All on 4 vs All on 6 — Which method is better?

All on 4 and All on 6 — two paths to new teeth

Both methods serve the same goal: durable reconstruction of the full dental arch on implants, with the possibility of fixing permanent teeth on the day of surgery. The difference comes down primarily to the number of implants and the biomechanical consequences that result from this. All on 4 uses four implants, while All on 6 uses six support points. This might seem like a small difference, but it has concrete implications for stability, distribution of chewing forces, and prosthetic possibilities.

How are implants positioned in each method?

In the All on 4 protocol, two front implants are placed vertically, while the two back implants are placed at angles up to 45°. The angled positioning of the back implants allows anchoring in naturally available bone, bypassing anatomical structures such as the maxillary sinus or the mandibular nerve canal. This means that in many cases, the procedure can be performed without the need for bone augmentation.

In the All on 6 variant, two additional implants are added — usually at the position of the last molars, which ensures better distribution of chewing forces along the entire arch. The greater number of support points translates to higher stability of the entire prosthetic structure. This is especially important in the maxilla, where bone is less dense than in the mandible.

Comparison: All on 4 vs All on 6

What determines the choice of method?

The decision between All on 4 and All on 6 is not universal — it depends on the patient's individual anatomy. Key factors include: quantity and quality of available bone, location (maxilla or mandible), bite force, and prosthodontic expectations. In Dr. Sawicki's practice, the treatment plan is determined based on CBCT imaging and digital simulation of implant positioning — before the procedure even begins.

Treatment Results

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Presented treatment results relate to individual cases. Results may vary depending on the patient's clinical situation.

How does the procedure work?

1. Consultation and diagnostics Clinical examination, CBCT imaging, analysis of bone conditions. Discussion of treatment plan, expectations, and possible options. Digital planning of implant positioning.
2. Day of surgery — implant placement Tooth extraction and implant insertion under effective local anesthesia. The procedure takes 1.5 to 2.5 hours per arch. Precise implant positioning according to the previously created digital plan.
3. Day of surgery — prosthetics On the same day, the prosthodontist and laboratory team prepare a temporary bridge, which is then secured to the implants. The patient leaves the office with a complete set of teeth.
4. Osseointegration period Over the next 3–6 months, the implants fuse with the bone (osseointegration). During this time, the patient functions normally with the temporary bridge, following a soft diet.
5. Final prosthetic work After confirming complete osseointegration, the temporary bridge is replaced with the final prosthetic work — precisely fitted for aesthetics, bite, and comfort.

Who is the All on 4 or All on 6 method suitable for?

Full arch reconstruction is intended for patients with complete or nearly complete tooth loss, as well as for people with extensive tooth damage, where individual implants do not constitute the optimal solution. This applies to:

• patients wearing removable dentures who are looking for a permanent solution
• people with advanced periodontal disease and loose teeth
• patients with bone loss who would require extensive bone grafts for conventional implant treatment
• people who want to avoid prolonged multi-stage treatment

Extra-maxillary anchoring — the most difficult cases

In situations of extreme bone loss, when standard implants lack sufficient support, Dr. Sawicki uses advanced extra-maxillary anchoring techniques. Zygomatic implants are anchored in the zygomatic bone, and pterygoid implants are anchored in the pterygoid process of the sphenoid bone. This makes it possible to perform full arch reconstruction even in patients who have been refused implant treatment by other centers.