All-on-4 vs All-on-6 Dental Implants: Which Is Right for You?

When patients are considering full arch dental implants, a common question arises: “Should I have 4 implants or 6 implants to support my new teeth?” You might also wonder what the term “All-on-4” really means and whether it’s sufficient for your case. Let’s explore this in plain terms.

What Does “All-on-4” Actually Mean?

The All-on-4 concept refers to a method where a full arch prosthesis (essentially a complete set of upper or lower teeth) is supported by four dental implants. The term "All-on 4" is a trademark that Nobel Biocare (Dental Implant company owns).

For the All on 4, two implants are placed upright in the front of the jaw, while two are tilted backwards at an angle. This clever angulation makes use of the available bone without needing extensive bone grafting. What is truly important is that the longest implants are used to give sufficient support for the patient. This is truly critical as short implants placed in an All on 4 'fashion' will unfortunately be insufficient in providing longevity and support.

Originally developed for patients with bone loss, All-on-4 is designed to provide a fixed, permanent solution without the downtime and added cost of major bone grafting procedures.

So Why Consider 6 Implants?

While All-on-4 is well-established, some cases benefit from six implants instead:

• Stronger support for heavier bite forces, especially in patients who grind their teeth (bruxism).

• Wider load distribution, reducing stress on each individual implant.

• Additional safety margin — if one implant fails, the prosthesis remains stable.

• Better aesthetic and functional support for larger jaws or more complex cases.

In simple terms, six implants give more anchorage, which might be recommended based on your individual anatomy and functional needs.

Do I Need Bone Grafting?

One of the main advantages of All-on-4 is its ability to avoid bone grafting in many situations. The angled implants reach deeper, denser bone, even in areas where vertical bone height is limited.

However, some patients with extreme bone loss may still require minor grafting or may be candidates for alternative solutions like zygomatic implants.

The Key Principle: A Solid Foundation

Whether using four implants or six, the goal is always the same — to provide a stable, long-lasting foundation for your new teeth. The choice depends on several factors:

• Bone quality and quantity

• Bite dynamics

• Aesthetic considerations

• Long-term prognosis

It’s not about the number of implants alone, but about choosing the most predictable, sustainable solution tailored to your needs.

Conclusion

Both All-on-4 and All-on-6 are excellent treatment options. The decision comes down to ensuring you receive the best possible outcome — a strong, secure smile that feels and functions just like natural teeth.