All-on-4 and All-on-6
A full arch of fixed teeth carried by four or six implants, using the bone that already exists so that extensive grafting is often unnecessary. A fixed temporary bridge is usually placed within the same visit.
What Is All-on-4?
All-on-4 is a way of replacing a whole jaw of missing teeth with a fixed bridge supported by four implants. The bridge is screwed onto the implants and stays in the mouth — you do not take it out.
The idea behind it is angulation. The two rear implants are placed at an angle rather than straight down, so they engage the denser bone at the front of the jaw and avoid the sinus above and the nerve canal below. That is what makes it possible to support a full arch on four implants, in jaws where a conventional plan would have required bone grafting first.
It is a solution for a jaw that has lost all or almost all of its teeth — not for a single gap. For individual missing teeth, see dental implants.
All-on-4 or All-on-6?
The difference is the number of implants, and it changes more than it sounds.
| All-on-4 | All-on-6 | |
|---|---|---|
| Implants | 4 per jaw | 6 per jaw |
| Bone required | Less; preferred where bone is limited | More solid bone needed |
| Load distribution | Spread across four points | Spread across a wider area |
| Support at the back | The rear of the bridge extends further unsupported | The rear is better supported |
| If one implant is lost | The whole bridge is affected | A temporary solution on the remaining implants may be possible |
| Need for bone grafting | Not required in most cases | May be required in some cases |
Neither is automatically better. All-on-6 gives a more robust system with more margin for error, and is preferred where the bone allows it and the bite is heavy. All-on-4 is chosen where bone volume is limited and grafting would otherwise be needed. The decision is made on the 3D scan, not on price — and a clinic that recommends the same configuration to every patient is not making the decision at all.
Who Is All-on-4 Suitable For?
It is considered when:
- all the teeth in a jaw are missing;
- the remaining teeth are beyond saving and will need extraction;
- a conventional full denture cannot be tolerated or does not stay in place;
- bone loss has made conventional implant plans difficult without grafting.
It is not suitable for everyone. Uncontrolled diabetes, active gum infection, heavy smoking and severe bone loss all affect the outcome and are assessed before any decision. Where there is not enough bone even for angled implants, grafting or a different plan is discussed rather than proceeding anyway.
Importantly, it is also not the right answer for a patient who still has healthy teeth. Extracting salvageable teeth to fit a full-arch bridge is not a shortcut — it is an irreversible loss.
How Is All-on-4 Done?
- Examination and 3D scan. Bone volume and density, and the position of the nerve canal and the sinus, are measured. The number and angle of the implants are determined on these images.
- Digital planning. Intraoral scan records are combined with the CT data, so the position of the teeth and the position of the implants are planned together rather than one after the other.
- Surgery. Under local anaesthetic — with sedation if preferred — any remaining teeth are extracted and four implants are placed. This usually takes 2–3 hours per jaw.
- Temporary fixed bridge. A temporary bridge is screwed onto the implants the same day or within the first 24–72 hours. You do not leave without teeth.
- Healing. Integration of the implants with the bone takes 3–6 months, during which a soft diet is followed.
- Permanent bridge. Once integration is complete, new impressions are taken and the permanent bridge is made.
Fixed Teeth in a Day
"Teeth in a day" refers to the temporary bridge, and it is worth being precise about what that means. The implants are placed and a fixed temporary bridge is attached the same day or within a few days — so you never go home without teeth.
The temporary is not the final result. It is deliberately lighter, and it is designed to protect the healing implants rather than to take full chewing force. The permanent bridge, in a stronger material and with the bite refined, is made after integration is complete.
Any clinic promising the permanent, definitive bridge on the day of surgery is describing something that skips the healing period. Ask which bridge is meant.
A Fixed Bridge Without a Palate
For patients moving from a conventional upper denture, this is often the change that matters most. A full upper denture covers the palate to stay in place by suction. An implant-supported bridge does not need to.
The practical consequences:
- Taste comes back, because the palate is no longer covered.
- Hot and cold are felt again.
- Nothing moves or lifts while eating or speaking.
- No adhesive.
Chewing force with a fixed bridge is far closer to natural teeth than with a removable denture. Most patients describe being able to eat food they had quietly given up on.
How Long Does All-on-4 Take?
Surgery itself takes 2–3 hours per jaw. The overall treatment spans 3–6 months, most of which is healing rather than appointments.
A typical sequence is: examination and scan; surgery with a temporary bridge fitted within 72 hours; a healing period of three to six months; then impressions and the fitting of the permanent bridge, which itself takes a small number of appointments across one to two weeks.
The healing period is not negotiable. It is the time the bone needs, and shortening it is the most common reason full-arch cases fail.
Coming to Turkey for All-on-4
This treatment is planned as two visits, and it cannot honestly be done as one.
First visit — around 7 to 10 days. Examination, 3D scan and digital planning; extractions and implant placement; the temporary fixed bridge fitted within 72 hours; suture check and review before you fly home. You leave with fixed teeth.
Second visit — around 7 to 10 days, after 3 to 6 months. Impressions, try-in, adjustment of the bite and fitting of the permanent bridge, with a review before you travel back.
Between the two visits you are wearing the temporary bridge and living normally on a normal diet, with the soft-food period limited to the first weeks after surgery. If a problem arises at home, we would rather you send photographs on WhatsApp early than wait for the next trip.
Before you travel, send us a panoramic X-ray — a 3D scan if you have one — and photographs of your mouth. Full-arch cases vary enormously, and a remote assessment tells us whether All-on-4, All-on-6 or something else entirely is the realistic plan, before you book flights.
How Long Does All-on-4 Last?
The implants and the bridge have different lifespans, and it is worth separating them.
The implants themselves, once integrated, can last decades — for many patients, for life. What threatens them is peri-implantitis, inflammation of the tissue around the implant caused by plaque left under the bridge.
The bridge is a wearing part. Depending on material and on how heavily you bite, it may need repair or replacement after ten to fifteen years. Replacing the bridge does not mean replacing the implants.
The single biggest factor in how long the whole system lasts is cleaning under the bridge, followed by whether a night guard is worn if you grind. Both are within your control; neither is optional.
The Drawbacks of All-on-4
This is a large, irreversible treatment and it deserves an honest list of what you are accepting:
- It cannot be undone. Remaining teeth are extracted; there is no way back.
- Losing one implant affects the whole bridge. With four implants there is little redundancy in the system.
- The bridge is a single piece. If one tooth fractures, the whole bridge usually goes to the laboratory, not just that tooth.
- Cleaning has to be learned. The space between the underside of the bridge and the gum is cleaned with special interdental brushes and a water flosser; ordinary brushing is not enough.
- There is an adjustment period for speech. Some sounds can be temporarily difficult in the first weeks.
- It is the most expensive of the full-arch options.
None of this makes it the wrong treatment. It makes it a treatment to enter with clear eyes rather than on the strength of a before-and-after photograph.
After All-on-4 Surgery
Swelling and bruising for several days are normal after full-arch surgery, and are usually more pronounced than after a single implant. They peak around the second or third day and then settle.
Follow a soft diet for the first weeks — the temporary bridge is not built for hard chewing, and the implants are healing beneath it. Your dentist will tell you when to progress.
Do not smoke. Smoking is the single strongest predictor of early implant failure in full-arch cases, and the first months are when it matters most.
Keep the sutured area clean as instructed, and use any prescribed mouthwash. Report increasing pain after the third day, a bad taste, discharge, or any looseness in the bridge.
Attend the review appointments. Bite adjustments in the early weeks prevent overload, which is the mechanical counterpart of infection.
Cleaning and Maintaining All-on-4
This is the part that determines whether the treatment lasts, and it is different from cleaning natural teeth.
- Under the bridge is the critical area. Plaque collects between the underside of the bridge and the gum, where a toothbrush cannot reach.
- Superfloss or a specific interdental brush is passed underneath, daily.
- A water flosser is a genuine help here rather than a gadget.
- Professional cleaning at the clinic, where the bridge can be inspected and if necessary unscrewed for thorough cleaning.
- A night guard if you clench or grind — the bridge takes the force that used to be shared by a full set of roots.
Patients who keep to this routine typically have straightforward reviews for years. Patients who do not are the ones who develop inflammation around the implants — and by the time it is visible, bone has already been lost.
Options for a Full Jaw of Missing Teeth
All-on-4 is one of three routes, and the right one depends on bone, budget and what you want day to day.
| All-on-4 / All-on-6 (fixed) | Implant-retained removable denture | Conventional full denture | |
|---|---|---|---|
| In the mouth | Fixed; not removed by the patient | Removed by the patient | Removed by the patient |
| Implants | 4–6 per jaw | 2–4 per jaw | None |
| Covers the palate | No | Partly or not at all | Yes (upper jaw) |
| Chewing force | Closest to natural teeth | Good | Limited |
| Bone loss | Slowed | Slowed | Continues |
| Cleaning | Needs interdental brushes and a water flosser | Removed and cleaned easily | Removed and cleaned |
| Cost | Highest | Middle | Lowest |
An implant-retained removable denture deserves more consideration than it usually gets. It costs less, cleans more easily, and for a patient with limited dexterity it can be the more sensible long-term choice. For that option see implant-supported dentures.
How Much Does All-on-4 Cost?
There is no single price. The cost follows the plan, and full-arch plans differ more from one patient to the next than any other treatment we offer.
What determines it:
- How many jaws are treated. One arch or both.
- Four implants or six. Decided on the scan, not in advance.
- The implant system used. There is a real difference between economy and premium brands, and it matters more here than in a single implant.
- The material of the permanent bridge. Acrylic on a metal framework, zirconia, or a hybrid — different cost and different lifespan.
- Extractions and any bone work needed.
- Whether sedation is used.
A package price quoted before a scan has to assume the simplest case. If your bone does not match that assumption, either the price changes or the treatment is compromised — and with an irreversible, full-arch treatment, neither is acceptable to discover after arrival.
Send us a panoramic X-ray, ideally a 3D scan, and photographs. We will tell you what is realistic and what it involves before you commit to travel. The definitive figure comes with the plan, after examination here.
All-on-4 and All-on-6 in Kuşadası
Beyaz Oral and Dental Health Clinic is a five-unit practice in the Cumhuriyet district of Kuşadası. The 3D tomography used for full-arch planning and the intraoral scanner used for digital records are both on site. The clinic holds the International Health Tourism Authorisation issued by the Turkish Ministry of Health.
Full-arch treatment is the largest decision in dentistry, and we treat it that way. The first examination and the plan are carried out personally by our founding dentist, Tuğçe Arslan, and where a patient's teeth can still be saved we will say so — even when the patient has arrived asking for All-on-4.
To find out which option fits your jaw, an examination and a 3D scan are the starting point. Use the form on this page to book, write to us on WhatsApp or call directly. Sending your existing X-ray on WhatsApp lets us give you a realistic answer before you travel.
The information on this page is general in nature and does not replace an examination. A treatment plan suited to you is determined after clinical and radiographic assessment.
All-on-4 and All-on-6
Will I feel pain during All-on-4 surgery?
The procedure is carried out under local anaesthetic; you will not feel pain during surgery, only pressure and vibration. Because the appointment is long, sedation is available for patients who prefer it. Some discomfort is expected for the first two to three days once the anaesthetic wears off, and is managed comfortably with the painkillers prescribed. Extractions are carried out in the same session, so swelling on the first day is normal.
Can both jaws be treated at the same time?
Yes, and in complete edentulism it is often the preferred route: the patient goes through one surgery and one healing period. Because the appointment is longer, sedation is chosen more frequently in these cases. Where general health does not allow it, the jaws are split into two separate sessions. The decision rests on whether the patient can tolerate the length of the procedure and on both jaws being found suitable on the 3D scan.
Is the upper or the lower jaw more demanding?
The upper jaw is generally more demanding. Upper jaw bone is softer than lower jaw bone, the sinus cavities sit above the back teeth, and resorption progresses faster after tooth loss. As a result the initial stability needed to fit a temporary fixed bridge cannot be achieved in every case, and some patients need additional implants or a sinus lift.
Will the temporary bridge look different from the permanent one?
Yes, and that is expected. The temporary bridge is made primarily for function and adaptation: it means you are never without teeth, and speech and the smile line are assessed on it. The permanent bridge is then produced after those assessments, with tooth length, shade and gum line refined, and in a more durable material. The appearance of the temporary should therefore not be judged as the final result.
What happens if a tooth on my bridge breaks?
Because the bridge is a single piece, a broken tooth usually cannot be repaired in the mouth; the bridge is unscrewed and sent to the laboratory. In bridges with acrylic teeth, repair is generally possible and relatively straightforward. In zirconia bridges fractures are rarer, but when they occur repair is difficult and replacement is often required. Keeping your old temporary bridge is recommended so that you are not left without teeth during the repair.
What is done if one of the implants is lost?
In a system working on four implants, losing one directly affects the support of the bridge. Depending on the cause, one of two routes is taken: a new implant is placed in the site once it has healed, or the bridge is reconfigured on the remaining implants. Loss usually occurs either in the first months, where integration did not take place, or years later as a result of inflammation around the implant. The second group is entirely preventable with regular review, which is why annual check-ups are not optional.
Will I be able to eat anything with All-on-4?
Once the permanent bridge is fitted, eating returns largely to normal; bread, meat, apples and similar foods are managed comfortably. Chewing force is markedly higher than with a removable denture. Very hard shelled foods (walnuts, nutshells, bone, ice), hard sweets and sticky foods are not advised — they can cause cracks in the bridge and loosen screws. During the first two to three months with the temporary bridge, a soft diet is required.
Will my facial features change after All-on-4?
After teeth are lost the jawbone begins to resorb, which reduces lip support, shortens the lower facial height and creates lines around the mouth. Implants transmit load to the bone and therefore slow that resorption. The bridge also restores the lost gum and tooth height, so lip support returns. In patients who have worn a removable denture for a long time, this change is usually positive and noticeable.
I have diabetes — can I have All-on-4?
Yes, provided blood sugar is under control. What matters is not the presence of the condition but the long-term blood sugar level; where that is high, healing slows and the risk of infection rises. Current blood test results are therefore requested from your physician before treatment, and if necessary treatment is postponed until the values are stable. In patients whose diabetes is controlled, success rates are not meaningfully different from other patients. Telling us which medicines you take is part of the planning.
I have worn a denture for years and my bone has shrunk — is it still possible?
In most cases yes — that is precisely why the All-on-4 technique was developed. Placing the rear implants at an angle makes use of the solid bone at the front instead of the back region, where resorption is greatest. This means many patients need no bone grafting. Where resorption is advanced, a bone graft or a sinus lift can be added to the plan. The definitive answer comes from measuring bone volume on the 3D scan.
Can the All-on-4 bridge be removed for cleaning?
Not by the patient, but by the dentist. The bridge is attached to the implants with screws; at a review the screws are undone, the bridge is removed, the area beneath it and the implant necks are cleaned, screw tightness is checked and the bridge is refitted. This is generally done once a year. Daily cleaning, by contrast, is carried out by the patient with an interdental brush and a water flosser, with the bridge in place.
I am coming to Kuşadası on holiday — can I complete treatment during the trip?
The surgical stage and the temporary fixed bridge can be completed in a single visit, for which about a week is usually enough (examination and scan, surgery, fitting of the temporary bridge and a review). The permanent bridge, however, is made after the implants have integrated, so a second visit three to six months later is required. Sharing your existing X-rays before you travel makes the initial assessment easier.
Other Treatments
Dental Implants
Zirconium Crowns
Laminate Veneers
Smile Design (Hollywood Smile)
Teeth Whitening
Implant-Supported Dentures
Composite Fillings
Aesthetic Fillings
Gum Disease Treatment
Root Canal Treatment
Tooth Extraction
Gum Contouring (Pink Aesthetics)
Dental Crowns
Paediatric Dentistry
Dental Bridges
Dentures
Bonding & Gap Closure
Bone Grafting
Sinus Lifting
Clear Aligners
Braces
Sealants & Fluoride
Dental Cleaning
Polishing & Airflow
Bad Breath (Halitosis)
TMJ Treatment
Night Guard
Masseter Botox
Wisdom & Impacted Teeth
