The main difference between All-on-4 and All-on-6 is the number of implants supporting a full set of teeth in one jaw: four implants in one approach and six in the other. Six implants are not automatically better for every patient, and four cannot be assumed sufficient for everyone. The decision considers bone anatomy, implant distribution and the planned fixed prosthesis together.
Which treatment do these names describe?
These approaches describe replacing the teeth in one jaw with a fixed bridge supported by implants. A separate implant is not needed for every missing tooth. The implants are support points for the bridge; the visible teeth form part of the prosthesis. The upper and lower jaws are assessed separately.
Tilted placement of the back implants is common in All-on-4 plans. The positions in All-on-6 are also planned according to the patient's anatomy. The name does not mean that bone grafting will be unnecessary or that every stage will be completed in one day. Learning the details of your proposed plan is more useful than comparing names alone.
What matters beyond the number of implants?
The ITI consensus on fixed full-arch prostheses recommends considering implant distribution, bone volume, opposing teeth and prosthesis design alongside implant number. Appearance, lip support and access for cleaning should also be explained during the consultation.
Bone conditions: Whether the implants can be placed in the planned positions is assessed.
Distribution of support: Their positions across the jaw matter as well as their number.
Prosthesis design: Materials, connections and the planned set of teeth are discussed.
Daily care: The ability to reach beneath the bridge for cleaning is considered.
When comparing two recommendations, make sure that they cover the same elements. Temporary and permanent prostheses, additional surgery that may be needed, check-ups and future repairs may be planned differently. Seeing these details in a written treatment plan makes the discussion easier to follow.
Does research show that one approach is superior?
A five-year randomised upper jaw study published in 2025 found similar bone level outcomes with four and six implants in 47 patients, but more technical problems in the four-implant group. It does not promise the same result for every anatomy or every All-on-4 or All-on-6 procedure.
Statements such as “two extra implants must make it stronger” or “if four are enough, six are never needed” oversimplify individual assessment. The key point to understand at your examination is why the recommended number is considered appropriate for your prosthesis plan.
Can fixed temporary teeth be fitted on the same day?
For some suitable patients, a fixed temporary bridge can be attached after implant placement. The ITI loading consensus highlights the importance of initial implant stability for this approach. If conditions are not met, a different temporary option or a waiting plan may be needed during healing.
A temporary bridge and the permanent prosthesis are different. Receiving teeth on the same day does not mean that implant healing is complete or that normal chewing can begin immediately. Obtain written eating, cleaning and follow-up instructions from your treatment team.
What should you ask at your examination?
Bring any existing denture and previous images. Share your medications, health conditions, smoking and teeth clenching. Explain your expectations about appearance, ease of speaking and care. The EFP highlights home cleaning and regular professional follow-up for health around implants.
Why are four or six implants recommended?
Might bone augmentation be needed?
What is the alternative if a fixed temporary bridge cannot be attached?
How will I clean beneath the bridge?
How will follow-up and possible repairs be planned?
Frequently asked questions
Is All-on-6 always better?
No. Whether more implants are appropriate depends on the bone and prosthesis plan.
Does All-on-4 guarantee that bone grafting can be avoided?
No. Tilted placement may offer advantages in some circumstances; the need for additional procedures is assessed individually.
Can the patient remove the fixed bridge?
The fixed bridge described here is not removed by the patient. Removable implant dentures are a different option.
This article provides general information; the method is chosen at an examination. You can arrange a consultation and find other patient information on the blog page.
