All-on-4 replaces a full arch of teeth on four implants: two placed vertically at the front, two angled toward the back, carrying a bridge of twelve teeth. At Aylan Clinic Tunisia, patients from Montreal, Quebec City, Toronto, Ottawa, Moncton and across Canada leave their first trip with fixed teeth already in place, and return three to six months later for the definitive bridge — for up to 60% less than Canadian private prices. Two things deserve to be understood before you commit: the teeth you leave with on trip one are temporary by design, and cleaning underneath a fixed bridge is a skill you have to learn. This guide sets both out plainly.
This page is the long-form guide. If you want the procedure itself — how the surgery is performed, the length of each stay, and the care that follows — see our All On 4 Dental Implant in Tunisia page. For an idea of what full-arch work costs compared with Canadian private treatment, see plastic surgery prices in Tunisia, and for the wider picture our dental care in Tunisia overview maps every treatment we offer.
For a patient who has been managing failing teeth for years, or wearing a denture that will not stay in, this is the treatment that ends it. Fixed teeth. No adhesive. No removing anything at night. Eating without thinking about it. And one thing distinguishes Tunisia: it is a French-speaking country. Not a clinic with French-speaking staff — a country where French is a working language across dentistry and daily life. This guide is organised around your journey: deciding, preparing, the trips, and the years that follow.
Part one — deciding
1. What All-on-4 is
The concept. A full arch of fixed teeth, supported on four implants. Two implants are placed vertically at the front, where bone is usually best preserved. Two are placed at an angle toward the back, which is the key to the technique: angling them allows longer implants to be used in available bone, and it frequently avoids the need for grafting or a sinus lift. A bridge of twelve teeth is fixed onto those four implants.
Why four implants can carry a full arch. Because the angulation spreads the support across the arch, and because the bridge itself acts as a rigid unit distributing load. This is well-established and widely documented. It is not a compromise version of a full-arch reconstruction — it is a specific, validated technique.
What it replaces. An upper arch, a lower arch, or both. For patients with a failing dentition — teeth breaking, moving, repeatedly needing treatment — it replaces an arch that has become a cycle of emergencies. For patients wearing a complete denture, particularly a lower one, it replaces something that moves with something that does not.
Fixed, not removable. This is the distinction that matters most to patients. The bridge is screwed onto the implants. It does not come out. You clean it in your mouth, as you would natural teeth — though differently, see section 15. Only your dentist removes it, at a maintenance appointment.
2. Is All-on-4 the right treatment for you?
Where it fits well. A failing upper or lower arch — teeth that are breaking, mobile, repeatedly treated and no longer worth saving individually. An existing complete denture, particularly a lower one that will not stay in place. Advanced periodontal disease where the remaining teeth cannot be saved. And where bone is limited at the back of the jaw, since the angled posterior implants frequently work with bone that would otherwise require grafting.
Where something else may serve you better. Where you have healthy teeth: All-on-4 requires removing any remaining teeth in that arch. We will not remove sound teeth to fit a treatment plan — and if your arch has salvageable teeth, individual implants, crowns and bridges may serve you better. Our full mouth rehabilitation guide covers that route.
Where you want more support: All-on-6 uses six implants and suits patients with softer bone, significant bruxism, or a natural opposing arch delivering heavy forces. Section 4 compares them honestly. And where a removable option would suit you better: an implant-retained overdenture on two implants costs considerably less, still clips firmly, and some patients prefer being able to remove it for cleaning — our removable dentures guide covers it. We set out which applies to you, and a number of patients who enquire about All-on-4 are better served by one of these.
What we need to assess. A CBCT scan — section 5, and it is not optional. The condition of any remaining teeth, and whether any are worth keeping. Your bite, and what the opposing arch is doing. And whether you grind, which affects the material choice and the long-term plan.
3. The temporary bridge: understanding what you leave with
This is the most important thing to understand before you commit.
What happens on trip one. Teeth are extracted where needed, four implants are placed, and a fixed temporary bridge is fitted — frequently the same day or the following day. You leave with fixed teeth. You are never without.
Why it is temporary. Because the implants have not yet integrated. The temporary is designed to look good, function adequately, and — importantly — to be lighter and more forgiving than a definitive bridge while the bone is bonding to the implants. It is usually acrylic, and it is not intended to last.
What the definitive bridge is. Made on trip two, three to six months later, once integration is confirmed. It is a different object: stronger materials, better fit, refined aesthetics, and made to last. Depending on your plan: acrylic on a metal framework, zirconia, or ceramic on a titanium framework. Section 11 covers the choice.
Why this matters when comparing clinics. A clinic offering « permanent teeth in one week » is either describing the temporary as permanent, or not describing osseointegration accurately. Ask directly: « Le bridge posé lors du premier séjour est-il provisoire ou définitif ? » A clear answer — temporary, with the definitive made at the second trip — is what you want.
Living with the temporary. Most patients find it entirely acceptable. It looks good, it is fixed, and it functions. Two practical points: it is more fragile than the definitive bridge, so avoid very hard foods during the integration period; and if it fractures or a tooth chips, it is repairable — contact us, and we can usually advise a local dentist on the repair.
4. All-on-4 or All-on-6? The honest comparison
| All-on-4 | All-on-6 | |
|---|---|---|
| Implants | Four | Six |
| Bone required | Less — angulation works around limits | More |
| Grafting | Frequently avoided | More often needed |
| Cost | Lower | Higher |
| Load distribution | Good | Better |
| If one implant fails | More consequential | More resilient |
| Suits | Most patients | Softer bone, bruxism, heavy opposing forces |
When four is right. For the majority of patients, and the technique is well documented. Where bone is limited at the back, the angulation is precisely what makes treatment possible without grafting.
When six is worth the difference. Softer bone, where more implants spread the load. Significant bruxism, where forces are higher. A natural opposing arch, which delivers considerably more force than a denture or another bridge. And where you want more resilience: with six implants, losing one is manageable; with four, it is more consequential — potentially requiring the bridge to be remade or another implant placed.
How we decide. From your CBCT, your bite, and whether you grind. Your plan states which we recommend and why, and where both are reasonable, we set out the trade-off and the choice is yours. Our All-on-6 page covers that option in full.
5. The CBCT scan
What it establishes. Bone height, width and density across the arch — which determines whether four implants can be placed, and at what angles. The position of the nerve in the lower jaw, and the sinus in the upper. Whether the angulation will work without grafting, which is the central question in All-on-4 planning. And where the implants should go to support a bridge in the right position.
Why a panoramic X-ray is not enough. It cannot show bone width or density, and All-on-4 depends entirely on both. Ask any clinic: « Un scanner 3D est-il réalisé, et la planification se fait-elle dessus ? »
Get it in Canada if you can. Send us the DICOM files — the raw scan data — and your plan and quote will be accurate before you travel. For a full-arch case this matters more than for a single implant, because the difference between « four implants, no grafting » and « grafting required » is substantial in both timeline and cost. This is the most useful thing you can do at the enquiry stage. Where grafting is anticipated, our dental bone grafting and sinus lift pages explain what that adds.
6. Why Canadian patients choose Tunisia
| Canada (private) | Tunisia — Aylan Clinic | |
|---|---|---|
| Cost | Very high for full-arch work | Up to 60% less |
| Insurance | Annual maximum exhausted immediately | Same limitation, but far lower total |
| Language | English or French | French throughout the country |
| Dentist training | Canadian | Frequently French-trained |
| Laboratory | External | In-house, technician on site |
| Accommodation | Not applicable | Included, full board |
| Companion | Not applicable | Free, accommodated and fed |
Why the absolute saving is largest here. Because full-arch treatment involves a large number of components, and a percentage saving on a full arch is substantial in dollar terms. And because Canadian annual insurance maximums make full-arch work difficult to fund — a patient needing both arches is frequently looking at treatment staged across several benefit years.
Where the in-house laboratory matters. Your definitive bridge is made on site, with the technician available. For a full arch that is significant: the try-in is where you see twelve teeth on your own face, and having the technician in the room while you assess it is worth more than any written instruction.
Where the language matters on this treatment. The try-in appointment. This is where you look at a full arch of teeth — shape, shade, how much shows when you smile, how full your lip looks — and say what you want changed. That is a conversation about your own face, and it involves vocabulary most people do not use daily. Patients consistently tell us they said more, and more precisely, in their own language. On a full arch, that directly affects the result.
Dentist training. A substantial proportion of Tunisian dentists and oral surgeons trained in France. Ask where yours qualified. We answer directly.
Part two — preparing
7. From first contact to confirmed dates
The online consultation. Send a recent panoramic X-ray — and DICOM files if you have a CBCT. What to send: the panoramic radiograph, any CBCT, photographs of your smile, your teeth apart, and your face from the front and side, a note of which teeth remain and their condition, your medical history and all medications, whether you grind, and whether you smoke. If you wear a denture, photograph it — and bring it with you. In French or in English, whichever you prefer.
What you receive. A plan naming whether four or six implants, whether the temporary is immediate, the number of trips, the intervals, the material for your definitive bridge, and the cost of the whole course. Within 24 to 48 hours.
Questions worth asking before you commit.
- « Un scanner 3D est-il réalisé, et la planification se fait-elle dessus ? »
- « Le bridge du premier séjour est-il provisoire ou définitif ? » — the answer should be temporary. Section 3.
- « Quatre ou six implants, et pourquoi ? » — the reasoning should reference your bone, your bite and whether you grind.
- « Quel matériau pour le bridge définitif ? » — section 11.
- « Une greffe est-elle anticipée ? »
- « Recevrai-je un passeport implantaire ? »
- « Comment nettoie-t-on sous le bridge, et me le montrerez-vous ? » — section 15, and a clinic that treats this seriously is thinking about year ten.
- « Combien de voyages, et à quels intervalles ? »
- « Où votre praticien a-t-il été formé ? »
What to arrange at home before you travel. Stop smoking: it is the largest modifiable risk factor for implant failure, and on a full arch the consequences of failure are correspondingly larger. Four weeks before and eight weeks after, and ideally permanently — Canadian provincial quitlines are free. Get your CBCT in Canada if you can, see section 5. Arrange your Canadian dentist for maintenance, see section 16: one conversation, before you travel. Bring a complete medication list, including bone medications and blood thinners. And prepare soft food for the first weeks after your return.
8. Getting ready for the first trip
What to expect physically. Extractions and implant placement in one session is a substantial appointment — two to four hours, under local anaesthesia with sedation available. Swelling and bruising are expected, peaking around day two or three, and they can be more noticeable than patients anticipate for a full arch.
What to bring. Soft, loose clothing. Lip balm — your lips will be stretched during a long appointment and they dry out. Your existing denture if you wear one. A list of your medications.
Practical preparation. Arrange soft food for the first two weeks at home, and for your stay we adapt your hotel meals. Plan not to have important commitments in the first week after you return.
Part three — the trips
9. Trip one: placement and your temporary bridge
Typically six to eight days.
Day 1 — Arrival. Your driver meets you at the airport and takes you to your hotel with your companion. Nothing clinical today.
Day 2 — Assessment and planning. Clinical examination, periodontal assessment, photographs, and CBCT if you have not brought one. Then your consultation: the plan on screen, with your scan in front of you — four implants or six, where they will go, the angulation, whether any grafting is needed, and what your temporary will look like. Shade and tooth shape are discussed, and if you have photographs of yourself smiling before you lost teeth, bring them. They are genuinely useful. By the end of the day your plan is confirmed.
Day 3 — Surgery. Extractions where needed, then four implants placed — two vertical at the front, two angled at the back. Two to four hours under local anaesthesia, with sedation available. Impressions or a digital scan are taken for your temporary.
Day 4 — Your temporary bridge. Your fixed temporary is fitted. This is the day patients remember. For someone who has worn a loose denture or lived with failing teeth, seeing a full arch of fixed teeth is a significant moment. The bite is checked and adjusted.
Days 5 to 7 — Review and adjustment. Review appointments, because a new bridge on fresh implants needs the bite refined once you have used it for a day or two. Swelling peaks around day two or three after surgery: ice, and your medication on schedule. Soft food — section 12.
Day 8 — Final check and departure. Final review, cleaning instruction for your temporary, and your documentation: treatment report, your CBCT, implant passport, and written aftercare in French or English. Then your transfer to the airport.
The interval. Three to six months, during which the implants integrate and you wear your temporary. Your plan states the interval, and it is a minimum rather than an appointment.
10. Trip two: your definitive bridge
Typically six to eight days, three to six months later.
Day 1 — Arrival. Transfer to your hotel. Nothing clinical today.
Day 2 — Assessment. A radiograph confirming integration. The temporary is removed, the implants are checked, and impressions or a digital scan are taken for your definitive bridge.
Days 3 to 5 — Fabrication and try-in. Your bridge is made in the on-site laboratory. The try-in is the appointment that determines your result. You see the bridge — frequently in wax or as a trial — before it is finalised: tooth shape, shade, how much shows when you smile, how full your lip looks, whether the teeth look too even or too white. Say what you want changed. Everything is adjustable now. Take your time. Look at yourself in natural light. Speak. Smile. Photograph yourself, and look at the photographs rather than only the mirror.
Day 6 — Fitting. Your definitive bridge is fitted and screwed onto the implants. The bite is checked and adjusted carefully.
Days 7 to 8 — Adjustment and departure. An adjustment appointment, because a new bite takes a day or two of use for high spots to become apparent. Hands-on cleaning instruction — section 15, and this is taught rather than described. Final documentation: treatment report, updated implant passport, written care guidance in French or English, and guidance for your Canadian dentist. Then your transfer to the airport.
11. Choosing your definitive bridge material
Acrylic on a metal framework. Teeth set in acrylic on a rigid metal substructure. Advantages: the most economical, lighter on the implants, and repairable — an individual tooth can be replaced without remaking the bridge. Considerations: the acrylic wears over years and the teeth eventually need replacing, typically after five to ten years. This is expected rather than a failure.
Zirconia. A solid milled zirconia bridge. Advantages: very strong, does not wear in the same way, and excellent aesthetics with modern layering techniques. Considerations: more expensive, rigid — which transmits more force to the implants — and where a fracture occurs, the whole bridge is generally remade rather than repaired.
Ceramic on a titanium framework. A titanium substructure with ceramic teeth. Advantages: combines strength with good aesthetics, and individual segments can sometimes be repaired. Considerations: cost sits between the other two.
How we choose. From your bite, whether you grind, and what the opposing arch is. A patient with a natural opposing arch and significant bruxism is a different proposition from a patient with a denture opposing. Your plan states the recommendation and the reasoning. Ask: « Quel matériau recommandez-vous, et pourquoi celui-là dans mon cas ? »
12. Eating: the progression
After trip one. Liquids and very soft food for the first week — nothing requiring chewing on the new bridge. Soft food for the following weeks, per your plan. And for the whole integration period — three to six months — avoid hard and crunchy foods. The temporary is more fragile than your definitive bridge, and more importantly, heavy loading during integration is what you are avoiding.
After trip two. Progressive return to normal food, guided by your dentist. Most patients eat normally within weeks, and describe the difference from a denture as the thing they most notice.
Permanently. Sensible limits remain: very hard items, nothing used as a tool, and caution with things like ice and hard nuts. A bridge on four implants is strong. It is not indestructible.
Part four — the years that follow
13. Your night guard
Where you grind, a night guard is part of the plan rather than an accessory.
Why. Bruxism transmits substantial force to the implants and the bridge. It is the most common cause of bridge fracture and of screw loosening.
What it does. Protects your investment, straightforwardly. Patients who understand this at the outset wear the guard. Patients handed one at the end frequently do not. It is made at your second trip and included where indicated.
14. Your implant passport
What you receive. A record of the implant brand, model, dimensions and lot number, for each implant, plus the positions and angulations.
Why it matters on a full arch more than anywhere. Because a full-arch bridge is entirely dependent on compatible components. A screw, an abutment or a replacement bridge in ten years must fit the system that was placed. Implant systems are not interchangeable, and for a full arch, a component you cannot obtain means a problem you cannot solve without replacing everything.
What to do with it. Keep the original. Photograph it. Give a copy to your Canadian dentist.
15. Cleaning under a fixed bridge
This is the section that determines whether your implants last twenty years, and it is a skill.
Why it is different. Your bridge does not come out, which means you cannot clean underneath it the way you would a denture. And there is a space beneath it, between the bridge and your gum, where plaque accumulates. That space is where peri-implantitis starts.
What is required. Superfloss or a floss threader, passed underneath the bridge and drawn along its length, daily. A water flosser, which most patients find is what makes this practical rather than tedious — for a full-arch bridge it is close to essential, and it is the single most useful thing you can buy. Interdental brushes around the implant sites. And brushing the bridge itself, twice daily.
Learning it properly. Ask for a hands-on demonstration before you leave, with your own bridge, rather than a printed sheet. Do it in front of your dentist and have them check. A technique that feels right and is wrong achieves nothing. This is taught at your second trip and it is part of your treatment.
Why patients underestimate it. Because the bridge feels like teeth. It does not decay, it does not hurt, and nothing signals that plaque is accumulating underneath. The first sign is frequently bone loss on a radiograph years later, which is why section 16 matters.
16. Your Canadian follow-up
What is required. A check-up and professional cleaning every six months, and radiographs periodically to monitor bone levels around each implant. And your bridge removed and cleaned professionally, typically annually — which your dentist does at an appointment.
Who provides it. Your Canadian dentist. This is routine maintenance work, and they are not being asked to take over the case.
How to arrange it. Before you travel, and the conversation is simple: « J’aurai un bridge complet sur implants posé à l’étranger. Je reviendrai avec un compte rendu, un passeport implantaire et des radiographies. Pourriez-vous assurer l’entretien habituel et un contrôle radiographique périodique ? » Most dentists say yes without hesitation.
Why this matters more on a full arch. Because the consequences of neglect are larger. Losing bone around a single implant is a problem. Losing it around the implants supporting a full arch is a considerably bigger one. Arranging maintenance takes one conversation. It is the difference between a bridge that lasts decades and one that causes trouble at year eight.
Canadian insurance. Full-arch implant work exhausts any annual maximum immediately. Ask your insurer in writing whether they reimburse treatment received outside Canada and at what rate, request pre-determination if available, and ask how they date a claim — where your treatment spans two calendar years, two annual maximums may be available. We provide itemised invoicing, in French or English.
Part five — practical matters
17. Canadian patients: travelling to Tunisia from your region
Aylan Clinic works with patients from every province and territory in Canada. Wherever you live, the process begins the same way: a free consultation from your panoramic X-ray, in French or English.
Montreal and the surrounding region. Montreal is our largest Canadian source for Tunisia. Connections from Trudeau to Tunis typically route through Paris, Frankfurt or Istanbul. Patients from Laval, Longueuil and Brossard are all within easy reach of the airport. For a two-trip course, the frequency of departures makes scheduling straightforward.
Quebec City and across the province. From Quebec City and the Capitale-Nationale region including Lévis, most patients connect through Montreal — as do patients from Trois-Rivières, Sherbrooke, Drummondville and Saint-Jérôme, all within driving distance of Trudeau. Gatineau patients depart from Ottawa or drive to Montreal. From Saguenay, a domestic connection through Montreal is the norm. On this treatment the francophone advantage matters at the try-in — where you look at a full arch of teeth on your own face and say what you want changed. That is a conversation about your appearance, using vocabulary most people do not use daily, and patients consistently tell us they said more, and more precisely, in their own language.
Acadia and New Brunswick. We work with patients from Moncton, Fredericton and Saint John. Moncton and the surrounding Acadian communities are served in French throughout. Most connect through Montreal.
Francophone Ontario. Sudbury, Thunder Bay and Sault Ste. Marie all have substantial francophone populations, served in French from first contact onward. Ottawa patients typically connect through Montreal.
Greater Toronto Area and southern Ontario. Toronto patients connect through European hubs, with Paris and Frankfurt the most common routes to Tunis. Across the wider Greater Toronto Area we work with patients from Mississauga, Brampton, Markham, Vaughan, Richmond Hill and Oshawa. Along the lake: Hamilton, Burlington, Oakville, St. Catharines and Niagara Falls. In southwestern Ontario: London, the Waterloo region — Kitchener, Waterloo and Cambridge — plus Guelph, Windsor and Barrie. Kingston patients generally drive to Toronto or Montreal.
Vancouver and British Columbia. Vancouver patients face the longest journey — typically two connections. We schedule assessment for the day after arrival. Across the Lower Mainland: Surrey, Burnaby and Richmond. From Victoria and Nanaimo, patients cross by ferry or short flight. Kelowna, Abbotsford and Kamloops patients connect through Vancouver or Calgary. Because the journey is long, we plan British Columbia courses to accomplish as much as possible per trip.
Alberta. Calgary and Edmonton both offer European connections onward to Tunis. Red Deer and Lethbridge patients generally drive to Calgary.
Manitoba and Saskatchewan. Winnipeg patients connect through Toronto or Montreal. The francophone community of Saint-Boniface is served in French. From Saskatoon and Regina, journeys involve a domestic connection followed by two further flights.
Atlantic Canada. Halifax patients typically route through Montreal or Toronto. From Charlottetown and St. John’s, journeys involve two or three connections.
Northern Canada. We work with patients from Whitehorse in Yukon, and from communities across the Northwest Territories and Nunavut. For northern patients, full-arch treatment ordinarily means several journeys to a southern centre; two well-planned trips compares favourably. We discuss your Canadian maintenance access early, since section 16 matters as much as the surgery on a full arch, and we plan northern itineraries with buffer days at both ends.
How we handle the logistics. Whichever city you are travelling from, your coordinator arranges airport transfers at both ends in Tunisia, confirms your hotel before you depart, and builds your schedule around your arrival time.
Four recommendations. Send your panoramic X-ray — and a CBCT if you can get one in Canada. Bring photographs of yourself smiling before you lost teeth. Arrange your Canadian dentist before you travel. And buy a water flosser — section 15.
18. What your package includes
- Free consultation in French or English, with a plan and quote for the whole course
- Full on-site assessment: clinical examination, periodontal assessment, photographs
- CBCT scan and three-dimensional planning
- Extractions where needed
- Four implants placed, with posterior angulation
- Bone grafting where planned
- A fixed temporary bridge during your first trip — you are never without teeth
- Review and bite adjustment appointments during each stay
- Definitive bridge made in our on-site laboratory
- Try-in before the bridge is finalised, with the technician available
- Shade and tooth shape selection
- Bite adjustment appointments after fitting
- Night guard where indicated
- Hands-on cleaning instruction specific to your bridge
- Written care guidance in French or English
- Treatment report, your CBCT, and an implant passport recording brand, model, dimensions and positions
- Guidance for your Canadian dentist
- Itemised invoicing
- Hotel accommodation, full board, for each trip, with meals adapted to your dietary stage
- A companion at no extra cost, accommodated and fed in the same room
- Airport–clinic–hotel transfers
- A personal coordinator from arrival to departure
- French-speaking care throughout, with English available on request
The clinical team. Oral surgeon or implantologist — placement and angulation, frequently French-trained. Prosthodontist — bridge design, bite and try-in. Periodontist — gum treatment where needed. Dental radiologist — CBCT interpretation. Master ceramist, on site — shade and aesthetics. And an in-house laboratory — fabrication, try-in and same-visit adjustments.
19. Results by patient profile
A failing upper arch. A patient in his sixties whose upper teeth had been breaking and needing treatment for years, with a new problem every few months. Extractions, four implants with posterior angulation, and a fixed temporary the following day. His definitive zirconia bridge was fitted five months later. He describes the end of the cycle of emergencies as the change that mattered, ahead of the appearance.
A lower denture that would not stay in. A patient who had worn a lower denture for nine years and could no longer keep it in place. All-on-4 in the lower arch. She describes eating in a restaurant without thinking about it as what she had missed most. For a lower arch, the difference from a denture is the largest change this treatment delivers.
Where the CBCT allowed treatment without grafting. A patient told in Canada that he would need bilateral sinus lifts before any upper implants. His CBCT showed that posterior angulation would work with the bone available: All-on-4 without grafting, which removed a year from his timeline and a substantial amount from his cost. This is precisely what the angulation is for.
Where we recommended All-on-6. A patient with soft bone, marked bruxism and a natural lower arch opposing. Six implants rather than four, with a night guard from the outset. More expensive, and the right recommendation for the forces her bite delivers.
Where we recommended against All-on-4. A patient with six sound upper teeth and six failing ones, enquiring about All-on-4. We explained that it would mean removing the sound teeth. Her plan instead combined implants, crowns and a bridge, preserving what was healthy. We will not remove sound teeth to fit a treatment plan, and this happens often enough to mention.
A patient who brought old photographs. A patient who brought a photograph of himself smiling from twenty years earlier. The ceramist set the teeth to match the shape and slight irregularity in the photograph rather than to a standard arrangement. His family said he looked like himself again — which is the objective, and which a shade guide alone cannot achieve.
A patient from Trois-Rivières. A patient who chose Tunisia so that the try-in could happen in French. Her comment was about that appointment specifically: she said she asked for the front teeth to be slightly less even, and for one canine to be a touch more prominent — requests she would not have known how to phrase through an interpreter.
20. Practical points to know
What to expect. A long appointment on surgery day — two to four hours — with swelling and bruising peaking at day two or three. Fixed temporary teeth from the first trip: you are never without. Three to six months of integration, on soft food and avoiding hard items. A definitive bridge at trip two, with a try-in before it is finalised. And cleaning that is a genuine skill — section 15.
Recognised points. All-on-4 is a well-documented technique with good published survival rates in appropriately selected, well-maintained patients. Your surgeon will discuss the considerations relevant to you. The main ones: failure of an implant to integrate, uncommon, and more consequential on four implants than on six — it may require another implant or remaking the bridge. Infection, uncommon and treated promptly. Peri-implantitis over the years — the main late consideration, and largely preventable with the cleaning and maintenance in sections 15 and 16. Screw loosening, straightforward to correct at a maintenance appointment. Fracture of the temporary bridge, repairable. Fracture or wear of the definitive bridge, depending on material and whether you grind. Nerve or sinus considerations, which the CBCT is performed to avoid. And speech adjustment in the first weeks, which settles.
Three things within your control. Stopping smoking — the largest modifiable factor. Cleaning under the bridge properly — and buying a water flosser. And attending six-monthly maintenance in Canada.
Who this suits. Adults with a failing or absent arch, adequate bone or the willingness to have it created, and the intention to maintain the bridge.
Pregnancy. Elective implant treatment is deferred.
21. Price: how it is built and how to compare it
Why we quote per case. Because whether four or six implants, whether grafting is needed, the bridge material, and the number of trips all vary. Your quote is built from your radiograph — and your CBCT where you send one — itemised, and fixed once you approve it.
What determines your price. Six factors: four implants or six; whether grafting is needed, which the CBCT establishes and which posterior angulation frequently avoids; how many extractions; the implant brand, named in your plan; the definitive bridge material, section 11, and the largest single variable after the implants; and the number and length of your trips.
What is included in your quote. Everything in section 18, including the CBCT and planning, extractions, four implants with angulation, any grafting, the fixed temporary bridge, all review and adjustment appointments, the definitive bridge made in our laboratory with a try-in, night guard where indicated, cleaning instruction, treatment report, CBCT and implant passport, guidance for your Canadian dentist, itemised invoicing, hotel with full board for each trip, transfers, and your coordinator. A companion is accommodated and fed at no additional cost, on every trip.
What sits outside it. Flights for each trip, travel insurance, your six-monthly maintenance in Canada, a water flosser and cleaning aids, and eventual replacement of an acrylic bridge after five to ten years where that is your material.
How to compare quotes properly. Five checks, and full-arch quotes vary enormously.
- Is the definitive bridge included, or only the temporary? The single largest source of confusion — a very low quote frequently covers implants and a temporary only.
- Which bridge material? Acrylic on metal, zirconia and ceramic on titanium sit at materially different prices, and a quote that does not say is not comparable.
- Is a CBCT included, and is grafting anticipated?
- Is the implant brand named? On a full arch this matters more than anywhere — components must be obtainable in ten years.
- How many trips, and is the second trip included?
Why the lowest quote is rarely the best value. On All-on-4, the savings available are identifiable: no CBCT, an unnamed implant system, the definitive bridge quoted separately, and the cheapest material without discussing your bite. The implant system matters most. A full-arch bridge depends entirely on compatible components. A system whose parts you cannot obtain in ten years is not a saving — it is a bridge that cannot be maintained.
Canadian insurance. Full-arch work exhausts any annual maximum immediately. Ask your insurer in writing about treatment abroad and the reimbursement rate, request pre-determination, and ask how they date a claim — spanning two calendar years may give you two maximums. Our itemised invoicing supports the claim, in French or English.
Payment. A deposit confirms the dates for each trip. The balance for each is settled on site, under terms set out in full when you approve your plan. There are no additional charges once accepted — and where the CBCT changes the plan, we discuss it with you before proceeding.
Getting your figure. Send a recent panoramic X-ray — and DICOM files if you have a CBCT. Add photographs of your smile and face, which teeth remain and their condition, your medical history and medications, whether you grind, and whether you smoke. If you wear a denture, photograph it. You will receive a plan and quote within 24 to 48 hours, in French or English. You can start with a free, personalized quote.
22. Glossary
- All-on-4 — a full arch of fixed teeth supported on four implants
- Posterior angulation — angling the back implants to use available bone and avoid grafting
- Temporary bridge — the fixed bridge fitted at the first trip, during integration
- Definitive bridge — the final bridge, made at the second trip
- Osseointegration — bone bonding to the implant; three to six months
- CBCT — three-dimensional scan showing bone height, width, density and nerve position
- Peri-implantitis — inflammation with bone loss around an implant
- Superfloss — floss with a stiff threader, used to clean under a fixed bridge
- Implant passport — record of brand, model, dimensions and positions
- Night guard — appliance protecting the bridge from grinding forces
23. How Canadians search for this
- « All-on-4 Tunisia cost » — the most common search. Ask whether the definitive bridge is included.
- « All-on-4 Tunisie » — how most Quebec patients search, and the reason this page exists in both languages.
- « Teeth in a day » — the teeth fitted on day one are temporary, and a clinic describing them as permanent is not describing the treatment accurately.
- « All-on-4 vs All-on-6 » — six for softer bone, bruxism or a natural opposing arch. Section 4 compares them honestly.
- « Full mouth dental implants cost Canada » — very high, and annual insurance maximums make it difficult to fund.
- « Do I need bone graft for All-on-4 » — the angulation frequently avoids it. A CBCT answers it.
- « All-on-4 bridge material » — acrylic on metal, zirconia, or ceramic on titanium. Materially different prices and different characteristics.
- « How to clean under All-on-4 » — superfloss and a water flosser, daily. It is a skill, and it determines whether the implants last.
- « All-on-4 problems years later » — peri-implantitis and screw loosening are the main ones, and both are addressed by maintenance.
- « All-on-4 temporary bridge » — fixed, acrylic, and not intended to last. Avoid hard food during integration.
- « Will I have teeth immediately » — yes, fixed temporary teeth from the first trip.
- « French speaking dentist abroad » — Tunisia’s distinguishing feature.
In summary
All-on-4 at Aylan Clinic Tunisia combines CBCT planning, four implants with posterior angulation that frequently avoids grafting, a fixed temporary bridge from your first trip so you are never without teeth, a definitive bridge made in our on-site laboratory with a try-in before it is finalised, and an implant passport you keep permanently. And it takes place in a French-speaking country, which matters most at the try-in — where you look at a full arch of teeth on your own face and say what you want changed. With accommodation, full board and a companion at no extra cost on every trip, for up to 60% less than Canadian private prices.
Five things worth holding onto.
- The teeth you leave with on trip one are temporary — by design. A clinic describing them as permanent is not describing osseointegration accurately.
- Get a CBCT, ideally in Canada, and send the DICOM files. On a full arch, the difference between no grafting and grafting required is substantial.
- Ask which bridge material, and why. It is the largest variable after the implants, and it should follow from your bite.
- Learn to clean underneath. Superfloss and a water flosser, daily — and ask for a hands-on demonstration before you leave.
- Arrange your six-monthly maintenance in Canada before you travel. On a full arch, the consequences of neglect are larger than anywhere.
Send your panoramic X-ray and you will have a plan within 24 to 48 hours — in French or in English. To go further, read the procedure page for All On 4 Dental Implant in Tunisia, compare plastic surgery prices in Tunisia, explore the full dental care in Tunisia overview, or request a free, personalized quote.