Full-Arch Dental Implants in Boston: Are You a Candidate?

If you are missing most of your teeth, living with teeth that are failing, or tired of a denture that moves when you eat, this page is for you. Full-arch implant treatment replaces all the teeth in an upper or lower arch with a fixed prosthesis supported by dental implants.

Full-arch treatment is not one solution but a spectrum of prosthetic options. The central question is not only whether implants can be placed, but which restorative design gives you the right esthetic, functional and long-term outcome for your situation.

This page explains the difference between FP1 and FP3 full-arch teeth, what determines candidacy, the options, the STAR Concept, planning, the treatment journey, cost, risks and aftercare. Our aim is to help you arrive at your consultation informed, with good questions, and without pressure.

Full-arch care at The Face Dental Group is led by Prof. Dr. Wael Att, a board-certified prosthodontist, former chair of prosthodontics at Tufts University School of Dental Medicine, author of 170+ publications and co-developer of the STAR Concept with David Norré. Request a Full-Arch Implant Consultation or call (617) 236-5969.

FP1 vs FP3 explained clearly
Prosthetically driven full-arch planning
The STAR Concept, where appropriate
Independent second opinions

FP1 vs FP3: Two Kinds of Fixed Full-Arch Teeth

Fixed full-arch teeth are not all designed the same way. Two common restorative categories are known as FP1 and FP3, and knowing which one is being proposed helps you understand what your new smile will look like.

FP1: teeth that emerge from the gums

FP1 is designed to replicate natural teeth emerging from the gum, with minimal or no artificial gum. When conditions allow, it aims for a natural look that integrates with your face and smile.

FP3: teeth and lost tissue

FP3 replaces both the teeth and the tissue that has been lost, often with prosthetic gum. It can be appropriate in advanced tissue-loss situations, or when augmentation is not desired or not indicated.

	FP1	FP3
What it replaces	Teeth, designed to emerge from the gum like natural teeth	Teeth and lost tissue
Artificial gum	Minimal or none	Often used (prosthetic gum)
Esthetics	Aims for natural esthetic integration, when conditions allow	Replaces lost tissue as well as teeth
When it may be appropriate	When bone, soft tissue and smile conditions allow	Advanced tissue loss, or when augmentation is not desired or not indicated

Neither category is automatically the right one. The choice depends on your anatomy and your goals, and at our practice the planned restoration comes first. For a closer look at how this compares with labels such as All-on-4, read All-on-4 vs alternatives.

Considering treatment elsewhere?

Bring your CBCT and treatment plan for an independent FP1/FP3 evaluation. Have you been told All-on-4 is your only option? An independent review can help you understand which restorative category is being proposed and what it means for you, so you can decide with clarity. Please bring your records to your appointment rather than emailing them, or call (617) 236-5969 and we will arrange a secure transfer.

Request an Independent FP1/FP3 Evaluation

Referring doctor? Submit a full-arch case for collaborative planning, or call (617) 236-5969 to arrange a secure transfer of records.

Who Is a Candidate for Full-Arch Dental Implants?

Patients who have lost or are losing most of their teeth in one or both arches are typically candidates for full-arch implant reconstruction. That includes people who have lost multiple teeth to gum disease, trauma or other causes, and people whose natural teeth are in poor condition. If you already wear a denture, you may still qualify for implant-supported teeth, and our team will evaluate your jawbone density and overall oral health to see whether you are a suitable candidate.

What determines candidacy

Being a candidate for full-arch treatment, and for a particular kind of full-arch teeth, depends on several things we evaluate together:

bone volume and anatomy
your smile line
lip mobility
the architecture of your gums and soft tissue
your esthetic expectations
whether you are willing to have staged or augmentation procedures when they are needed

Enough bone for implants is not the same as enough prosthetic support for the esthetic category you are hoping for. A scan may show that implants can be placed, but whether FP1 or FP3 teeth suit you depends on the full picture above.

Health factors we look at during your assessment

Bone. Years of tooth loss and denture wearing shrink the jawbone, and a 3D CBCT scan shows what is there. Where bone is insufficient, options include bone grafting, angled implant placement that uses the available bone (as in All-on-4 and the STAR Concept), or zygomatic implants for extreme bone loss. Read more about bone grafting for dental implants.
Gum health. Candidates should be free of gum disease and other oral conditions that could affect the implants. Some patients need preliminary care first, such as gum disease treatment or bone grafting.
Diabetes. Well-controlled diabetes is not a contraindication to dental implants; uncontrolled diabetes is. The difference comes down to blood-glucose control, measured mainly by your HbA1c. See dental implants and diabetes.
Smoking. Smoking is not an absolute contraindication to implants, but it is the most significant risk factor that you can change, and for full-arch cases the effect is often larger. See smoking and dental implants.
Grinding and clenching (bruxism). Bruxism is not a contraindication to implants, but it has to be taken into account in the planning. For full-arch cases that can mean using six implants rather than four where anatomy permits, and monolithic zirconia teeth rather than layered ceramics.
Medications. Medicines we ask about include bisphosphonates, denosumab, long-term corticosteroids, certain immunosuppressants and anticoagulants.
Age. There is no upper age limit for dental implants; what matters is health status, bone condition and medications rather than age itself. See dental implants for seniors.
Commitment to care. Candidates should be ready to keep up excellent oral hygiene to support their implants over the long term.

When implants are not the right answer

Implants are not right for everyone, and it is better to say so plainly. Situations that often rule them out include recent head and neck radiation, IV bisphosphonates for cancer, active chemotherapy, a recent heart attack or unstable cardiovascular disease, and uncontrolled diabetes. Many of these are temporary, and an honest consultation separates a temporary delay from a permanent reason not to proceed. A minority of patients with extreme anatomy are better served by dentures, and some natural teeth are better saved than replaced. Our article on when dental implants are not the right answer covers these exceptions in more detail.

What Patients Often Misunderstand

Avoiding grafting is not always the same as keeping your esthetic options open. A plan that avoids grafting may also narrow the esthetic pathway available to you.
Same-day teeth do not define your final restoration. Whether you leave surgery with teeth on the same day is a separate question from whether your final teeth are FP1 or FP3.
Know the trade-offs before you consent. You should understand any bone reduction that is planned, the vertical restorative space your teeth will need, and the restorative trade-offs of your plan before you agree to treatment. Ask us to explain each of these for your case.

Your Full-Arch Options: Fixed Teeth and Removable Overdentures

“Full-arch” is a category of treatment rather than one single technique. Within it, the options described on our site include:

All-on-4: four implants per arch, typically two upright in the front and two tilted in the back. Learn more about All-on-4 dental implants.
All-on-6 or All-on-8: six or eight implants per arch, used when bone quality or quantity allows.
Implant-retained overdentures: removable teeth supported by two to four implants.
The STAR Concept: a digitally planned protocol for full-arch treatment, explained below.

Fixed full-arch teeth

Fixed implant teeth are permanently attached to the implants that support them and can only be removed by a dental professional. Many patients like the idea of having their teeth in place all the time; the main trade-off is that a fixed option may need more implants than a removable one. A fixed bridge can be designed as FP1 or FP3, as explained above. The final bridge can be made from monolithic zirconia, hybrid acrylic-titanium or ceramic, and the material chosen accounts for a large part of the cost.

Removable implant overdentures

A removable implant denture snaps on and off small attachments on top of the implants, so you can take it out yourself. Removable implant dentures are often suited to people who have lost some jawbone volume, because they typically need fewer implants. Our pages on implant dentures and dental implants vs. dentures compare these choices with a conventional denture.

The STAR Concept for Full-Arch Implants

The STAR Concept is a full-arch protocol co-developed by Prof. Dr. Wael Att and David Norré for the immediate placement and restoration of full-arch dental implants. It is used for patients with a failing dentition as well as those who have already lost all their teeth.

In the STAR Concept, everything from the shape of the teeth to the full surgical plan is designed on the computer, and the parts are manufactured before any tooth is extracted. Computer-guided technology is then used to place both the implants and the temporary bridge.

How it differs from a conventional approach

Conventional All-on-4 is a well-studied protocol with documented long-term outcomes. It is largely freehand surgery, in which the surgeon decides implant angle and position during the procedure based on the bone that is available. The STAR Concept keeps the basic idea of full-arch reconstruction but replaces freehand surgery with a digital workflow:

CBCT-based planning of every implant position before surgery
computer-designed surgical guides that direct where each implant goes
provisional teeth made in advance and designed to the planned final look
fixed provisional teeth delivered on the day of surgery
a priority on preserving bone and gum tissue

For some cases, particularly revision work or patients with very specific bone anatomy, variations on conventional All-on-4 or All-on-6 are appropriate. Not every patient is a candidate for full-arch immediate implant placement, so careful case evaluation and planning come first. You can read the full description on our STAR Concept page and a side-by-side comparison in full-arch implants vs. All-on-4.

Digital Planning: What You See Before Surgery

CBCT: a 3D view of your jaws

A CBCT scan is a low-radiation 3D x-ray of your jaws. It shows bone volume and quality, the position of nerves and sinuses, hidden problems that a flat x-ray can miss, and areas that may need grafting before implants are placed. We have CBCT imaging on-site, so the scan goes straight into our planning software without a separate imaging appointment. More in CBCT scans for dental implants.

Digital smile design: planning from your face

Digital smile design starts with photographs and video of your face in natural expressions, and the shape, size and position of the teeth are designed to suit your face. In full-arch cases, the smile design defines where the implants need to go to support the planned result, and the surgical guide is designed backward from it. In a STAR Concept case, a 3D smile design session lets you wear and evaluate your planned new smile from every angle before surgery. See digital smile design explained, and learn more about our predictive planning process.

Guided surgery

In computer-guided surgery, the final teeth are designed first, each implant is positioned virtually to support them, and a 3D-printed guide then directs the drills along the planned path. Every implant case at our practice is planned in CBCT-based software, and full-arch STAR Concept cases are fully guided, with provisional teeth made in advance. Read guided vs. freehand implant surgery for the full comparison.

Same-Day Teeth: Immediate Full-Arch Treatment

Two terms are often confused. Immediate placement means the implant is placed on the day the tooth is removed; immediate loading means teeth are attached on the same day as placement. Immediate loading is the more demanding of the two, because it needs excellent stability of the implants at placement and a carefully designed provisional.

On STAR Concept surgery day, teeth are removed and implants are placed through the guide in a planned sequence, and temporary teeth are then delivered as planned. Many patients leave their surgical appointment with a fixed set of provisional teeth the same day. Same-day teeth do not, however, decide whether your final teeth are FP1 or FP3.

When same-day teeth may not be appropriate

Immediate implants are not universally appropriate. Our article on immediate dental implants in Boston describes conditions that have to line up, such as the absence of active infection, enough bone beyond the extraction site, and intact surrounding bone walls. Whether same-day teeth suit you is decided during careful evaluation and planning.

Provisional teeth and final teeth

The provisional teeth are the temporary teeth you wear while the implants heal. After surgery, the pre-designed shape of the temporary teeth guides how the gums heal around them. Once the implants have integrated, the final teeth are made according to the original design. The final prosthesis is more refined in look and function than the provisional.

Your Full-Arch Treatment Journey, Step by Step

Every plan is individual, but a STAR Concept case generally follows these steps:

Consultation. A one-on-one conversation about your wishes and concerns, a full clinical exam, digital photographs of your smile in our studio, a 3D CT scan and intraoral scans.
Design. Using this information, our design team creates a custom smile prototype intended to suit your facial features.
3D smile design session. You try on and evaluate the planned smile.
Planning. Doctors, designers and technicians plan the guided surgery and the delivery of your teeth, with attention to safety, appearance, implant position and support for the future teeth.
Fabrication. The surgical guides and the immediate teeth are designed and made before surgery.
Surgery day. Teeth are removed, implants are placed through the guide and temporary teeth are delivered. We use sedation and local anesthetic so that you feel little to nothing in the chair.
Healing. The implants bond with the jawbone over a period of months. A no-chew diet is usually needed for a few days after surgery, moving on to soft foods as you heal.
Final teeth. Once the implants have integrated, your final teeth are made to the original design. Delivery typically involves two to three visits for try-ins and adjustments.

How long does it take?

From start to finish, it is common for full mouth reconstruction to take a few months or longer. If gum treatment or bone grafting is needed first, the timeline is longer, and some bone grafts need a few months to integrate before implants can go in. Your own timeline depends on your treatment plan and is discussed at your consultation. Our All-on-4 recovery timeline describes a typical All-on-4 course week by week.

Cost of Full-Arch Dental Implants in Boston

The cost depends on the starting state of your oral health and the details of your treatment plan. A full-arch fee usually covers several parts:

planning: CBCT imaging, intraoral scans, digital smile design and surgical guides
extractions and site preparation, including bone grafting if needed
the implants themselves, typically four to eight per arch depending on the protocol
anesthesia and surgical time
the provisional teeth and the final teeth, where the material chosen drives a large part of the cost
follow-up and maintenance

Costs depend on case complexity, grafting needs and the final material, and every patient receives a case-specific quote after consultation. Our article on the cost of full-mouth dental implants in Boston explains these factors in more detail.

Insurance and financing

Most medical insurance plans do not cover implants, and dental insurance typically covers a small part of the cost. We can file insurance claims on your behalf and accept third-party financing. We will go through the numbers and your payment options with you at your consultation, so there are no surprises later.

Risks and Limitations to Know About

Full-arch treatment is surgery, and it is worth understanding the risks before you decide.

Recovery. As with any dental procedure, you may have some soreness, swelling and general discomfort while you recover. Swelling peaks at 48 to 72 hours after surgery.
Peri-implantitis. This is a bacterial infection of the tissues around an implant that, if untreated, gradually destroys the bone that supports it. It is the leading cause of late implant failure, and early detection makes a large difference. Read about peri-implantitis diagnosis and treatment.
Biting forces. Implants do not have the cushioning ligament that natural teeth have, so grinding, an unbalanced bite or poorly designed teeth can lead to bone loss or fractures of the prosthesis.
Prosthetic design. Excessive cantilevers on full-arch prosthetics are among the common contributors to late failure.
Surgical planning. Implants placed in insufficient bone, at poor angles or without enough initial stability are more likely to fail early.
Lifelong upkeep. Implants require lifelong professional hygiene.

If a problem does develop, it can often be addressed: peri-implantitis caught early can be treated, prosthetic problems can be redesigned, and a failed implant can often be removed, the site regenerated and a new implant placed. Our article on why dental implants fail explains the causes in more depth, and our page on implant failure and salvage covers second opinions for implant problems.

Caring for Full-Arch Implants

Fixed full-arch bridges have particular cleaning needs, because food and plaque collect on the underside of the bridge where it sits near the gum. Daily tools include threaded floss that passes under the bridge, a water flosser, end-tufted brushes and interdental brushes sized to the spaces.

Professional care and night guards

A professional hygiene visit every 3 to 4 months for implant patients.
A yearly check of bone levels, implant mobility and prosthetic screw tightness.
Removal of screw-retained bridges for a thorough cleaning every 5 years or as needed, when clinically indicated.
For anyone with a history of grinding, a custom hard-acrylic night guard is provided with the final teeth, to be worn every night.

Avoid hard toothbrush bristles and chewing very hard objects such as ice or pens, and do not ignore bleeding around an implant, which is the earliest sign of peri-implantitis. Our guide on how to clean and maintain dental implants has the full routine.

Full-Arch Cases from Our Boston Practice

Our smile gallery shows cases treated at the practice, including full-arch implant treatment in both jaws. Browse our full-arch outcomes and other cases.

Why Patients Choose The Face Dental Group and Prof. Dr. Wael Att

Full-arch treatment at our Boston practice is led by Prof. Dr. Wael Att, a board-certified prosthodontist, former chair of prosthodontics at Tufts University School of Dental Medicine, author of 170+ publications and co-developer of the STAR Concept with David Norré. He is a professor in the Department of Prosthodontics at the University of Freiburg in Germany. His board certification in prosthodontics is from the German Society of Prosthodontics.

Our team carries out the implant procedure in-house, from planning to final teeth, and our CBCT imaging is on-site. If you are researching full-arch implants Boston options, you can learn more on Meet Dr. Att, our academic authority page, and our overview of dental implants in Boston and full mouth reconstruction.

Dentists who would like to refer a full-arch case can call (617) 236-5969 to arrange a secure transfer of records.

Full-Arch Dental Implants: Frequently Asked Questions

What is the difference between FP1 and FP3?

FP1 is designed to replicate natural teeth emerging from the gum, with minimal or no artificial gum. FP3 replaces both teeth and lost tissue, often with prosthetic gum, and can be appropriate in advanced tissue-loss situations or when augmentation is not desired or indicated.

Am I too old for full-arch implants?

There is no upper age limit for dental implants. What matters is your health status, bone condition and medications, not your age alone.

Will I leave with teeth on the day of surgery?

With the STAR Concept, many patients leave their surgical appointment with a fixed set of provisional teeth the same day. Not every patient is a candidate for full-arch immediate implant placement, so this is decided during careful evaluation and planning.

What is the difference between full-arch implants and All-on-4?

“Full-arch” is the general category of treatment in which all the teeth in an arch are replaced with a fixed prosthesis on implants. All-on-4 is one specific technique within it, using four implants per arch with the two back implants tilted.

Will I need a bone graft?

Not always. CBCT-based planning shows your exact bone anatomy, and in many cases implants can be placed at angles or in positions that use the existing bone. The All-on-4 concept and the STAR Concept were developed to avoid extensive grafting in full-arch cases, although grafting is still necessary in some situations. Keep in mind that avoiding grafting is not always the same as keeping your esthetic options open.

Can I get full-arch implants if I smoke or have diabetes?

Often, yes. Smoking is not an absolute contraindication, but it is the most significant risk factor you can change. Well-controlled diabetes is not a contraindication to implants, while uncontrolled diabetes is.

How do I look after a full-arch bridge?

Clean under the bridge every day with tools such as threaded floss, a water flosser and interdental brushes, and see the hygienist every 3 to 4 months. If you grind your teeth, wear your night guard every night.

Book a Full-Arch Implant Consultation in Boston

The first step is always a consultation. We will listen to what you want, examine your mouth, take the scans and photographs we need, and talk honestly about whether full-arch implants, an overdenture or another approach suits you, and whether FP1 or FP3 teeth fit your situation. Our aim is clarity, not pressure. If full-arch treatment is not right for you, we will tell you.

Request a Full-Arch Implant Consultation or call us at (617) 236-5969. Already have a plan from another practice? Request an Independent FP1/FP3 Evaluation.