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All-On-4® Implants

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If you have a history of poor dental health or have many missing or damaged teeth, you may be a good candidate for All-on-4® dental implants. This restorative treatment replaces the existing teeth with a fixed denture attached to a set of dental implants.

Dental implants are a fundamental part of our practice, where we replace single teeth, multiple teeth, and full dental arches. Our board-certified oral and maxillofacial surgeons provide high-quality treatment and care to people in who want durable, natural-looking dental restoration.

Our surgeons recommend the All-on-4 treatment concept to patients who want:

A more comfortable and secure alternative to traditional dentures.

A natural-looking smile and to enjoy greater confidence in everyday social settings.

A fully functional bite and the ability to get back to eating the types of food you may have given up because you couldn’t chew properly.

As specialists in dental implants, our board-certified oral & maxillofacial surgeons’ combined experience lends itself to predictable and durable outcomes with the All-on-4 treatment concept. They leverage their training and years in practice to create a natural appearance, promote long-term oral health, and improve daily comfort.

Why Choose The All-On-4 Technique?

One of the most common questions we hear from dental implant patients is why they would benefit from the All-on-4 technique instead of more conventional dental implants.

The major benefit of All-on-4 is that it allows for complete dental restoration using only four to six implants, strategically placed throughout the mouth. Because only four to six implants are needed, the surgical procedure tends to be comparatively simple and straightforward, while the recovery process may be somewhat abbreviated.

We typically emphasize the All-on-4 technique for patients in the DC Metro who are missing all of their teeth on the upper arch, lower arch, or on both the top and bottom arches. All-on-4 makes it easy for these patients to get an entirely new set of healthy teeth that look and behave just like normal.

By contrast, patients who are only missing one or two teeth may not benefit from All-on-4. For patients whose tooth loss is less extensive, one or two implants may be all that is required.

Our oral surgeons have ample experience assessing patients and helping them determine the type of implant technique that is right for them. If you have any questions about whether or not All-on-4 is right for you, our surgeons will be more than happy to clear things up during your consultation.

An Overview Of All-On-4 With Our Practice

Your Consultation

During your initial visit to our office, the surgeons will perform a thorough examination to determine if All-on-4® dental implants are right for you. They will also use state-of-the-art 3-D CT scans to evaluate the supporting bone structure that will anchor the dental implants. This step helps determine if you will require bone grafting as part of your procedure.

Once our surgeons understand your needs, they will confer with your restorative dentist and a lab technician to develop a treatment plan. They will then review the treatment plan with you and answer any questions that you may have. You will also have the opportunity to speak with a financial coordinator so that you can have complete transparency into the costs associated with All-on-4 dental implants.

Supporting Treatments For All-On-4

Depending on the patient, there may be additional treatments required to ensure a successful All-on-4 procedure. For example, patients with any untreated, periodontal disease will need to receive treatment before they can have their implants placed. The best way to determine any supporting treatments that you require is to schedule your consultation with one of our oral surgeons.


Before dental implants can be placed, any unhealthy teeth may need to be pulled. While the goal of dentistry is always to preserve naturally growing teeth, this is not always possible. Significant damage, decay, or dental neglect may make some teeth unsalvageable. Our surgeons can remove them to prepare the mouth for the All-on-4 surgery.

Bone Grafting

Patients who lose teeth may also lose bone tissue. The result is that they may not have sufficient jawbone to receive implants. In these situations, bone grafting may be required. This process involves bone tissue being transplanted to the jaw, protecting from further bone loss.

Bone grafting is important for the dental implant process because the implants need to be securely anchored in place. Generally, the best place to anchor them is in an area of the jaw known as the alveolar ridge. If this part of the jaw has inadequate bone tissue, it will not be able to support dental implants.

During the bone graft procedure, the surgeon will take a small section of bone from elsewhere on your body and graft it onto the jaw. This stimulates the growth of new bone tissue. In other words, this procedure actually helps your body build new bone mass where it is needed in order for you to get dental implants.

Traditional Dental Implants

Some patients may prefer traditional dental implants instead of All-on-4. This is especially true for those who only need to have a couple of teeth replaced, as opposed to an entire arch. No matter your needs and expectations, our oral surgeons can help you determine the implant surgery options that are right for you.

What Costs Are Involved In Getting All-On-4

One of the most common questions we get regarding All-on-4 implants is how much the procedure costs. Patients naturally want to know how much they should budget for this treatment. The specific cost can vary depending on patient need, including the specific number of dental prostheses required. The best way to get an individualized quote is to contact our practice in McLean to schedule a consultation.

Our oral surgeons will build a treatment plan that addresses all of your dental implant needs and helps restore your smile, alleviate pain, and promote robust oral health. This treatment plan will include the type of implants that are right for you and any supporting treatments you need to ensure your implant surgery is successful. In other words, our patients get more than just a set of implants. They also benefit from our surgeons’ skill and experience, who will custom tailor the treatment options for each patient.

The total cost of All-on-4 dental implants may encompass the implants and prostheses themselves, as well as the costs associated with sedation. Also, note that, in some cases, you may need to have supporting treatments, such as bone grafting or tooth extraction. Naturally, these extra procedures can increase the total cost of getting All-on-4 dental implants.

What To Expect With Your Treatment

The All-on-4® treatment concept is a multi-step procedure that occurs during a single appointment based on the plan that our surgeons, the restorative dentist, and the lab technician jointly develop. Our surgeons provide treatment using IV sedation so that their patients can be comfortable and relaxed throughout their care. Typically, the process takes 3-4 hours instead of the typical 30-45 minutes that a standard dental implant procedure takes.

In step one, the surgeon will extract any remaining teeth, perform bone grafting in areas of need, and place four or more dental implants in the dental arch. Establishing these dental implants in strategic locations will give the final restoration greater strength and stability.

In step two, the lab technician and restorative dentist will work together to adjust a temporary denture and attach it to the newly placed implants. The temporary denture will replace your missing and damaged teeth with an aesthetically appealing prosthetic.

Your Aftercare Experience

After treatment with All-on-4® dental implants, our staff will guide you to a private recovery room. We will help keep you comfortable and safe as you reach a normal level of alertness. Then, we will review post-operative care instructions and schedule your follow-up appointments.

While the temporary denture will look like a natural set of teeth, our oral surgeons advise their patients not to chew on these teeth for 3-4 months. After this period, you will return to the practice for a check-up. Once our surgeons see that your implants are well-integrated with your jaw bone, they will refer you to your dentist, who will produce and attach your final prosthetic. Once the process is complete, you should be able to enjoy a natural-looking smile, greater comfort when chewing, and better long-term oral health.

Common Questions Patients Ask About All-

Yes, our practice works with patients to make the procedure as affordable as possible. You can speak with our financial coordinator to discuss options such as CareCredit® or monthly payments.

We understand that our patients want the benefits of treatment as soon as possible. Our surgeons use a variety of techniques to improve healing time. Typically, patients can expect treatment to take 3-4 months. Those who require extensive bone grafting may need additional time to ensure a strong foundation for their implants.

No, there is limited discomfort following the treatment. Many of our patients only take over-the-counter pain medicine the next morning and don’t continue with medication afterward.

There are many reasons why patients should choose All-on-4 implants over dentures. For one, implants help to preserve the jawbone, preventing deterioration that could change the facial profile. Dentures don’t stimulate the jawbone, and as a result, they can begin to become loose and slip over time as the jaw loses density. All-on-4 implants won’t become loose because they are securely implanted in the jaw, meaning they allow patients to eat and speak just like they did with normal teeth. Finally, dental implants can be cared for just like normal teeth, whereas dentures must be removed for cleaning.

Yes, the results of All-on-4 implants look, feel, and function just like natural teeth. Our surgeons will perform a thorough examination of the patient’s mouth during the initial consultation at his office so that he can create replacement teeth that perfectly fit the jaw and match with the patient’s other teeth. If the patient no longer has any teeth, he may also consult old photographs to get a better idea of what the teeth used to look like. The result is a smile that mimics the appearance of the old teeth as closely as possible to ensure they look natural.

Patients can use the All-on-4 system to replace both their upper and lower arches of teeth. Our surgeons will simply place four to six implants in the bottom jaw and four to six implants in the top jaw to create a brand-new smile for their patients. Best of all, both sets of implants can be inserted at the same time, reducing the recovery time for the patient and eliminating the need for multiple procedures. Patients who decide to have this done will just need to keep in mind that they won’t be able to chew for three to four months.

For this type of procedure, our surgeons recommend IV sedation for all patients. With IV sedation, patients will receive a sedative medication directly into their bloodstream that renders them unconscious for the duration of the procedure. They won’t feel any pain or remember the surgery at all. This method works better than oral sedative medications, as these must first be digested by the body and can have varied results between patients, leading to unpredictability. With IV sedation, it’s easier for our surgeons to deliver the exact dose needed depending on the patient’s weight, height, and metabolism.

All-on-4® treatment can be an ideal solution for patients who are dissatisfied with dentures or who have been living with multiple missing or damaged teeth. Learn more about treatment by calling or filling out a form to schedule an appointment at Virginia Advanced Surgical Arts.

Meet Doctor

Craig Vigliante, MD, DMD

Dr. Vigliante became interested in oral surgery after having double jaw surgery for his open bite. Since then, he’s dedicated himself to showing his patients the highest level of care possible. He’s certified by the American Board of Oral and Maxillofacial Surgeons and holds medical and dental licenses in Virginia. 

What Our Patients Say


“I felt welcomed and valued from the second I walked in the door to the moment I left. Every person I interacted with- from the front desk staff, to the surgical assistants, and even the doctor himself- was kind, informative, and helpful. I had my wisdom teeth removed on Friday and was back to work with only a mild and easily manageable headache on Monday. They gave clear instructions on how to prevent infection and dry socket, and even called to check up on me the day of and week after my procedure! I strongly recommend this office to anyone who is searching for the services they offer.

Jacquelyn Candito


“Everyone was super nice, friendly, and courteous. The office is clean and modern. Everyone was professional and seemed pretty organized. I got to watch Netflix laying down while I waited as well. The staff was nice enough to even switch it to a show I recommended!! Also, there are snacks and drinks available for your drivers waiting on you. As someone who is wary of going to the dentist, it was a great experience and I’d recommend this place! Cute valentines day decorations when I was there too!”

Amy Vu

Experienced Oral Surgeons Serving the DC Metro Area


Dr. Vigliante, Dr. Gocke and Dr. McAdams are board-certified oral and maxillofacial surgeons thoroughly qualified to perform complex restorative surgical procedures, no matter the circumstance, for patients in Northern Virginia and Maryland. Their experience and training have given them an unmatched skill set balanced between art and science. You can be confident in choosing Virginia Advanced Surgical Arts for your oral surgery needs.