Permanent fixed dentures after an All-on-4

Permanent fixed dentures after on all-on-4

Are you having trouble determining the total cost of an All-On-4?

Do you have any doubts that you are being cheated or that something is being hidden from you regarding the prices of this procedure, because once started, you cannot go back?

Thousands of people like you have these concerns and if you don’t increase your knowledge about it, then you may end up paying double the price.

Fortunately, as I am not a dentist, but a person who creates a website for dentists in Colombia, I absolutely have to give the exact time transparently to the people who read and contact me.

And no matter, whether or not you choose Colombia with prices 50 to 75% cheaper, it is essential to understand the factor often « voluntarily forgotten » by dentists about permanent fixed dentures which could double the final price of All-On-4.


Dishonest tactics to extract more money

When dentists talk to a patient about an All-On-4, therefore a complete restoration of an arch, they devote a lot of time and attention to planning surgical aspects like extraction, dental implants, bone grafts, sinus elevation and the temporary acrylic prosthesis which will be put on immediately after these treatments.

Most of the dentist’s work is almost finished, but it remains to select the permanent fixed dental prosthesis which will be put in place after the healing period (between 3 to 6 months).

Obviously, many dentists speak very little about it so as not to draw the patient’s attention too much to this aspect, because you see, this permanent fixed prosthesis often costs double the initial treatments. In my view, this is willful dishonesty based on the fear of losing money if they clearly explain to patients that a temporary prosthesis will have to be replaced by a permanent one later.

Therefore, the permanent fixed prosthesis can have a huge impact on the patient in terms of cost and convenience.

In this article, I focus on the types of permanent fixed dentures for an All-On-4 that are available as well as the pros and cons of each.


Here is a price list for permanent fixed prostheses on an All-On-4


Colombia (including airfare for the second tript) 4500 $ us
Canada 15000 $ us
UK 18000 $ us
USA 20000 $ us


Permanent fixed prostheses Canada UK USA Colombia
Acrylic and resin 4000 $ us 4500 $ us 5000 $ us Included
Metal/Porcelain 6000 $ us 7000 $ us 7500 $ us 3500 $ us
Zirconia 9000 $ us 9500 $ us 10000 $ us 4500 $ us


1. The permanent fixed prosthesis in acrylic and resin

A permanent fixed prosthesis (also known as a hybrid prosthesis) is a screw-on treatment option that has been used for many years. A metal frame is made, then a pink acrylic base and the teeth (in resin or Duratone) are placed on this frame.


Permanent fixed hybrid prostheses


The pros: This option is popular due to the low cost associated with manufacturing the prosthesis. In addition, the repair cost is minimal, since they are easily made with resin, which is added to the defects or areas to be repaired at the dentist. Therefore, the patient keeps his prosthesis all the time, as it does not need to be sent to the laboratory for repair.

The cons: The use of this prosthesis presents distinct disadvantages. Acrylic and resin wear out faster than porcelain or natural teeth. Consequently, if the prosthesis comes into contact with natural or porcelain dentition, the prosthesis will wear out more quickly, which will lead to the flattening of the incisal edges and cusps of the teeth. This will significantly reduce the effectiveness of chewing and compromise aesthetics. Ultimately, the vertical dimension of the patient’s occlusion will decrease if left untreated over a period of time.


2. The fixed complete prosthesis in metal and porcelain

This processing option uses a metal structure as the foundation and inserts individual porcelain crowns into the foundation. Individual crowns are produced and glued to the structure by the laboratory. Thus, the final restoration is delivered to the patient in a single unit.


permanent fixed prosthesis in metal/porcelain


The pros: The different crowns are cemented and give this prosthesis a more natural appearance without requiring the implants to be in precise positions. It is important to note that the use of porcelain has a significantly better aesthetic in terms of translucency and greater lift than acrylic in order to maintain the vertical dimension of the occlusion.

The cons: With this type of prosthesis, the risk of fracture is increased, because the porcelain can chip and can crack, and the costs of repairs are high. However, since crowns are made and glued individually to the structure, the risk and cost of repair are greatly reduced, since a crown can be replaced.


3. The complete fixed zirconia prosthesis

With this prosthesis, the force is maximized, because the entire restoration is made of a single material, zirconia. A full-contour zirconia restoration is milled from a solid block of zirconia. The zirconia is then colored to resemble enamel and gum tissue to optimize the aesthetic.


Permanent fixed prosthesis in zirconia


The pros: This material is extremely resistant and durable, with minimal wear and no risk of chipping or greyish line.

The cons: Unfortunately, zirconia is very expensive and its translucency reduces the aesthetics of the prosthesis. In addition, there are cases where there may be a catastrophic fracture of the foundation which could break the prosthesis in half. If this were to happen, the entire prosthesis had to be removed and redone, which is not ideal for the dentist or the patient in terms of cost and time.


4. The fixed complete prosthesis with PFM bridges

Another option to restore a full arch with a fixed prosthesis is to use traditional metal / porcelain (PFM) bridges with implants as abutments.
Permanent fixed prosthesis with bridge
The pros: This is a fairly simple procedure for dentists, as it mimics the dental crown and bridge procedures in patients with teeth and is therefore familiar. With natural spaces in the midline and elsewhere in the arch, the aesthetics appear more natural. In addition, in the event of a porcelain fracture, the affected bridge can be replaced quite easily without affecting the entire arch.

The cons: In this option, a minimum of two implants must be placed in very precise positions for each bridge of three to four units, unlike the four implants which can be used for complete prostheses of the arch for the All-on- 4. As such, the costs will be higher. Implant placement may also require additional bone grafting. In addition, the establishment of several bridges in PFM can be difficult, since many contacts must be adjusted, which can make it difficult to achieve a perfect fit of the prostheses.


Prices for dental crowns

For a 14-tooth arch, the price of a bridge depends on the price of a crown per unit. Thus, for 14 crowns of an arch, in Colombia the price is 3,850 US $ and for Canada the price is 15,400 US $.


Colombia 275 $ us
Canada  1100 $ us
UK 1200 $ us
USA 1200 $ us



All the above prostheses, with the exception of PFM bridges, have a particular advantage, they are designed as a single unit for the strength and stability of the implants, as well as for restoration. However, in the event of a fracture of the foundation or structure, it will have to be removed and possibly transformed, which will produce a major inconvenience for the patient and high costs.

It is also necessary to take into account your dentition opposite to the prosthesis when choosing materials for the final restoration. Zirconia may appear to be ideal for minimum strength and wear, however, if opposed to an acrylic prosthesis, this can result in increased wear of the acrylic prosthesis.

Most importantly, the choice of prosthetic material could increase the jaw weight and therefore require more implants. Thus, an All-On-4 could become an All-On-6.