Full-Arch Restoration
All-on-4 vs All-on-6 Dental Implants: Which Is Right for You?
Both All-on-4 and All-on-6 are life-changing procedures that replace an entire arch of teeth with a fixed, permanent restoration. Understanding the key differences helps you and your implant specialist choose the best path to your new smile.
What All-on-4 and All-on-6 Have in Common
Both procedures are full-arch implant solutions designed to replace all of the teeth on the upper or lower jaw — or both — using a fixed bridge anchored by titanium implants. Neither requires a separate implant for every missing tooth, which dramatically reduces treatment time, cost, and recovery compared to placing 28 individual implants. In both cases, patients leave the procedure with a complete, beautiful set of teeth that look, feel, and function like natural teeth. There are no adhesives, no removal at night, and no plastic palate covering the roof of your mouth. Both procedures can often be completed with same-day teeth, meaning you walk out of the office with a temporary fixed arch on the same day your implants are placed.
The titanium implants used in both procedures fuse with the jawbone through a process called osseointegration. This bond preserves bone density, prevents the facial collapse that accelerates with conventional dentures, and provides the structural foundation for a restoration that can last a lifetime with proper care. At Fixed New Teeth, Dr. Xhoana Gjelaj uses advanced 3D CBCT imaging to plan every implant case with precision, ensuring optimal implant placement regardless of whether you are a candidate for four or six implants.
Side-by-Side Comparison
| Feature | All-on-4 | All-on-6 |
|---|---|---|
| Number of implants | 4 per arch | 6 per arch |
| Bone volume required | Moderate — angled implants maximize existing bone | Higher — requires good bone density |
| Bone grafting needed? | Rarely | Sometimes |
| Stability & load distribution | Excellent | Superior — more anchor points |
| Best for | Most patients, including those with some bone loss | Patients with strong, ample bone or larger arches |
| Cost | Lower | Slightly higher |
| Same-day teeth possible? | Yes | Yes |
| Long-term durability | Excellent | Excellent |
All-on-4: Maximum Results with Minimal Implants
The All-on-4 technique was developed to give the widest possible range of patients access to fixed, permanent teeth — even those who have experienced significant bone loss. The two rear implants are placed at an angle of up to 45 degrees, allowing them to anchor in denser bone farther back in the jaw without requiring bone grafting in most cases. This angled placement distributes biting forces efficiently across all four implants, providing excellent stability and function.
All-on-4 is the preferred choice for patients who have worn dentures for many years and have experienced resorption of the jawbone, as well as for patients who want to minimize surgical complexity and overall treatment time. The streamlined implant count also makes All-on-4 more cost-accessible than All-on-6 while still delivering outstanding long-term outcomes.
All-on-6: Enhanced Stability for the Right Patient
All-on-6 uses two additional implants — six total — to distribute the load of the full-arch prosthesis across a wider base. For patients with sufficient bone volume and density, this added support can increase the strength of the bite and provide an even more rigid foundation for the final restoration. All-on-6 may be recommended for patients with larger arch sizes, higher bite forces, or those who want every possible structural advantage from their implant investment.
Patients who are candidates for All-on-6 typically have good overall bone health — either naturally or following a successful bone grafting procedure. Dr. Gjelaj evaluates each patient's 3D CBCT scan to determine whether the jaw can support six implants without compromising adjacent anatomy, and whether the additional implants would provide a meaningful clinical benefit over four.
How Dr. Gjelaj Chooses the Right Option for You
The decision between All-on-4 and All-on-6 is never made based on preference alone — it is a clinical determination made after a thorough evaluation of your bone density, arch width, bite forces, overall health, and treatment goals. During your Signature Consultation at Fixed New Teeth, Dr. Gjelaj takes a 3D CBCT cone beam scan and a full set of intraoral photographs. She then maps the exact position, angle, and depth for every proposed implant site before recommending a treatment plan.
Many patients who initially believe they are not candidates for any implant procedure are surprised to learn that Dr. Gjelaj's expertise in bone management and angled implant techniques makes them excellent All-on-4 candidates — without the need for extensive bone grafting. If you have been told elsewhere that you don't have enough bone for implants, we encourage you to schedule a second opinion at our Trinity, FL office.