All-on-4 vs All-on-6 Dental Implants: What Is the Difference and Which May Be Suitable?

Four implants or six?

All-on-4 and All-on-6 both describe full-arch implant-supported restorations. Six implants do not automatically mean a better result, and four do not automatically mean inadequate treatment. The design must follow the patient’s anatomy and diagnosis.

The practical difference

The names usually refer to the planned number of implants supporting one full arch. More implants can distribute support differently and may offer additional options if one implant fails, but they require suitable bone and can increase cost and surgical complexity.

What determines suitability?

  • bone quantity and quality in each implant position;
  • jaw shape and location of nerves or sinuses;
  • bite forces and teeth grinding;
  • gum health, cleaning ability and smoking;
  • the proposed bridge material and span;
  • the clinician’s evidence-based treatment plan.

The decision should follow clinical examination and appropriate imaging. A clinic should be able to explain why it recommends a particular number and position of implants rather than using a sales package as the diagnosis.

Feature All-on-4 All-on-6
Implants per arch Usually four Usually six
Surgery Fewer implant sites More implant sites
Cost Often lower Often higher
Bone requirement Design may avoid some grafting Needs suitable additional sites
Best choice Diagnosis-dependent Diagnosis-dependent

Questions to ask before agreeing to treatment

  • Why is this number of implants recommended for my anatomy?
  • What happens if one implant fails?
  • Is grafting included or deliberately avoided?
  • How will the bridge be cleaned?
  • Is bruxism assessed and is a night guard included?
  • Are both temporary and final bridges in the quote?
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General information only. This does not replace an examination or personalised advice from a qualified dental professional.