Yolanda holding a framed photograph of her smile before treatment
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All-on-4 Dental Implants in McLean & Alexandria, VA

Your Path to a Brand-New Smile.

An entire upper or lower arch on four titanium posts. Most patients walk out of surgery with fixed provisional teeth already in place.

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Is All-on-4 Right for Me?

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Which sounds most like you?

Most teeth in one jaw failing or missingA denture that slips, rubs or needs adhesiveBoth jaws need new teethOne or two missing teeth
Why All-on-4

What All-on-4 Gives You

All-on-4 rebuilds a whole upper or lower arch on four titanium implants. Here is what that changes for you, from implant day to the final zirconia teeth Dr. Nahlah fits months later.

4 postsPer arch, upper or lower
Same dayPMMA provisional teeth
3–4 moTo the zirconia final
FP1 firstPlanned as thin as the bone allows
“
My smile held me back. That’s behind me now.
Melanie · Full-Arch Implant Patient

Teeth on Implant Day

In most cases you leave surgery wearing a fixed provisional arch, so there is no night without teeth while the implants fuse.

Four Implants per Arch

A whole arch rests on four titanium posts instead of one implant for every missing tooth. Upper, lower or both jaws can be done.

Works With Bone Loss

The two rear implants are angled into denser bone, which often avoids grafting. Bone loss is frequently the reason All-on-4 is chosen.

Teeth That Stay Put

The arch is screwed down and stays in at night. No plate rubbing on your gums, and no adhesive to hold it.

Care Like Natural Teeth

You brush and floss the arch like natural teeth and keep a cleaning every six months. The zirconia final resists decay, fractures and chips.

Supports Your Jawbone

Implants load the jawbone, which a denture resting on the gums cannot do, and help support your jaw and facial structure.

All-on-4 vs. Dentures

How All-on-4 Compares

Three ways to replace a full arch, side by side: a fixed arch on four implants, a removable denture, and an implant for every missing tooth.

CompareAll-on-4Removable DentureOne Implant per Tooth
What holds the teethScrewed onto four implantsRests on the gumsOne implant under each tooth
At nightStays inComes outStays in
MovementFixed in placeCan slip, rub or need adhesiveFixed in place
The jawboneImplants keep it loadedDoes nothing to stop it recedingEach implant keeps it loaded
Bone lossRear implants angled into denser bone, often avoiding graftingThe bone keeps receding, so the fit loosensEach post needs bone at its site, or grafting first
Daily careBrushed and flossed like natural teethTaken out to cleanBrushed and flossed like natural teeth
CostLess than an implant for every toothThe least on day oneThe most for a whole arch
A restored full arch
Am I a Candidate?

Who Is a Good Candidate for All-on-4?

All-on-4 replaces a whole arch, so it suits people losing most or all of the teeth in one jaw, or living with a denture they want gone. Bone loss is often the reason it is chosen rather than a reason against it.

  • Most teeth in one jaw missing, failing or loose
  • A denture that slips, rubs or needs adhesive
  • Bone loss at the back of the jaw, which the angled implants avoid
  • Teeth that cannot be saved: where the case allows, they come out the day the implants go in

Both arches: full-mouth implants

Arch Types

What Are FP1, FP2 and FP3 All-on-4 Teeth?

Two practices can both quote you “All-on-4” and hand back very different teeth. What separates the three types is how much is teeth and how much is pink acrylic standing in for gum and bone. We plan the arch as thin as the case will carry.

FP1

Replaces teeth only

  • Natural crown-and-bridge look
  • No added pink, no extra bulk
  • Typically on more natural gum architecture
FP2

Longer teeth, minimal pink

  • Longer teeth, minimal pink acrylic
  • The pink that is added still follows the natural gum contour
  • Rarely indicated, and often not ideal
FP3

Replaces teeth, gums and bone

  • Thick pink acrylic stands in for gum and bone
  • Thicker, stronger prosthesis
  • Typically best where there is bone loss, and a lower hygiene risk
FP1, FP2 and FP3 full-arch prostheses side by side
The same arch, three ways. The pink is the difference.

A thin arch is not always possible. Where bone loss is advanced, FP3 is both the honest answer and the stronger one, and it is easier to keep clean. What is worth asking of anyone quoting you is which of the three they are planning, and why. Thin-Arch FP1, Explained

How It Works

How All-on-4 Dental Implants Work

All-on-4 implants work in a similar manner to single dental implants, but rather than a single tooth, they replace a full (upper and/or lower) arch of teeth! With over 20 years of experience in implant surgery, Dr. Esam Abou Nahlah possesses the intricate skill and technique necessary to engineer a natural-looking arch of teeth for patients who need All-on-4 implants.

Four implants carrying a full arch
4 postsPer arch
A clinician showing a patient their X-ray beside an implant model
GuidedPlanned on the scan
Smile before All-on-4 treatment, with missing, broken and stained upper and lower teeth
Where it starts
The same smile after All-on-4 treatment, with full upper and lower arches of even, natural-looking teeth
One day later

Implant surgery involves permanent fixation of titanium posts into the jawbone, and this requires adequate dental health to ensure the most effective results. Wondering if Dr. Nahlah’s All-on-4 implants are a practical option for you and your dental needs? Get in touch with our office today to schedule a detailed consultation and oral examination! Contact Us

Why Choose Us

Why Patients Choose Dr. Nahlah for All-on-4

Two offices can both quote All-on-4 and deliver very different arches. These are the questions worth asking, and how our practice answers them.

What to askOur practiceOther offices
Who plans your archDr. Nahlah, a board-certified prosthodontist, plans the surgery and the final arch himselfSome split the work between a surgeon, a dentist and an outside lab
Arch typePlanned as thin as the bone allows, FP1 first, with no thick pink acrylic where it can be avoidedSome use one thick FP3 prosthesis for every case
PlacementEvery implant goes through a computer-generated surgical guide built from your scanSome place implants freehand and judge by eye
Where the arch is madeA digital lab in both offices, so shade and fit are corrected while you waitSome send the work out and wait weeks for it
Failed archesComplex and failed full-arch cases accepted, including work other practices declineSome accept straightforward cases only
SedationNitrous oxide or oral sedation, given by the practice's own teamAsk which options are offered, and who gives them
WarrantyFive years on the full arch, kept with a cleaning every six monthsAsk what yours covers, in writing
Dr. Esam Abou Nahlah in black scrubs with his arm around a smiling patient in the office hallway
Dr. Esam Abou NahlahD.D.S., M.S.
Meet the Doctor

Meet Dr. Esam Abou Nahlah

As an award-winning board-certified specialist in prosthodontic dentistry, Dr. Nahlah provides patients with a premier level of dental care using the industry’s most advanced technology. He has been practicing since 2003, in Northern Virginia since 2013, entirely on prosthodontics. Diplomate of the American Board of Prosthodontics and Fellow of the American College of Prosthodontists. In 2013, the American Board of Prosthodontics awarded Dr. Nahlah the most prestigious award in prosthodontics: “Diplomate of American Board of Prosthodontics.”

Adjunct faculty at Virginia Commonwealth University, teaching the residents in its Prosthodontics Postgraduate Program, and lecturing on smile design and implants.

Across that career, over 18,000 implants placed and over 15,000 arches restored.

Credentials & Certifications

  • Diplomate, American Board of Prosthodontics
  • Fellow, American College of Prosthodontists
  • Adjunct Faculty, VCU Prosthodontics Postgraduate Program
  • Certificate in Prosthodontics
  • M.S., Master of Science in Oral Biology
  • Fellow, International Congress of Oral Implantologists
  • Associate Fellow, American Academy of Implant Dentistry
Meet Dr. Nahlah
The Process

What Are the Steps for All-on-4?

The bench and stereo microscope in the practice's in-house laboratory01

Come in for a Personalized Consultation

The first step of All-on-4 dental implant full mouth restoration is to schedule an appointment to meet with Dr. Nahlah. During your initial consultation, he will conduct a full mouth oral examination (including any necessary imaging scans) in order to determine the state of your current oral health. In order for the fixed permanent implants to adequately fuse with the jawbone, a patient needs enough healthy bone. Where bone has been lost, All-on-4 is often still possible, and some cases need grafting first. During your initial consultation, Dr. Nahlah will perform an extensive 3D scan of your mouth using a Cone-beam CT scanner. This will allow Dr. Nahlah and his team to adequately determine if All-on-4 implants are a practical option for you. Together we’ll discuss the best option for you and if you’d like, you can see before and after case studies from real patients including how their treatment truly changed their lives. Dental implant pricing, insurance coverage, and financing options will also be discussed. If dental implants are best for you, our McLean and Alexandria implant dentist completes precise surgical planning to ensure each implant placed is in the exact angle, depth, and location for optimal, lasting success, and ideal aesthetics.

A patient resting with her eyes closed in the chair under sedation02

Surgical Placement of Your All-on-4 Implants

The second step of All-on-4 implants is Transformation Day, when the four titanium posts are placed into the jawbone. In most instances, surgery is a single visit process wherein you will leave the office with your polymethyl methacrylate (PMMA) provisional prosthesis. In order to make your surgery experience as seamless and pain-free as possible, Dr. Nahlah offers a full range of sedation options, including nitrous oxide and oral sedation. Dr. Nahlah also uses advanced, state-of-the-art surgical computer guide benefits in order to deliver All-on-4 implants with an unparalleled level of precision and accuracy. This results in a look, feel and functionality that is nearly identical to that of your natural teeth.

A patient reviewing her CBCT scan and an implant model with a clinician03

Come in for Your Follow-up Appointments

From the time of initial surgery (when the titanium posts are inserted into the jaw), roughly three to four months of healing are required until the final prosthesis can be placed.

Lab model of an implant-supported denture clipped onto implant posts, mounted on an articulator04

Placement of the Final Prosthesis

The fourth and final step of your All-on-4 implant surgery is placement of the final zirconia prosthesis (your new permanent artificial teeth). After you receive your new teeth, an additional two- to four-month period is usually required in order to achieve complete healing.

4Implants per arch
1 visitSurgical placement
0Nights without teeth, in most cases
6 moPrecare cleanings, for warranty
Gloved technician handling a finished full-arch dental prosthesis on a firing tray in a dental lab
Recovery

What Is Recovery Like After All-on-4?

For three to four months most patients wear a fixed provisional arch in PMMA while the implants fuse. It looks and works like teeth, but it is a stage, not the result.

  • Soft foods while the implants integrate
  • Reviews along the way to check integration
  • Adjustments to the provisional as the gum settles
  • Back to normal activity within about a week
  • Minor discomfort, handled with over-the-counter medication

Then the zirconia arch is fitted, and two to four more months finish the healing around it. From that point it is brushed and flossed like natural teeth, with a cleaning every six months.

Before & After

Real Patient Results

Single arch means one jaw was restored; double means both.

Both arches failing before treatmentBoth arches restored on implantsBeforeAfter
Double arch · upper and lower on implants
Before: failing upper and lower dentitionA completed double-arch implant restorationBeforeAfter
Double arch · fixed zirconia prosthesis
Before: failing upper archAn upper arch restored on four implantsBeforeAfter
Single arch · upper restored on four implants

See the full gallery

Cost & Financing

Your Price in Writing, Before Anything Starts.

Your price depends on whether one or both arches are restored, whether grafting is needed and the material of the final arch, so you get it in writing after the scan.

Up to $60,000Through Proceed Finance, over terms of up to 96 months, subject to lender approval.
Three LendersCareCredit, Proceed Finance and LendingClub.
Most PPO PlansWe file claims with your dental insurance on your behalf.
Free Second OpinionOn implant surgery. Bring the plan and any imaging.
What Decides the CostFinancing Options

What Our Patients Say

Other Options

If All-on-4 Is Not the Right Fit

Also hereSame-Day Dental ImplantsDenturesSedation DentistryImplant CostFinancingFive-Year Warranty
Questions

All-on-4 Questions

Will I leave surgery without teeth?
No. In most cases you leave the same visit wearing a fixed PMMA provisional prosthesis, which stays in place while the implants integrate.
Can All-on-4 do both jaws?
Yes: upper, lower, or both. Cases are described as single arch or double arch for exactly that reason.
What if I have bone loss?
All-on-4 is often the answer because of bone loss: the rear implants are angled to reach denser bone. Some cases still need grafting first, which the cone-beam scan determines at the consultation.
What sedation is available?
Nitrous oxide and oral sedation, both given by our own team. After oral sedation you need someone to drive you both ways. Sedation options →
How long until it is finished?
Three to four months from surgery to the final zirconia prosthesis, then a further two to four months for complete healing around it.
Is All-on-6 better than All-on-4?
Not by default. A fixed arch can be carried on four to eight implants, and the number is chosen from your cone-beam scan rather than from a package name. With four, the rear implants are angled into denser bone, which often avoids grafting.Full-mouth dental implants →
What are same-day teeth?
The fixed provisional arch fitted on implant day, which carries you until the zirconia final three to four months later.Same-day implants →
Where can I get All-on-4 in McLean?
At the Tysons Corner office: Suite 220, 7901 Jones Branch Drive.All-on-4 in McLean →
Where can I get All-on-4 in Alexandria?
At 2855 Duke Street, Alexandria.All-on-4 in Alexandria →
Can a failed All-on-4 be redone?
Often. We accept complex and failed full-arch cases, including work other practices decline. A scan of both jaws shows whether the posts, the bone or the bridge gave way, and the new arch is planned from it.Failed dental implants →
Book a Consultation

Book Online, or Ask Us First

A consultation includes the 3D scan and a straight answer about what your case needs, before you commit to anything.