A full-arch implant restoration replaces all teeth in an arch on a small number of implants — classically four (All-on-4) or more (All-on-X, typically 4–6). For the final prosthesis you choose between a titanium-acrylic hybrid (lighter, repairable, lower cost) and monolithic zirconia (stronger, more wear-resistant, longer-lasting). Most workflows deliver an acrylic provisional the day of surgery, then a definitive bridge once the tissues settle.
Planning a full-arch case? BioDent fabricates provisional and final full-arch prostheses — titanium-acrylic hybrids and monolithic zirconia — for practices nationwide. Send a case · 800-517-5250
All-on-4 vs. All-on-X: how many implants?
All-on-4 uses four implants per arch (two anterior, two angled posterior) to support a fixed full-arch bridge — a proven, cost-efficient protocol. All-on-X is the umbrella term for the same concept with a variable number of implants (often 4–6), letting the surgeon add support for bone quality, arch length, occlusal load, or a heavier final material like zirconia.
Material comparison: acrylic-hybrid vs. monolithic zirconia
| Titanium-acrylic hybrid | Monolithic zirconia | |
|---|---|---|
| Strength / wear resistance | Moderate; teeth/acrylic wear over time | High; resists wear, holds shape |
| Weight | Lighter | Heavier |
| Repairability | Easy to adjust/repair chairside | Harder to repair if fractured |
| Esthetics / longevity | Good; may need refurbishing | Excellent, long-term |
| Cost | Lower | Higher |
| ~5-yr prosthesis survival | ~83% | ~94%+ (95%+ at 10 yr in selected cases) |
Reported data: acrylic-based hybrids show roughly 83% survival at 5 years and frequently need refurbishing (about a quarter refurbished after ~7.8 years on average), while monolithic zirconia full-arch prostheses show about 93.7% at 5 years and 95%+ at 10 years in properly selected cases (one 2024–25 study reported 98.6% to ~6 years). Underlying titanium implant survival is ~96.4% at 10 years.
The workflow: provisional then final
The common sequence: place implants, then deliver an acrylic provisional (immediate-load) bridge the same day because acrylic is easy to adjust while tissues remodel. After healing and tissue stabilization, fabricate the definitive bridge — often monolithic zirconia for durability, or a refined titanium-acrylic hybrid where weight, repairability, or budget lead. Accurate verified impressions/scans and a passive-fitting framework are essential at the final stage.
Choosing the final material
- Monolithic zirconia — best for longevity, wear resistance, and patients who want a definitive, low-maintenance result (and can support the added weight on adequate implants).
- Titanium-acrylic hybrid — best when weight, easy reparability, staged budgeting, or a softer occlusal scheme are priorities.
- More implants (All-on-X, 5–6) — consider for longer arches, heavy occlusion/bruxism, or when planning a zirconia final.
Cost
Full-arch lab costs vary with material (zirconia > hybrid), number of units, and provisional-vs-final stage. The right call balances upfront cost against refurbishment/longevity. BioDent quotes full-arch cases per arch and material — ask for current lab pricing.
How BioDent fabricates full-arch cases
We fabricate immediate provisionals and definitive full-arch prostheses — titanium-acrylic hybrids and monolithic zirconia — on a fully digital workflow with verified, passive-fit frameworks milled on an industrial-grade Haas mill. Compatible with all major implant systems. Direct technician communication throughout the case.
Send your full-arch case and we will guide material and workflow per arch. Open a lab account · 800-517-5250
Frequently asked questions
What is the difference between All-on-4 and All-on-X?
All-on-4 uses exactly four implants per arch; All-on-X is the same fixed full-arch concept with a variable number of implants (often 4–6) chosen for bone, load, and final material.
Zirconia or acrylic-hybrid for a full arch?
Zirconia lasts longer and resists wear (95%+ at 10 years in selected cases); acrylic-hybrid is lighter, cheaper, and easier to repair but shows lower long-term survival and often needs refurbishing.
Why is the first bridge usually acrylic?
Acrylic provisionals are easy to adjust while tissues settle after surgery; the definitive (often zirconia) bridge is made once the tissues stabilize.
How many implants are needed?
Four at minimum (All-on-4); many cases use five or six (All-on-X), especially for zirconia finals, long arches, or heavy occlusion.
Does BioDent fabricate full-arch restorations?
Yes — provisional and final, hybrid and zirconia, for practices nationwide.
