- 6 implants per jaw, so the load is shared across more points
- Often chosen for the upper jaw and for a strong bite
- May need enough bone at the back of the jaw, or a graft
All-on-6 is a plan in which a fixed full-arch bridge sits on six implants instead of four. The principle is the same as All-on-4: a single-piece bridge, screwed to the implants and not removable by you, for a jaw with no teeth or with teeth that cannot be saved. The difference is that the load is divided between six points and the implants are spread across a wider part of the jaw.
Six implants are not always "better" than four. They give more support, but in return they need more bone, longer surgery and sometimes an additional procedure. This page explains when six implants are worth that trade-off; for a side-by-side comparison of the two plans, see our full-arch implants page.
When does a sixth implant make a difference?
We seriously discuss six implants if the examination shows any of the following:
- A strong bite. Large jaw muscles, clenching or grinding increase the load on the bridge and its screws.
- Natural teeth or a fixed bridge in the opposing jaw. A bridge biting against these takes far more force than one that bites against a denture.
- A wide or long dental arch. If the curve along which the teeth sit is long, the spans between four implants and the unsupported end of the bridge become longer.
- Enough bone at the back of the jaw. If the bone is already there, there is no reason not to use it.
- The upper jaw. We explain why separately below.
Conversely, there are situations where we do not recommend six implants. In the lower jaw, if the bone is dense and there will be a denture in the opposing jaw, four implants are often enough. If there is no bone at the back and you do not want a graft, a plan with angled implants makes more sense than extra surgery for a sixth implant. And for patients whose general health makes a long operation difficult, a shorter procedure takes priority.
Why is it chosen more often for the upper jaw?
The bone of the lower jaw is usually dense and hard; the bone of the upper jaw is more porous and spongy. In porous bone an implant holds less firmly and needs more cautious loading while it fuses. Dividing the same force between six implants reduces the share each one carries. That is why it is common for the same patient to have four implants planned in the lower jaw and six in the upper; each jaw is assessed separately.
If the sinus at the back of the upper jaw has dropped lower, some of the implants may first need a sinus lift. At that point the question changes: do you accept the extra surgery and the longer timeline, or go back to a four-implant plan with angled implants? We make this decision together with you, with the scan in front of us.
What do two extra implants change in the bridge?
First, the unsupported end of the bridge. Because the implants are spread further back — often as far as the first molar area — this end becomes shorter or disappears altogether. The bridge usually carries 12 teeth.
Second, a reserve. With a bridge on four implants, losing one implant means the bridge can no longer be used. With six implants, in many cases the bridge can still be carried by the remaining implants; you are not left without teeth while a replacement implant is being planned. This does not apply automatically in every case — it depends on the dentist's assessment.
Third, design flexibility. If the implants are well distributed, the bridge can in some cases be made in two or three sections; if a problem arises in one section, the whole bridge does not have to be removed.
What do you give up in return?
Two more implants mean two more surgical sites, a slightly longer operation and a little more swelling in the first few days. If a graft or sinus lift has been added at the back, those areas are not loaded until they have healed, so it becomes less likely that a fixed temporary bridge can be fitted quickly. There are also more implants to clean every day. Swelling in the first days after surgery is normal; swelling that increases after the third day, a fever or difficulty swallowing is not normal, and you should see a dentist or doctor without delay — the nearest one if you are not in İzmir.
The cost depends on the same factors: the number of implants, whether a graft or sinus lift is needed, the material of the final bridge, and whether one jaw or both are treated. You receive a written, itemised quote after the examination, based on the plan we prepare from your scan.
How the treatment timeline takes shape
| Situation | Temporary teeth | Final bridge |
|---|---|---|
| Enough bone, implants held firmly | Fixed temporary bridge, usually within a few days | After 3–6 months |
| Small graft in the same session as the implants | Usually still fixed; sometimes removable | Depends on how the grafted area heals |
| Sinus lift or major graft first | Removable temporary denture | Graft and implant healing one after the other; can approach a year in total |
Daily care of six implants
Because the bridge is fixed, you clean underneath it with it in place. The daily target is the point where each implant emerges from the gum; for this you use a water flosser, thick floss threaded under the bridge and interdental brushes. At your first check-ups we show you, in your own mouth, which tool goes where.
At regular intervals the bridge is removed and the implants and the underside of the bridge are cleaned in the clinic. If you clench your teeth, wearing a protective night guard protects the bridge and its screws; see also our teeth grinding treatment page. If you travel to us from outside İzmir, some of the interim check-ups can be followed with photos and X-rays; removing the bridge for cleaning, however, is done in the clinic.
Common questions
Are six implants always better than four?
No. They give more support, but if there is no bone at the back, a graft or sinus lift is needed to gain that support. In that situation a four-implant plan can do the same job with less surgery and in less time. The right number is decided by your bone and the strength of your bite.
Can a temporary bridge be fitted quickly with All-on-6 too?
If the implants are held firmly enough and no area has been grafted, yes — a fixed temporary bridge is usually fitted within a few days. If a sinus lift or a major graft has been done, you wear a removable temporary denture until those areas have healed.
What happens to my bridge if an implant is lost?
With a six-implant bridge, the bridge can often continue to be used on the remaining implants while a replacement implant is planned. This depends on the dentist's assessment. If you notice the bridge moving or pain around an implant, do not keep loading it — contact us and have it checked.
Can I have four implants in one jaw and six in the other?
Yes, it is a common plan. The upper and lower jaws differ in bone structure and in the load they carry, so each jaw is planned from its own scan. Most often we consider six implants in the upper jaw and four in the lower, but it can be the other way round.
Is the surgery longer and harder?
Because two more implants are placed, the surgery takes a little longer and there may be slightly more swelling in the first few days. It is done under local anaesthetic, with sedation if needed; you usually feel no pain during the procedure, and tenderness and swelling for a few days afterwards are normal.
Is it harder to look after than an All-on-4 bridge?
The tools are the same: a water flosser, floss that threads under the bridge and interdental brushes. With more implants to clean it takes a few minutes longer. At check-ups we work out together which spots are hard to clean and adjust your routine accordingly.
Not sure if this is right for you?
Send us a photo. We will tell you honestly what you need — and what you do not.