Am I a Candidate for All-on-4 in Baltimore, MD?

You’ve heard about All-on-4 dental implants in Baltimore, but you’re not sure if you qualify. Maybe you’ve been told you don’t have enough bone, or you have health conditions that worry you. Maybe you’ve been missing teeth for so long that you assume it’s too late.

The good news is that All-on-4 was specifically designed for patients like you. It uses four strategically placed implants to support a full arch of teeth, and it eliminates the need for bone grafting. That means many patients who were told “no” by other dentists can still get a permanent smile.

At Cosmetic & Advanced Dentistry in Owings Mills, Dr. Andrey Doroshenko and Dr. Ed Lazer evaluate every patient individually. They don’t use a one-size-fits-all checklist. They look at your unique situation and find solutions. Let’s walk through what makes a good candidate and what happens if you have concerns.

The Core Requirements

All-on-4 isn’t right for everyone, but the requirements are broader than you might think:

You’re Missing Most or All Teeth in One or Both Jaws: This is the primary indication for All-on-4. If you’re missing most or all of your teeth in an arch, this treatment can replace them with a fixed, permanent solution. In most cases, you leave the same day as surgery.

You Have Healthy Gums (Or We Can Get Them There): We need to treat active gum disease before implant placement. Bacteria from gum disease can interfere with healing and lead to implant failure. If you have gum disease, we’ll treat it first. This might mean deep cleanings or other periodontal therapy. Once your gums are healthy, we can proceed.

You’re Committed to Oral Hygiene: All-on-4 implants need care, just like natural teeth. You’ll need to brush, floss, and attend regular dental visits. If you’re not willing to maintain your new smile, implants aren’t the right investment. But if you’re ready to take care of them, they can last for decades.

What About Bone Loss?

This is the concern that stops most patients from pursuing implants. They’ve been told their bone isn’t strong enough. They assume that’s the end of the road, but it’s not.

All-on-4 Was Designed for Bone Loss

Traditional implants require a certain amount of bone for each individual implant. If you’re missing that bone, you need grafting. That adds months to treatment and thousands to the cost.

All-on-4 takes a different approach. Two implants go in the front of your jaw, where bone is typically denser. Two go in the back at an angle, up to 45 degrees. This angled placement lets us use the bone you still have, even if it’s limited.

As a result, most All-on-4 patients don’t need bone grafting at all.

When Bone Grafting Is Still Needed

Some patients have severe bone loss that All-on-4 can’t overcome. Dr. Doroshenko evaluates this with 3D CBCT imaging. If you need a graft, he’ll discuss it with you. But many patients are surprised to learn they qualify without one.

Health Conditions: What Matters

Your overall health affects how well you heal after surgery. Dr. Doroshenko carefully reviews your medical history. He looks for these issues and more:

Controlled Diabetes: If you have diabetes, your blood sugar control matters. Patients with controlled diabetes (HbA1c less than 7%) heal normally and have similar implant success rates to non-diabetics. Uncontrolled diabetes (HbA1c greater than 8%) significantly increases implant failure risk. We’ll need your diabetes under control before surgery.
Smoking: Smoking is the most critical modifiable factor. Smokers have 3 to 5 times higher implant failure rates than non-smokers. We’ll discuss smoking cessation with you. Many patients can still receive implants safely with guidance and support.
Medications: Certain medications, particularly bisphosphonates for osteoporosis, can affect bone healing. We’ll review your medications and consult with your physician if needed. In most cases, treatment is still possible with precautions.
Radiation Therapy History: If you’ve had radiation therapy for cancer, bone healing may be compromised. All-on-4 is more challenging in these cases, but sometimes still feasible with special precautions.

Dr. Doroshenko evaluates each patient individually. He doesn’t automatically disqualify you based on a single factor or medical condition.

The Prosthodontist’s Checklist

Here’s the checklist Dr. Doroshenko uses when evaluating All-on-4 candidates.

Are You Missing Most or All Teeth? If yes, you’re in the right place.
Is Your Gum Disease Controlled? If you have active gum disease, we’ll treat it first. Once your gums are healthy, we can proceed.
What Does Your Bone Look Like? We use 3D CBCT imaging to measure bone height and density. In the lower jaw, we need at least 10 to 12mm of bone height from the ridge to the nerve canal. In the upper jaw, we need 8 to 10mm to the sinus. All-on-4 often works even when these measurements are less than ideal because of the angled implant placement.
Is Your Overall Health Stable? We review your medical history, medications, and any conditions that affect healing. Controlled conditions are usually fine. Uncontrolled conditions need to be addressed first.
Are You Committed to Aftercare? Implants require maintenance. Regular checkups, good oral hygiene, and a willingness to follow post-surgical instructions are essential.

If you check most of these boxes, you’re likely a candidate. Dr. Doroshenko will confirm during your consultation.

Why the Cosmetic & Advanced Method Matters

At most practices, you’d see one doctor for the surgical evaluation and another for the restorative plan. They might never meet. Communication happens through phone calls and faxed records. We do things differently.

Our practice is built around a rare model. Dr. Doroshenko, a fellowship-trained prosthodontist and implant specialist, handles the surgical phase. Dr. Lazer, a nationally recognized cosmetic dentist trained at the Las Vegas Institute, designs your final smile. They co-diagnose, co-plan, and co-execute your treatment.

This matters for candidacy. When Dr. Doroshenko evaluates your bone, he’s doing so with Dr. Lazer’s aesthetic goals in mind. When Dr. Lazer designs your final teeth, he knows exactly what Dr. Doroshenko can achieve surgically. Function and beauty are never separate conversations.

You’re not just a surgical candidate here; you’re a smile candidate.

What If You’re Not a Candidate for All-on-4?

Some patients have severe bone loss that even All-on-4 can’t address. If so, we have alternatives:

Zygomatic Implants: These longer implants anchor in your cheekbone instead of your jawbone. They provide support without bone grafting and have success rates of 90-95%. They require specialized surgical training, which Dr. Doroshenko has.
Pterygoid Implants: These extend further back in the jaw, maximizing the spread between the front and back implants. They’re another creative option for limited bone.
Implant Overdentures: If you prefer a removable solution, implant overdentures are supported by 2 to 4 implants. They cost less than All-on-4 but offer more stability than traditional dentures.

Dr. Doroshenko will discuss all your options if All-on-4 isn’t the right fit.

Learn more about our implant dentistry here:

Serving Owings Mills and Greater Baltimore

Cosmetic & Advanced Dentistry is located at 5 Park Center Ct, Suite 302, in Owings Mills, MD. We’re about a 20-minute drive outside of Baltimore. Our office offers easy highway access via 695 and ample free parking. We proudly serve patients from Owings Mills, Baltimore, Towson, Pikesville, Reisterstown, Randallstown, and surrounding communities.

Schedule Your Complimentary Consultation

The only way to know if you’re a candidate for All-on-4 is to be evaluated. We offer free cosmetic and implant consultations. Your visit includes a comprehensive oral exam, a customized implant plan, and a Q&A with Dr. Doroshenko and Dr. Lazer.

Call Cosmetic & Advanced Dentistry at (410) 697-6290, or request an appointment online. You might be a better candidate than you think. Let us find out together!

Am I a Candidate for All-on-4? A Baltimore Prosthodontist’s Checklist