All on 4 and All on 6 implants: what they are, when they are recommended and their advantages

All on 4 and All on 6 dental implants are advanced full-arch rehabilitation techniques that restore a complete fixed arch of teeth (upper or lower) using a small number of dental implants.

These solutions are especially suited to people who have lost most or all of their teeth and want a fixed, permanent alternative to removable dentures.

What are the All on 4 and All on 6 techniques?

All on 4 involves placing four dental implants in the upper or lower jawbone. A full-arch prosthesis replacing all the missing teeth is then fixed onto these four implants.

Two of the implants are placed straight at the front, while the other two are placed at an angle at the back, which makes it possible to avoid areas with little bone, such as the maxillary sinus or the nerves in the lower jaw.

All on 6 follows a similar approach, but in this case six implants are used to anchor the prosthesis.

The two extra implants give greater stability and are especially useful for patients with more advanced bone loss or who need extra anchorage for their prosthesis.

Both techniques allow the patient to leave surgery with a fixed temporary prosthesis the same day, restoring the function and appearance of the teeth immediately.

Differences between All On 4 and All On 6

The key difference between All on 4 and All on 6 lies in the number of implants used to support the prosthesis:

• All on 4: uses four implants, two of them angled to optimise contact with the bone and avoid problem areas. It is ideal for patients with moderate bone loss who do not want to undergo bone grafts.
• All on 6: uses six implants, which gives the prosthesis greater stability. It is recommended for patients with more severe bone loss or who want extra support for the prosthesis. The two additional implants spread the bite load better and offer greater long-term durability.

When are All on 4 and All on 6 implants recommended?

All on 4 and All on 6 implants are indicated for patients who have lost all or most of their teeth and want a fixed, permanent solution to get back their smile and their ability to chew.

These techniques offer a quick, effective option for those who do not want, or are unable, to undergo conventional implant treatment with bone grafts.

Below we look at the cases in which these techniques are most recommended.

Patients with no teeth or with removable dentures

Patients who have lost all their teeth, or who wear removable dentures and are tired of the discomfort they cause, are the main candidates for All on 4 and All on 6 implants.

Removable dentures can be uncomfortable and make you self-conscious when they move while you talk or eat. All on 4 and All on 6 implants, by contrast, offer a fixed, stable solution that never has to be taken out or constantly adjusted, improving quality of life with a permanent set of teeth that work and look good.

Patients with advanced gum disease

Patients with advanced periodontal disease who have lost a significant number of teeth or have severely damaged gums can also benefit enormously from All on 4 and All on 6 implants.

In these cases the disease has affected both the teeth and the bone, making it necessary to remove the remaining teeth and look for a fixed solution that avoids removable dentures.

This technique not only improves the appearance of the teeth but also helps stabilise the jaw and prevents further bone and functional damage.

Patients with little bone

One of the great benefits of All on 4 and All on 6 is that they are especially suited to patients with little bone available in the upper or lower jaw.

Instead of resorting to complex bone grafts, the implants are placed strategically, with the rear implants angled to avoid areas of bone deficiency, such as the maxillary sinus or the mandibular nerve.

This makes these treatments an ideal option for patients who would otherwise not be candidates for traditional implants because of bone loss.

How do we place All on 4 and All on 6 implants?

It is done quickly and efficiently, and the patient leaves the procedure with a fixed temporary prosthesis the same day.

Below we explain the process step by step and the main differences from conventional implants.

Differences from traditional implants

The main difference between All on 4 or All on 6 and conventional implants lies in the number of implants used and the treatment time.

With conventional implants, more individual implants are usually placed (generally 6 to 8 per arch) and the process takes longer, since it often requires bone grafts when the patient does not have enough bone.

Number of implants: conventional implants need more implants per arch. With All on 4 only 4 implants are used, and with All on 6 just 6, optimising contact with the available bone and avoiding areas that would need grafts.

Treatment time: with conventional implants the process can take several months, since the patient has to wait for the implants to integrate with the bone before the final prosthesis is fitted. With All on 4 and All on 6, the patient can receive a fixed temporary prosthesis on the day of surgery, significantly cutting the waiting time.

Bone grafts: conventional implants often need additional procedures such as bone grafts to increase bone volume, especially in patients with bone loss. With All on 4 and All on 6, the implants are placed strategically in areas with enough bone, which in most cases removes the need for grafts.

In short, All on 4 and All on 6 are faster, less invasive and need fewer implants than traditional methods, making treatment more accessible and comfortable for many patients.

Advantages of All on 4 and All on 6 implants

Shorter treatment time

One of the main advantages of All on 4 and All on 6 is that they restore a full arch in less time than conventional implants.

The patient can leave the clinic with a fixed temporary prosthesis on the day of surgery, which considerably reduces appointments and waiting time.

No need for bone grafts

Thanks to the angling of the rear implants, All on 4 and All on 6 allow the implants to be placed where there is still enough bone, avoiding the need for bone grafts.

This is especially beneficial for patients with bone loss.

Fixed teeth from day one

Patients can enjoy fixed teeth on the day of surgery, since a temporary prosthesis is fitted straight after the implants.

This improves both appearance and function from the very first moment, letting the patient chew and smile with confidence.

Stability in cases of bone loss

Even with significant bone loss, All on 4 and All on 6 offer great stability.

The implants are placed where bone quality is best, ensuring a solid base for the prosthesis without additional procedures such as grafts.

Disadvantages of All on 4 and All on 6 implants

Possible problems with the cantilever of the prosthesis

One drawback of these techniques is that the back teeth of the prosthesis are usually cantilevered, meaning there is no implant directly underneath supporting them.

This can put more pressure on that area, which could lead to the prosthesis fracturing over time if it is not well maintained.

Limitations if an implant fails

With All on 4, if one of the four implants fails, the whole prosthesis can be affected, which may require further surgery to place a new implant.

Although with All on 6 this is less likely, the risk is still there.

Frequently asked questions about All on 4 and All on 6 implants