CONUS vs. All-on-4®: What’s The Difference?

Senior Dentures

For patients who have lost all of their teeth or require the removal of the remainder of their teeth, a variety of full-mouth tooth replacement options exist.  Among these options are the All-on-4® concept and the CONUS option.  There are advantages and considerations for each that bear review and understanding before a choice is made on one over the other.

All-on-4® is a technique that involves the removal of all of the remaining teeth and the placement of 4 dental implants in each jaw.  If the implants are able to be inserted tightly into the bone, the possibility of placing and securing a nice temporary set of teeth onto the implants exists.  In these instances, the patient can leave the office having received “Teeth-In-A-Day”®. Approximately 3-4 months later, a final definitive set of teeth is made to replace the temporary set of teeth.  While this can frequently be accomplished, often the implants cannot be placed tightly enough, or even at all, if bone is deficient or soft in one or more areas of the jaw.  In this case, the patient receives conventional dentures to use until implants are ready for teeth to be added to them.  The advantages of this technique also mirror its disadvantages.  The teeth are fixed to the implants and cannot be removed by the patient.  Typically, the patient sees their dentist 2-4 times per year and the dentist removes the prosthetic set of teeth and cleans them.  As the teeth are secured in the mouth, it is difficult, if not impossible, for the patient to clean effectively under the prosthetic set of teeth and around the implants.  As many of these patients lost their natural teeth due to bone loss (periodontal disease) and remain susceptible to it, the difficulty for them cleaning around the implants can lead to similar bone loss and implant failure.

By contrast, CONUS is a technique that involves the removal of all of the remaining teeth and the placement of the same number of implants per arch (4).  In this technique, however, the implants are not “loaded” immediately (ie, no non-removable prosthetic teeth are placed at that time), but the patient does leave with their smile intact with a nice set of custom temporary dentures.  8-12 weeks later the doctor checks to see if the implants are ready for the final prosthetic teeth, and if so, the patient is referred to their dentist to fabricate them.  The other difference from “All-on-4”® is that while these teeth fit tightly to the implants and are designed to be worn 24/7, they can be removed by the patient and cleaned periodically.  Thus, patients have all the advantages of teeth that “stay in” as well as the advantages of being able to clean them frequently and more easily on their own between dental visits.


Both of these techniques have their places, and we provide both of them based on the needs and desires of that particular patient, but more and more, CONUS is being selected as the preferred option by our patients.  If you have a need for replacement of your teeth, please feel free to contact either Dr. Nail or Dombrowski for an office visit to review your tooth replacement options.