All-on-4 and All-on-6 Implant Methods: A Modern Solution for Tooth Loss

Many patients who have lost their teeth or use removable dentures face serious issues both in daily life and self-confidence. Dentures moving while eating, feeling insecure while speaking, aesthetic concerns… All these problems actually arise from the absence of fixed and functional teeth.

In traditional implant treatments, each missing tooth may require a separate implant. Additionally, for patients with bone loss, additional surgeries such as bone grafting or sinus lifting may be needed, which prolong the process. At this point, All-on-4 and All-on-6 implant methods provide a revolutionary solution.

What Are All-on-4 and All-on-6 Implants?

All-on-4 and All-on-6 systems are modern implant methods that allow fixed prostheses to be placed on completely edentulous jaws.

All-on-4 Implant System:

This system involves placing 4 implants in the jaw, on which fixed prosthetic teeth are attached. Two implants are placed in the front at a straight angle, while the other two are placed in the back at a special angle (usually 30–45°). This allows the prosthesis to be fixed over a wide area even if bone support is limited.

All-on-6 Implant System:

This system involves placing 6 implants in the jaw. The additional two implants provide a more balanced and stable support for the prosthesis. It is especially suitable for patients who require high chewing force or seek stronger support in the long term.

These methods make it possible to achieve fixed teeth in a single session.

Advantages: Why Choose Them?

Based on my 30 years of clinical experience, the main advantages of All-on-4 and All-on-6 methods are:

1. Quick Results – Teeth on the Same Day
   Patients can receive their temporary fixed teeth immediately after implants are placed. There is no need to wait for months.
2. Less Surgical Intervention
   In most cases, bone grafting is not required. This reduces both cost and recovery time.
3. Natural and Aesthetic Appearance
   Prostheses are designed considering the facial shape and lip support, giving patients a youthful and natural smile.
4. Comfortable Use
   Problems like movement, oral sores, and discomfort while eating, which occur with removable dentures, are completely eliminated.
5. Durable and Reliable
   Scientific studies show that the success rate of All-on-4 and All-on-6 treatments is over 95%.

All-on-4 / All-on-6 Implant Procedure in Istanbul

1. Detailed Examination and Digital Planning

In the first step, the patient’s general health and oral structure are thoroughly examined.

• 3D dental tomography and digital oral scans are used to assess jawbone density, sinus cavities, and bone thickness with millimeter precision.
• Based on this data, implant placement points are digitally planned.
• The most suitable method (All-on-4 or All-on-6) is decided at this stage.
• Smile design is also included in the planning for aesthetic purposes.

This stage is critical and directly affects the success of the treatment.

2. Surgical Procedure

Once planning is complete, the surgical date is scheduled.

• The operation is performed under local anesthesia or sedation depending on the patient’s preference.
• Implants are placed in the jaw at the angles determined in the digital plan.
• A total of 4 implants are used in All-on-4, and 6 implants in All-on-6.
• The procedure usually takes 1–2 hours.

In most cases, additional bone grafting is not required.

3. Temporary Fixed Teeth

Temporary fixed prostheses are attached immediately after the operation.

• These prostheses look natural and allow the patient to adapt to daily life immediately.
• Basic functions like eating, speaking, and smiling can be comfortably performed even the day after the procedure.
• Temporary prostheses also help implants integrate properly with the jawbone during the healing process.

Thus, the patient never goes without teeth.

4. Permanent Prostheses

About 3–4 months are allowed for the implants to fuse with the jawbone (osseointegration).

• After this period, the patient’s mouth is measured again, and custom permanent prostheses are prepared.
• Permanent prostheses provide the highest quality in terms of durability and aesthetics.
• The patient’s chewing strength will be very close to natural teeth.

At this stage, the aesthetic design is finalized; the smile line, tooth color, and size are adjusted to fit the patient’s facial structure.

5. Recovery and Follow-Up

• Mild swelling and sensitivity are normal for a few days after the operation. This is easily managed with medication.
• The patient is called for regular check-ups to monitor implant integration with the bone.
• Oral hygiene education is provided, and maintenance tips for long-lasting prostheses are shared.

Comparison of All-on-4 and All-on-6 Implant Methods

1. Number of Implants and Durability

• All-on-4: Only 4 implants are placed in the jaw. Two in the front and two in the back at special angles. Using fewer implants results in a shorter procedure and generally lower cost.
• All-on-6: 6 implants are placed in the jaw. The additional two implants make the prosthesis stronger and more balanced. This is advantageous for patients with high chewing forces in the long term.

If the patient’s jawbone structure is sufficient, All-on-6 is safer for long-term use. However, All-on-4 can be preferred if bone density is low or cost is a concern.

2. Surgical Procedure and Healing Time

• All-on-4: Less implants mean a shorter surgical procedure. Patients usually receive temporary fixed teeth the same day. Recovery is also faster.
• All-on-6: Requires a slightly longer surgery. However, the additional implants distribute the load more evenly, reducing the risk of implant loss in the long term.

For patients with systemic conditions (e.g., diabetes, hypertension) where a shorter surgery is preferred, All-on-4 is more suitable.

3. Functional Use (Chewing and Speaking)

• All-on-4: Provides sufficient chewing and aesthetic results for daily use. However, for patients consuming very hard foods or with high jaw strength, implants may be overloaded in the long term.
• All-on-6: More support points make the prosthesis more balanced. Chewing feels closer to natural teeth.

Especially for male patients or those with high chewing force, All-on-6 offers a longer-lasting solution.

4. Cost and Economic Aspect

• All-on-4: Using fewer implants makes it more affordable than All-on-6. If no additional surgery is needed, it is economically advantageous.
• All-on-6: More implants mean slightly higher costs. However, the durability it provides can save costs in the long term.

For patients with limited budgets, All-on-4 is recommended; for those prioritizing “quality/longevity,” All-on-6 is suggested.

5. Patient Profile for Selection

All-on-4:

• Patients with low jawbone density,
• Those requiring a shorter operation time,
• Patients seeking a more economical solution.

All-on-6:

• Patients with sufficient jawbone volume and density,
• Those with high chewing force, younger or middle-aged patients,
• Patients seeking a stronger prosthesis for long-term use.

Frequently Asked Questions

1. Is the procedure painful?
   No. Local anesthesia is applied during the procedure. Mild swelling or sensitivity may occur for a few days afterward.
2. How long does the treatment take?
   Implants are placed and temporary prostheses are attached in the first session. Permanent prostheses are applied after 3–4 months.
3. How long do implants last?
   With proper care and regular check-ups, implants can last a lifetime.
4. Which method should I choose?
   The choice between All-on-4 and All-on-6 is determined by your jaw structure and lifestyle in consultation with your dentist.