All-on-4 dental implants for $15,000 per arch, all-inclusive — including the final zirconia bridge. Performed by a board-certified oral surgeon. Three appointments. Permanent zirconia in 12 weeks. The full clinical picture, with no marketing shortcuts.
Surgery, IV sedation, same-day provisional, prototype try-in, final zirconia bridge — all in one transparent price.
Developed in 1998 by Dr. Paulo Maló in Lisbon, the All-on-4 protocol is the most-studied and most-validated full-arch implant approach in modern dentistry.
Four implants per arch. Two angled posteriorly. One fixed prosthesis that doesn't come out at night. The protocol that made full-arch implant therapy accessible without bone grafting for the great majority of patients.
The "permanent teeth in 24 hours" claim has become a marketing centerpiece for some chains. The honest comparison reveals a meaningful clinical tradeoff.
The tradeoff: Speed at the cost of refinement time. The bite, esthetics, and phonetics are determined in a 24-hour window, before bone has integrated. Adjustments to the permanent prosthesis are mechanical-only (you can't easily reshape a finished zirconia bridge).
The tradeoff: A few additional weeks for the chance to perfect the design before committing it to permanent zirconia. Bone integration occurs before final loading, which the implantology literature consistently associates with better long-term outcomes.
Both approaches result in a permanent zirconia prosthesis. Both can produce excellent outcomes for the right patient. The honest difference is what you optimize for.
The 24-hour approach optimizes for speed and convenience. For patients with significant travel constraints, a single concentrated visit can be valuable. The clinical tradeoff is that the final prosthesis design is locked in before bone integration completes and before the patient has had time to live with their new teeth and identify what they'd want to refine.
The three-visit approach optimizes for prosthesis quality and long-term patient satisfaction. The week-eight prototype try-in gives you several weeks to test-drive the design — to identify where a slight adjustment to the bite, the tooth shape, or the gum line would improve the outcome — before any of those decisions are committed to permanent zirconia. Final loading happens after osseointegration, consistent with the foundational implant research from Brånemark forward.
Neither approach is wrong. We use the three-visit approach because it produces what we believe are better outcomes for most patients. Patients who specifically value the 24-hour timeline above all other factors may prefer a chain that offers it.
Pricing data drawn from competitor public marketing, third-party industry reports, and patient-reported outcomes. Updated April 2026.
Comparison reflects published price ranges and operating models as of April 2026. Individual practice pricing varies by case complexity. Pricing for ClearChoice based on published $14K-$36K range and third-party patient-reported data. Pricing for Nuvia based on published industry reports — Nuvia does not publish specific pricing on their website. The above does not constitute a medical or financial endorsement or critique of any practice.
All-on-4 has been studied longitudinally for over two decades. The numbers below come from the most-cited Maló Clinic studies, published in JADA and Clinical Implant Dentistry and Related Research.
The longest-running All-on-4 outcome studies follow patients up to 18 years post-treatment. Implant survival — meaning the implants remain integrated and functional — sits in the low-90s percent range across these studies. Prosthesis survival is even higher, because the protocol's redundancy means a single implant loss rarely means losing the prosthesis itself.
These outcomes are comparable to or better than the survival rates of natural teeth that have undergone extensive restorative or endodontic treatment — including teeth with crowns, multi-surface restorations, or root canal therapy.
The All-on-4 protocol is not experimental. It is a clinically validated approach with the longest published outcomes data of any modern full-arch implant protocol.
References: ¹ Maló P, de Araújo Nobre M, Lopes A, et al. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. JADA, 2011. ² Maló P, de Araújo Nobre M, Lopes A, et al. The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up. Clin Implant Dent Relat Res, 2019; 21(4):565-577.
The Full-Arch pillar page covers candidacy, protocols, materials, risks, and alternatives in depth — including the All-on-4, All-on-6, and zygomatic protocols compared side by side.
Both protocols result in a permanent zirconia prosthesis. The difference is when the final prosthesis is delivered — and what that timing optimizes for.
Nuvia mills the zirconia bridge in their in-house lab within 24 hours of surgery and seats it the next day. The protocol optimizes for speed and a single concentrated visit, which is genuinely valuable for patients with significant travel constraints.
Elite's protocol places a same-day printed PMMA provisional, then has the patient return at week 8 for a printed prototype try-in — at which point we refine the bite, esthetic, phonetic, and gumline characteristics based on how the patient has lived with the provisional. Final zirconia is delivered at weeks 10-12, after osseointegration is well underway and the design has been confirmed.
The clinical question is whether the additional refinement window improves outcomes. We believe — based on the foundational implant literature on delayed loading and the practical reality that patients often refine their preferences after living with the provisional — that it does for most patients. Reasonable specialists can disagree on this.
Three structural differences. Surgeon assignment: ClearChoice partners with surgeons at each location. The surgeon you meet at consultation may not be the surgeon performing your case, and follow-ups may be handled by different providers. At Elite, Dr. Volland personally performs every case and sees every patient at every visit.
Pricing structure: ClearChoice's published pricing range is $14,000–$36,000 per arch. Real-world patient reports cluster in the $20,000–$35,000 range. Their zirconia is typically a premium upgrade. Elite's $15,000 includes zirconia as standard.
Ownership: ClearChoice is owned by Aspen Dental Management, which is private-equity controlled. Elite is independently owned. Independence affects pricing structure, sales pressure, and how the practice prioritizes patient outcomes versus quarterly returns.
The affordable implant chains often advertise prices similar to Elite's or slightly lower. The key difference is who performs your surgery.
Those practices are typically led by general dentists with continuing-education training in implants — not by board-certified oral and maxillofacial surgeons. The clinical scope, surgical training (4-6 years of residency for OMS specialty versus continuing education courses), and complication management capability is materially different.
Dr. Volland is a board-certified oral and maxillofacial surgeon. Implant placement is one of the core procedures of OMS specialty training. When something requires complex surgical judgment — significant bone deficiency, sinus complications, medically complex patients, true zygomatic candidacy, atypical anatomy — that training matters.
Several structural reasons. First, Elite is a focused practice. Full-arch implant therapy is the practice's primary service, which produces operational efficiencies that broader OMS practices don't capture.
Second, Elite is owner-operator. There is no DSO management fee, no shareholder return obligation, no regional management overhead. Costs that would otherwise go to corporate structure flow to patient pricing.
Third, the in-house workflow — IV sedation administered by an oral surgeon, in-house consultation through final delivery, transparent material selection — eliminates fees that other practices pass through to patients.
The pricing reflects the operational structure, not a quality compromise.
Most adults missing most or all teeth in at least one arch are candidates. This includes long-term denture wearers, patients with widespread tooth failure, patients facing full extractions, and patients with previous implant failure who want to start over.
Candidacy is determined at consultation through 3D Cone Beam CT imaging and medical history review. Conditions that complicate or contraindicate treatment include uncontrolled diabetes (HbA1c above 7.5%), active heavy smoking, current bisphosphonate therapy, certain bleeding disorders, severe untreated periodontal disease, and a history of head and neck radiation. Many of these are conditional rather than absolute — a patient with controlled diabetes or a former smoker who has quit can typically proceed.
Patients turned away as "not candidates" by other practices often are candidates here, particularly when zygomatic implant protocols are appropriate.
The titanium implants are designed as a lifetime solution. Published longitudinal data from the Maló Clinic studies shows implant survival rates of 93-95% at 10-18 years post-placement. The zirconia prosthesis is engineered for decades of service.
Long-term success depends meaningfully on oral hygiene compliance, six-month professional maintenance, and behavioral factors (smoking, glycemic control). Patients who follow recommended care typically retain their implant-supported prosthesis for life, with periodic component maintenance.
The All-on-4 protocol was specifically designed to minimize the need for bone grafting through angled posterior implant placement. Most patients require no significant grafting beyond minor socket preservation when teeth are extracted.
Patients with substantial bone loss may require sinus lifts ($2,500-$4,500), additional grafting ($1,500-$5,000), or alternative protocols like zygomatic implants. The clinical need for any of these is determined at consultation, in writing, before surgical scheduling — not in the chair on surgery day.
The surgery itself is performed under in-house IV sedation; patients are not aware of the procedure. Post-operative discomfort is typically described as moderate, well-controlled with prescribed medication, and substantially less than patients anticipate.
The first 48-72 hours are the most uncomfortable. Swelling peaks around day 3-4 and resolves over the following week. By day 5-7, most patients return to non-strenuous work. A soft food diet is required for 6-8 weeks while implants integrate with bone.
No. IV sedation requires that you have someone drive you home and stay with you for the first 24 hours. This is a non-negotiable safety requirement — not a preference. If you don't have a transportation arrangement, we can help you identify options before scheduling.
All-on-6 uses six implants per arch instead of four, providing additional support distribution. Selection between the two is a clinical decision based on jawbone density, bite forces, history of bruxism (teeth grinding), and patient anatomy.
All-on-6 is not a "premium upgrade" at Elite — it's a clinical choice when the additional support is biomechanically warranted. Pricing is the same all-inclusive structure regardless of whether 4 or 6 implants are used. The recommendation is made based on what your specific case requires.
3D Cone Beam imaging. A written treatment plan with exact pricing for your specific case. A direct conversation with Dr. Volland — no rotating surgeons, no high-pressure treatment coordinators, no obligation to proceed.
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