All-on-4 vs All-on-6: Clinical Differences That Matter
All-on-4 and All-on-6 are full-arch implant strategies designed to restore an entire dental arch with a fixed prosthesis.
They are not interchangeable. The difference is not marketing—it is biomechanics.
Implant Number and Load Distribution
The primary difference is the number of implants supporting the prosthesis.
- All-on-4 uses four implants
- All-on-6 uses six implants
More implants generally reduce force per implant, increasing redundancy and safety margins.
Bone Requirements
All-on-4 relies heavily on:
- Anterior bone availability
- Posterior implant angulation
All-on-6 typically requires:
- More bone volume
- Less angulation
- More uniform distribution
Patients with borderline bone conditions may benefit from additional implants.
Immediate Loading Considerations
Both systems may support immediate loading, but:
- All-on-4 demands higher precision
- All-on-6 offers greater forgiveness
Immediate load failures often result from underestimating force and stability requirements.
Prosthetic Design Implications
With fewer implants:
- Cantilevers are often longer
- Prosthetic stress increases
All-on-6 allows:
- Shorter cantilevers
- Improved occlusal balance
- Reduced mechanical complications
Surgical Complexity vs Long-Term Risk
All-on-4:
- Less invasive
- Shorter surgery
- Lower upfront cost
- Higher sensitivity to error
All-on-6:
- More invasive
- Higher initial cost
- Greater long-term stability margin
The choice should be clinical, not financial.
Failure Management
When an implant fails:
- All-on-4 systems lose 25% of support
- All-on-6 systems lose ~17% of support
Redundancy matters when complications occur.
Choosing the Right Approach
The correct approach depends on:
- Bone anatomy
- Bite forces
- Patient risk profile
- Maintenance capability
There is no universally superior option. There is only appropriate planning.
Expert Evaluation in Northern California
At Fusion Dental Implants, our specialists evaluate each case individually using 3D imaging and biomechanical analysis. We recommend the approach that offers the best long-term outcome for your specific situation.
Schedule your free consultation
About Fusion Dental Implants: Full-arch implant specialists serving Sacramento, Roseville, and the Bay Area.