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.
All-on-4 Dental Implants in 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.
Is All-on-4 Right for Me?
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Which sounds most like you?
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.
“
My smile held me back. That’s behind me now.Melanie · Full-Arch Implant Patient
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
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
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.
Replaces teeth only
- Natural crown-and-bridge look
- No added pink, no extra bulk
- Typically on more natural gum architecture
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
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
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. Ask at your consultation
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.
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 our Alexandria office, 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 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
The Process
What Are the Steps for All-on-4?
01Come 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 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.
02Surgical 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.
03Come 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.
04Placement 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
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 Results From Our Patients
BeforeAfter
BeforeAfterCost & 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 Our Alexandria Patients Say
The Office
Take a Look Inside Our Alexandria Office
Other Options
If All-on-4 Is Not the Right Fit
01
Full-Mouth Dental Implants
Both arches rebuilt together, on four to eight implants per arch.
Explore02
Implant-Supported Dentures
A removable denture that clips onto implants, at a moderate cost.
Explore03
Dental Implants
One implant for one missing tooth, or a bridge for several.
Explore04
Failed Dental Implants
An arch from another office giving way? The second opinion is free.
ExploreQuestions
All-on-4 in Alexandria: Questions We Hear
What does All-on-4 cost in Alexandria?
Your price is set after the scan, once it is clear whether one or both arches need restoring and whether any grafting comes first. We accept most PPO plans and file claims for you, and financing through Proceed Finance reaches $60,000 over terms of up to 96 months.Cost and financing →
What if I have bone loss?
Bone loss is often why All-on-4 is chosen: tilting the rear implants reaches bone that straight ones would miss. Some mouths still need grafting first, and the scan shows which.
How long until the final teeth?
About three to four months after surgery, and then the gum takes another two to four months to settle around the zirconia arch.
Which number should Alexandria patients call?
New patients can call us at (571) 617-7245; current patients can reach us at (571) 712-8958.
Who places the implants?
Dr. Esam Abou Nahlah, a board-certified prosthodontist, plans and places them, with our team beside him.Meet Dr. Nahlah →
New Teeth. New Smile. New Beginning.
New patients, call (571) 617-7245 today and speak with one of our dental professionals about All-on-4 implant surgery.
Alexandria
Dr. Nahlah Implants and Prosthodontics Specialists2855 Duke Street
Alexandria, VA 22314
New patients(571) 617-7245
Current patients(571) 712-8958
DirectionsBook Online