All-on-6 vs All-on-4 Dental Implants?
Dental implantology has advanced significantly in recent decades, offering patients permanent solutions for edentulous (toothless) or severely damaged teeth. The most popular total reconstruction methods include All-on-4 and All-on-6. Both techniques replace the entire dental arch with implants and a fixed prosthetic replacement, but they differ in the number of implants, load distribution, and indications.
Principle of both methods
All-on-4
The All-on-4 method uses four implants per dental arch – two in the front of the jaw in a vertical position and two in the back inserted at an angle of approximately 30-45 degrees. The oblique placement of the back implants allows for better use of the available bone and often eliminates the need for bone augmentation or sinus lift. A fixed bridge is attached to the implants, replacing all teeth.
All-on-6
The All-on-6 technique works on a similar principle, but instead of four, six implants are inserted. The two front implants are usually placed vertically, while the four back ones are placed at a lower or no inclination, as the larger number of support points allows for a more even distribution of chewing load. Here, too, a temporary restoration can be placed immediately after the procedure.
Advantages and disadvantages
Advantages of All-on-4:
- A smaller number of implants means a shorter procedure time and lower cost.
- The oblique insertion of the back implants often eliminates the need for bone grafts.
- Suitable for patients with a limited amount of bone in the back of the jaw.
- The possibility of obtaining teeth in one day.
Disadvantages of All-on-4:
- A smaller number of implants means a higher load on each of them.
- In the event of failure of one implant, the stability of the entire restoration may be compromised.
- Less suitable for patients with sufficient bone who want maximum stability.
Advantages of All-on-6:
- A larger number of implants provides better distribution of the chewing load.
- Greater stability and durability, especially with long-term use.
- If one implant fails, the structure can remain functional. Suitable for patients with sufficient bone density and volume.
Disadvantages of All-on-6:
- Higher cost due to the larger number of implants and longer surgery time.
- In some cases, additional bone procedures are required.
- Slightly longer recovery time than with All-on-4.
When comparing the two methods, it can be said that All-on-4 uses four implants for the entire arch, while All-on-6 uses six. Due to the smaller number of implants, All-on-4 is generally cheaper, and the procedure is shorter. On the other hand, this method places greater stress on individual implants, and if one of them fails, the stability of the entire restoration may be compromised. All-on-6, thanks to the larger number of implants, provides even greater stability and a more even distribution of chewing load, so even if one implant is lost, the restoration can remain functional. The All-on-4 method is more suitable for patients with less bone volume who want a quick and less invasive solution, while All-on-6 is intended for those who have sufficient bone mass and are looking for maximum durability and long-term durability. In terms of the need for bone augmentation, it is less frequent with All-on-4, while it may be necessary more often with All-on-6 due to the direct insertion of multiple implants.
Conclusion
Both methods – All-on-4 and All-on-6 – represent cutting-edge solutions for complete denture replacement. The choice between them depends primarily on the condition of the bone, financial possibilities, and expectations of the patient. All-on-4 offers a fast, less invasive, and economical solution, while All-on-6 provides maximum stability and long-term durability. The right decision should always be based on an individual examination and the recommendation of an experienced implantologist. Contact us today to discuss your options to improve your smile!