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General Dentistry

Dr. Sarkis Nalbandian

Registered Specialist, Prosthodontist & Implant Surgeon In Sydney


Specialist Services

Dr. Sarkis Nalbandian

Registered Specialist, Prosthodontist & Implant Surgeon In Sydney


Children Dentistry

Dr. Sarkis Nalbandian

Registered Specialist, Prosthodontist & Implant Surgeon In Sydney


Specialist Prosthodontist & Implant Surgeon

Dr. Sarkis Nalbandian

Registered Specialist, Prosthodontist & Implant Surgeon In Sydney

Finally, you just want to smile with confidence and get rid of you lose denture

Finally, you just want to smile with confidence and get rid of you lose denture

Dr Immediate post op fixed teeth!

Dr Nalbandian was one of the first few clinicians in Aaustralia to treat patients with all on 4 procedure. The video you will see is made in 2002 for a 86 yr old patient Margaret.

When Dr Nalbandian was doing these procedure, you may find that those dentists advertising on the radio the all-on 4 procedures and claiming this as a new treatment concept, were not even dentists at that point in time. Experience and knpwledge is everyhting .

Patients who arrive in my surgery are sometimes in a terminal dentate state and are usually in a desparete situation for a solution. I find itextremely important to finding the best possible solution each individual patient. Making decision to remove teeth that are irerversible are not taken lightly by Dr Nalbandian.

Visit our clinic and get the right perspective of your dental needs

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Who can benefit from an All-On-4? Remember Age is no barrier

  • Multiple Missing teeth
  • Terminal dentition: multiple loose and broken teeth.
  • Teeth affected by Periodontal disease/gum infection
  • Loose dentures, unable to function: chew food comfortably

Would my medical condition prevent me from having All-On-4?

Implant placement is similar to minor oral surgery. Medical conditions can affect the healing of soft tissues and implants with bone. Once we know you medical condition, the treatment will be modified accordingly to tailor specifically to your needs.  It is extremely rare for Dr Nalbandian to refuse patients for implant placement.

Therefore, it is essential to tell us your full medical history. Some examples of these medical conditions include but are not confined to;

  • Uncontrolled high blood pressure
  • Uncontrolled diabetes
  • V bisphosphonates
  • recent heart attack or cardiac surgery – usually 6 months, consultation with the cardiologist is required
  • Recent INR (clotting ratio) > 3.5

Please remember, our aim is to save teeth and no to remove teeth!

However, there are certain situations when few remaining teeth remaining are not conducive to comfort and function. Some patients are simply tired of having loose teeth and denture. Immediate post op fixed teeth!

So careful examination and prognosis of remaining teeth are essential.

Dr Nalbandian does not take this procedure lightly and will determine with you the best treatment plan and outcome.

We need to realise that teeth are lost for a reason. Implants are not a panacea for fixed teeth.

You may hear on radio and TV about Paulo Malo technique as if was the first person to carry out. The reality is that they were others before him. However,he improved on the technique and published useful data.

Also, you should be weary of dentists advertising this procedure in radio.

The law does not prevent a dentist to place implants.

Being a prosthodontist and implant surgeon, it takes 10 years of post-graduate training.

You should check the dentists training and post graduate qualification and make sure the training was not in a motel! As 2 days of training does not make anyone an expert.

It’s unfortunate to see patients making appointment with dentists placing advertising in the TV or a radio to find out that after 3 days following initial consultation they are booked for this all on 4 procedures!

A specialist would normally take few weeks to work out the best possible treatment plan and inform you in detail to help you through this complex treatment and adaptation period.

Maintenance protocol

Please remember that your losingteeth for a reason. Data shows that os is usually due to neglect. Implants are not teeth replacement, but replacement for missing teeth.

Implant dentistry requires constant maintenance/recare visits to our centre that is individually tailored for each patient.

You must commit to the maintenance/recare protocol specifically tailored for you, before we commit in treating you

Procedure Steps to an All- On- 4 Oral Rehabilitation

Appointment 1. Initial appointment

Oral examination, impressions, study models, radiographic records, clinical photography

Appointment 2.

Final consultation, discussion of treatment planning options and decision making All- On- 4 usually in the mandible (lower jaw) and all- on- 6 whenever possible in the maxilla (upper jaw).

Appointment 3.

Not all teeth require removal. We like to keep teeth with good gum and bone support that are healthy. We proceed with removal of hopeless teeth and implant placement. We issue All on 4 bridge same day.

Appointment 4.

Review healing and make any alterations to the bridgework that may be required.

Post op instructions: this will be individualised and tailored to your needs

All on 4 treatment options in relation to mandible (lower jaw) only & FEES


Stage Item number Cost
Examination, CBCT(CT scans taken in our centre) radiographic diagnosis, treatment plan, impressions and pre-treatment photos
011, 039/037, 022 x 4, 071, 072
Clinical & laboratory procedure for construction of lower bridgework and surgical guide to be fitted at the implant placement session.
711 or 712, 679
Removal of hopeless teeth and Implant placement and issue same day)of preliminary implant supported bridgework
688 x 4
661 x 4
311 x No. Teeth
8-12 weeks healing depending on the bone quality
Reinforcement and remodelling of the metal reinforced acrylic bridge
666 x 1
Total Fees

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Different types of All On 4.

At Designer Smiles™ we do not just replace teeth using the All on 4 bridges, but we build faces! This means that besides replacing missing teeth, gum and bone, we can improve and provide support to the face. The implants supported bridgework provides the scaffolding to the facial soft tissues and this creates youthfulness and naturally: comfort, function and aesthetics. In general, there are four options when it comes to All-ON- 4 bridges on the lower jaw. However, to simplify the treatment and costs we offer three types. Metal reinforced, Procera bar (titanium reinforced) and Zirconia based porcelain bridgework. However, on the upper arch Dr Nalbandian prefers to place six implants whenever possible for better stability, since the bone on the upper arch is generally softer. This may incur additional fees to be discussed at a time of consultation.
All above procedures were performed by Dr Sarkis Nalbandian.

1. Metal reinforced high impact acrylic

Most affordable All-On-4.  Constructed from high impact denture teeth and acrylic. Functional & aesthetics

2. Titanium reinforced hybrid lower implant supported bridgework (Procera bridgework)

This bridge is reinforced with a (CAD CAM) computer designed & milled bar. This bridgework is very comfortable, durable and strong. Following three months of initial implant integration, laboratory procedure is required. Additional fee of 8 -12,000 will incur.

3. Zirconia based porcelain bridgework

This bridge is usually requested by patients who want more tactile feel of the tooth like material. This bridgework requires additional fees of 15-20,000 and is recommend to patients with high discerning aesthetics

Implant therapy requires long term maintenance and review. Your warrantee is to have a healthy life style and attend for regular reviews and hygiene therapy.