovery feels like. Knowing what to expect during the clinical procedure and the recovery stages can help you feel much more prepared.

The Surgical Visit: Step-by-Step

An All-on-4 procedure typically takes 2 to 3 hours per arch. We prioritize your comfort and offer options ranging from local anesthetics to IV sedation:

  1. Numbing and Sedation: We apply local anesthetics to ensure you do not feel any discomfort. If you choose IV sedation, a certified provider will monitor you while you rest comfortably.
  2. Site Preparation: Any remaining teeth that are damaged or failing are carefully removed, and the sockets are thoroughly cleaned.
  3. Ridge Nivelation: We gently smooth the bone ridge to ensure a healthy base for your new implants and keep the bridge line hidden when you smile.
  4. Placing the Implants: We place four titanium implants. The front two are placed straight, while the back two are placed at a 45-degree angle. Angling the back implants helps us secure them in areas with more natural bone density.
  5. Securing the Temporary Bridge: We take a digital scan of your implants. Our in-house lab immediately mills a temporary acrylic bridge, which we screw onto the implants so you can go home with a functional smile the same day.

Milestones in Your Recovery

Everyone heals at their own pace, but most patients follow a predictable recovery path:

  • Days 1-3 (Managing Swelling): Swelling is normal and usually peaks on the second or third day. Applying ice packs and taking standard over-the-counter discomfort relievers as directed helps manage this phase. You will want to stick to soft foods.
  • Week 2 (Healing Check): We check your healing progress and remove any sutures if they are not the self-dissolving type. By this time, your swelling will have mostly cleared.
  • Months 1-3 (Osseointegration): During this time, the implants are actively fusing with your jawbone. You will need to maintain a softer diet (nothing harder than pasta or soft fish) to avoid putting too much force on the healing implants.
  • Month 4 (Your Final Smile): We verify that the implants have fully bonded with your bone, take a digital scan, and create your permanent, durable zirconia bridge in our lab.

Scientific References & Studies

  1. Malo P, de Araujo Nobre M, Lopes A, Moss SM, Molina GJ. (2011). 'All-on-4' immediate-function concept for completely edentulous maxillae: a clinical report on 242 patients with 5-year follow-up. Clin Implant Dent Relat Res, 13(2):73-85.[PubMed PMID: 21323812]

Schedule a Diagnostic CBCT 3D Scan

Our Aliso Viejo clinic is fully equipped with 3D guided surgical planning, an in-house lab, and sedation options. Checkups are 100% free.

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