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

The idea behind both

When all teeth in an upper or lower arch are lost (or unsalvageable), a full denture is one option — but it moves, shifts, and affects chewing. Implant-supported full arches replace all teeth with a fixed bridge anchored to 4 or 6 implants in the jaw.

All-on-4

• 4 implants per arch: 2 straight in the front, 2 tilted backwards toward the rear
• The tilting gets around limited bone height at the back of the jaw
• Often allows same-day teeth (temporary bridge placed immediately on surgery day)
• Proven by 20+ years of clinical data (Malo protocol, 1998)

Best for: patients with moderate-to-severe bone loss, budget constraints, or who want faster treatment.

All-on-6

• 6 implants per arch: more anchors, more stability
• Better for heavier bite force patients (grinders, muscular jaws)
• More forgiving if one implant ever has a complication — 5 remain functional
• Slightly better long-term bone preservation across the arch

Best for: patients with adequate bone height, heavy occlusal forces, longer-term outlook, or anyone doing both arches and wanting maximum stability.

Cost difference in Dubai

• All-on-4 per jaw: AED 55,000–90,000
• All-on-6 per jaw: AED 75,000–120,000
• Both jaws (dual full arch): 1.7–1.9× single-jaw pricing

Same-day teeth (immediate load)

Both protocols can support immediate loading — temporary fixed teeth placed within 24 hours of implant surgery. Final zirconia prosthesis follows 3–4 months later after bone integration.

Who qualifies for same-day teeth:

• Adequate primary stability of implants (measurable at surgery)
• No severe medical conditions (uncontrolled diabetes, immunosuppression)
• Not a heavy smoker
• Willing to eat soft foods for the initial healing period

What the final prosthesis is made of

• Acrylic over titanium frame: lighter, more affordable, slightly more wear — good for the temporary bridge
• Full zirconia (monolithic or layered): premium, highly durable, aesthetic — the final choice for most patients

Aftercare

Full-arch prostheses last 15–25 years with:

• Professional cleaning every 4 months
• Water flosser daily underneath the bridge
• Nightguard to protect against grinding forces
• Annual x-rays to verify bone stability

The fixed bridge is removable only by the dentist for periodic cleaning — not by the patient. Daily cleaning is done underneath with a water flosser and interdental brushes.

The decision matrix

| Factor | All-on-4 | All-on-6 | |---|---|---| | Budget | ✓ | | | Faster completion | ✓ | | | Heavy grinder | | ✓ | | Both arches long-term | | ✓ | | Severe bone loss | ✓ | | | Bigger safety margin | | ✓ |

Neither is universally better. The right choice depends on your bone volume, bite force, and long-term priorities.

References

• Malo P. — Malo Clinical Protocol
• Journal of Oral and Maxillofacial Surgery — All-on-4 15-year outcomes