All-on-4 Cases in New York City
I'm Dr. Nina Izhaky. Every All-on-4 case starts as a situation, not a procedure: a mouth full of failing teeth, a denture that never fit right, bone loss another office said ruled implants out. At 54 Warren Street, our team has planned and restored full-arch implant cases in-house since 2007. This page walks through the case types we evaluate, how each one is planned, and how a 3D evaluation tells you whether yours qualifies.
What an All-on-4 case actually is
Four implants, one fixed full arch — planned around your anatomy, not a template.
A fixed arch, not a denture.
All-on-4 supports a complete fixed bridge on four strategically placed implants. Nothing comes out at night, no adhesives, and no palate coverage on the upper arch.
Angled back implants use the bone you have.
The two posterior implants are angled to engage available bone — which is why many bone-loss cases qualify without grafting, and why some still need grafting or zygomatic implants. The 3D scan decides.
Planned digitally before surgery day.
CBCT imaging maps your bone, nerves, and sinus position, so implant angle, depth, and the design of your bridge are decided before surgery — not during it.
Teeth during healing, in qualifying cases.
When implant stability allows, a fixed provisional bridge is attached on surgery day — the Teeth in One Day approach — so you heal with teeth in place.
The case types we evaluate
Four situations account for most full-arch cases. Yours may combine more than one.
The failing-teeth case.
Most or all teeth in an arch are broken down, heavily restored, or failing from advanced decay or gum disease. The evaluation maps which teeth — if any — are worth keeping, and plans extractions and implant placement as one coordinated case instead of years of patchwork repairs.
The denture-wearer case.
You wear a removable denture — or have been told one is your only option — and want fixed teeth instead. We evaluate the bone under the denture, the bite space, and lip support to design a fixed bridge that stays in place day and night.
The bone-loss case.
Bone shrinks after teeth are lost, and some patients have been told implants are impossible. Angled posterior implants, bone grafting, a sinus lift, or zygomatic implants each solve a different anatomy. Your CBCT scan shows which combination your case needs.
The full-mouth case — both arches.
Upper arch, lower arch, or both together. Full-mouth cases are planned as one bite: both arches designed to meet correctly, staged or combined based on your health, schedule, and healing. It is the case type that benefits most from a single team planning the whole mouth.
How a case is evaluated and planned
No two cases get the same plan. Here is the sequence every case follows.
Records and 3D evaluation.
Consultation, a CBCT scan, and an exam of bone anatomy, gum health, bite and prosthetic space, and medical history. You get an honest candidacy answer and an exact price before anything is scheduled.
The digital plan.
Implant positions and angles are planned on your 3D anatomy, along with any bone grafting or sinus lift the case requires — and the design of your provisional and final bridges.
Surgery day.
Remaining failing teeth are removed if needed, the implants are placed as planned, and — in qualifying cases — your fixed provisional bridge is attached the same day. Full anesthesia with an anesthesiologist is available for larger cases.
Healing and the final bridge.
Over the following months, bone integrates with the implants while you function with your provisional bridge. Then your definitive bridge is refined for fit, bite, cleansability, and esthetics.
“If the tooth is no longer there and the bone is good, the replacement process is actually very uneventful — very little recovery at all. What we hear from our patients is how unremarkable the procedure was. They're surprised, and we're thankful for their appreciation.”
— Dr. Nina Izhaky
When All-on-4 is not the answer
A real evaluation sometimes lands elsewhere: a case may be better served by grafting first, by zygomatic implants, or by keeping teeth that are still healthy. If All-on-4 is not right for your anatomy, I will tell you at the evaluation — and show you the scan that says why.
Hablamos español
We warmly welcome Spanish-speaking patients. Nuestro equipo le explica su tipo de caso y su precio exacto en su idioma — llámenos al (212) 561-5303. No facturamos directamente al seguro; le ayudamos con el financiamiento.
All-on-4 case questions, answered
01Who is an All-on-4 case?
Typically someone missing most or all teeth in an arch, someone whose remaining teeth are failing, or a denture wearer who wants fixed teeth. Candidacy depends on oral health, bone anatomy, medical history, hygiene, and restorative goals — and is confirmed at a 3D evaluation.
02I've been told I don't have enough bone. Can I still be a case?
Often, yes. The angled posterior implants in All-on-4 use the bone you have, and bone grafting, a sinus lift, or zygomatic implants solve other anatomies. Your CBCT scan shows exactly what your case needs — being told 'no' elsewhere is a reason to get a 3D evaluation, not the final word.
03Do I have to do both arches at once?
No. A case can be a single upper arch, a single lower arch, or both. Full-mouth cases are planned as one bite, and the arches can be staged or combined depending on your health, schedule, and healing.
04Will I have teeth while I heal?
In qualifying cases, a fixed provisional bridge is attached on surgery day — the same approach as our Teeth in One Day treatment — so you heal with teeth in place. After the bone integrates, the provisional is replaced by your final bridge.
05What happens at the evaluation?
A consultation and CBCT 3D imaging, plus an exam of your bone, gums, bite, and medical history. You leave with a candidacy answer, a plan for your case type, and an exact price — before anything is scheduled.
06How is an All-on-4 case different from dentures?
The bridge is fixed to four implants and does not come out at night. There are no adhesives and no palate coverage on the upper arch — and the case is planned, placed, and restored by our team in one office.
07How much does an All-on-4 case cost?
It depends on the case type — one arch or both, grafting needs, and the final bridge design. You'll get an exact number at your evaluation, plus financing options. We don't bill insurance directly; we help with financing. Call (212) 561-5303.
08Where are you located?
54 Warren Street, New York, NY 10007, in the heart of Tribeca — welcoming patients from across New York City.
All-on-4 cases in New York City
Find us at 54 Warren Street, New York, NY 10007 — in the heart of Tribeca, welcoming patients from across New York City.
Find out what your case qualifies for
A 3D evaluation, an honest candidacy answer, and an exact price. Call (212) 561-5303 or book online.
