If you’re missing most or all of your teeth and have been told that dentures are your only option, All-on-X may change everything you thought you knew about tooth replacement. This full arch solution uses at leastfour to six intentionally placed implants to support an entire fixed arch of teeth, giving patients a permanent, natural-looking smile without the daily inconvenience of removable appliances. For the right candidate, the results are life-changing.
At Precision Oral and Maxillofacial Surgery in Deer Park, NY, our full arch rehabilitation services are led by Dr. Mohamed El-Ounsi, a Board Certified Oral and Maxillofacial Surgeon who trained as Chief Resident at NYU Langone and Bellevue, two of the most respected Oral and Maxillofacial Surgery programs in the country. As both a Fellow of the American Association of Oral and Maxillofacial Surgeons (AAOMS) and a Diplomate of the American Board of Oral and Maxillofacial Surgery (ABOMS), Dr. El-Ounsi brings an unmatched level of precision and clinical depth to every full arch case he treats.
What Is All-on-X?
All-on-X is a full arch implant protocol that replaces an entire upper or lower row of teeth with a fixed prosthesis supported by at least four to six dental implants. The “X” refers to the varying number of implants used, which is determined based on each patient’s anatomy, bone density, and treatment goals.
Unlike traditional dental implants that replace individual teeth one at a time, All-on-X rehabilitates an entire arch in a single surgical procedure. The implants are placed or angled strategically to maximize contact with available bone, which means many patients can avoid the lengthy and invasive bone augmentation that older protocols required. A temporary prosthesis is typically placed the same day, so patients leave with functional, esthetic teeth immediately following surgery.
How All-on-X Differs from Traditional Dentures
The most significant difference between All-on-X and traditional dentures comes down to stability. Conventional dentures rest on the gum tissue and depend on suction or adhesives to stay in place. They shift during eating and speaking, require nightly removal, and contribute to ongoing bone loss in the jaw.
All-on-X implants, by contrast, are anchored directly into the jawbone. This provides a fixed, non-removable solution that functions like natural teeth. A 2023 longitudinal study published by the National Institutes of Health found cumulative implant survival rates of 97.4% at up to 17 years of follow-up, reinforcing what clinicians have observed in practice: when properly placed and cared for, full arch implants are one of the most durable tooth replacement options available. Additionally, because the implants stimulate the jawbone, they actively work to prevent the bone resorption that accelerates facial aging in denture wearers.
Who Is a Good Candidate for All-on-X?
Most adults who are edentulous (fully without teeth) or who have teeth that are failing beyond repair may be worth evaluating for All-on-X. Candidacy is determined through a comprehensive examination, but the following factors are strong indicators:
- Significant tooth loss: Patients who are fully edentulous or have multiple failing teeth in one or both arches.
- Adequate bone volume: Sufficient bone in the anterior jaw region to support implant placement, though tilted implants in the All-on-X protocol reduce the bone requirements compared to traditional approaches.
- Good systemic health: Patients who are medically stable, as conditions like uncontrolled diabetes or recent radiation to the head and neck may affect healing.
- Non-smoker or willing to quit: Smoking is one of the most significant risk factors for implant failure, and patients who smoke are counseled accordingly.
- Realistic expectations: All-on-X is a long-term investment that requires consistent oral hygiene and routine follow-up care.
Even if a patient does not immediately meet all criteria, procedures like bone grafting may be used to build adequate bone volume before implant placement. Dr. El-Ounsi evaluates each patient individually, taking into account their full medical history, imaging, and functional needs before recommending a treatment path.
What to Expect During the Process
The All-on-X process begins with a thorough consultation and imaging, typically including a 3D cone beam CT scan that maps the anatomy of the jaw in detail. From there, a customized treatment plan is developed. For patients who are anxious about surgery, we bring in an anesthesiologist and offer IV sedation so the procedure is as comfortable as possible. On the day of surgery, any remaining failing teeth are extracted, the implants are placed, and a temporary fixed arch is delivered.
The final prosthesis is typically placed several months later, once the implants have fully integrated with the bone. Some patients, depending on their bone quality and the surgical findings, may also be candidates for immediate implants, which compress the timeline even further. Throughout the entire process, our team prioritizes transparency with patients about each step, realistic timelines, and what they can expect in terms of recovery and long-term maintenance.
Find Out If All-on-X Is Right for You at Precision OMF Surgery
Choosing a full arch implant solution is one of the most significant decisions a patient can make for their oral health, and choosing the right surgeon to perform it matters just as much. Dr. El-Ounsi’s background includes training at the highest levels of oral and maxillofacial surgery, and his approach to full arch cases reflects a commitment to individualized care, state-of-the-art technology, and complete financial transparency. Financing options, including CareCredit, Cherry, Alphaeon, HFD, and Proceed, are available to make treatment more accessible, and our team works with patients to help them understand exactly what their investment covers.
If you’ve been living with failing teeth or an uncomfortable denture and want to learn whether All-on-X may be right for you, we welcome the conversation. To take the first step, contact our office and schedule a consultation with Dr. El-Ounsi today.
