All-on-4 Dental Implants — Full Guide for Canadian Patients

Robert from Toronto needed his upper arch replaced — quoted $72,000 locally. All-on-4 uses four implants per arch (two straight, two tilted) for a fixed same-day bridge. Published long-term success is strong; at Stunning Dentistry you get Straumann/Nobel systems with CAD $10,000–$14,000 typical for both arches vs CAD $50,000–$70,000+ in Canada.

How All-on-4 Works

The protocol was developed by Professor Paulo Maló in Lisbon and commercialised by Nobel Biocare. Its key innovation: tilting the posterior implants at 30–45° angles to maximise contact with available bone while avoiding critical anatomy.

Two straight anterior implants + two tilted (30–45°) posterior implants per arch
Tilting avoids the maxillary sinuses (upper jaw) and mental foramen (lower jaw)
Eliminates or minimises the need for bone grafting
Allows immediate loading — you leave surgery with a fixed provisional prosthesis the same day

Clinical Evidence Base

All-on-4 has the largest published evidence base of any full-arch implant protocol — spanning 30+ years of clinical data.

18-year implant survival rate: 98.2% (Maló et al., 2019)
Patient satisfaction: >95% at 5 years (Babbush et al., 2011)
Marginal bone loss: <0.6mm at 5 years (Taruna et al., 2014)
Immediate loading success: >97% across published meta-analyses

Cost — Canada vs Stunning Dentistry

The cost difference is significant — even after accounting for flights, accommodation and travel expenses, Canadian patients typically save CAD $33,000–$63,000.

Component	Canada (CAD)	Stunning Dentistry (CAD)
All-on-4 (one arch)	$25,000–$35,000	$5,500–$8,000
All-on-4 (both arches)	$50,000–$70,000	$10,000–$14,000
Bone grafting (if needed)	$700–$7,000 additional	Included
Provisional prosthesis	Included	Included (same-day)
Definitive zirconia prosthesis	Included or $3,000–$5,000 extra	Included
Remote follow-up (1 year)	$500–$1,500	Included

The Procedure at Stunning Dentistry

Your entire All-on-4 treatment is completed in a single 7–10 day trip to New Delhi.

Day 1: Comprehensive exam + 3D CBCT scan + digital intraoral scan (3Shape TRIOS) + Digital Smile Design consultation + treatment plan confirmed with CAD pricing
Day 2 (Surgery): Local anaesthesia + IV sedation (optional GA) → extractions (if needed) → 4 implants per arch placed → immediate impression → provisional fixed prosthesis fabricated in-house and delivered same day
Days 3–7: Post-operative review at 48 hours, occlusal adjustments, diet progression (liquids → soft foods → semi-solid), impression for definitive prosthesis
Days 8–10: Final adjustments, travel clearance, depart for home

All-on-4 vs All-on-6 — Key Differences

Both protocols deliver excellent long-term outcomes. Dr. Sethi recommends the optimal protocol based on your specific anatomy, bone quality, and opposing dentition.

Feature	All-on-4	All-on-6
Implants per arch	4	6
Cost (per arch at SD)	$5,500–$8,000	$6,500–$9,000
Bone requirement	Less (tilted posteriors bypass atrophy)	Slightly more
Cantilever length	Longer	Shorter (biomechanical advantage)
Force distribution	Concentrated on 4 points	Distributed across 6 points
Best for	Most edentulous patients	Larger arches, opposing natural teeth
Evidence base	Largest (30+ years)	Growing (15+ years)

Frequently Asked Questions

How long do All-on-4 implants last?

Published research shows 98.2% implant survival at 18 years. With proper care and regular reviews, All-on-4 implants are designed to last a lifetime. Stunning Dentistry provides a lifetime warranty on all implant components.

Is All-on-4 painful?

Surgery is performed under local anaesthesia with optional IV sedation or general anaesthesia. Most patients report mild to moderate discomfort for 2–3 days post-surgery, managed with standard pain medication. By day 5–7, most patients feel comfortable eating soft foods.

Can I get All-on-4 if I have bone loss?

Yes — that is one of All-on-4's key advantages. The tilted posterior implants maximise bone contact while avoiding areas of atrophy. For severe bone loss, zygomatic or pterygoid implants can be combined with the protocol.

How much does All-on-4 cost in Canada vs India?

Both arches in Canada: CAD $50,000–$70,000. At Stunning Dentistry: CAD $10,000–$14,000 all-inclusive. Including flights and hotel, total from Canada is typically CAD $11,200–$16,600 — saving CAD $33,000–$63,000.

Do you use the same implant brands as Canadian clinics?

Yes. We use Straumann (Swiss) and Nobel Biocare (Swedish) — the same premium brands used by top Canadian clinics. All implants come with manufacturer warranty and full traceability documentation.