If you’re missing most or all of the teeth in one arch, you’ve probably come across two names in your research: All-on-4 and All-on-6. Both are full-arch implant solutions — a complete row of fixed, non-removable teeth supported by a small number of dental implants. Both eliminate the slipping, clicking, and adhesives of traditional dentures. So what actually separates them, and how do you know which one is right for your mouth?
The short answer: the difference is mostly about your jawbone, not your preference. Here’s how Dr. Edward Nam evaluates the choice at ID Dental Implant Center in Koreatown, Los Angeles.
The Core Difference: Four Implants vs Six
As the names suggest, All-on-4 supports a full arch of teeth on four titanium implants, while All-on-6 uses six. In All-on-4, the two rear implants are placed at an angle — typically around 30 to 45 degrees — to maximize contact with the densest available bone and avoid anatomical structures like the sinuses and nerves. All-on-6 adds two more implants along the arch, usually placed more vertically, creating additional anchor points for the prosthesis.
Two extra implants may sound like a small detail, but it changes the requirements of the procedure and, in some cases, how forces are distributed when you chew.
Bone Density: The Deciding Factor
Every implant needs a certain volume of healthy bone to fuse with. Because All-on-6 places six implants, it generally requires more available bone — in both quantity and quality — distributed along the arch. Patients who have worn dentures for years, or who lost teeth long ago, often have significant bone resorption that makes six well-positioned implants difficult without grafting first.
This is exactly the scenario All-on-4 was designed for. By angling the posterior implants, Dr. Nam can anchor them in stronger bone toward the front of the jaw, often avoiding bone grafting entirely. For many patients with moderate bone loss, All-on-4 is the difference between a straightforward treatment and a multi-stage surgical plan.
Conversely, if your CBCT scan shows generous, healthy bone throughout the arch, All-on-6 becomes a strong option — you have the anatomy to support the additional implants without extra procedures.
Stability and Load Distribution
With six implants sharing the work, each implant in an All-on-6 restoration carries a smaller share of your biting force. That broader load distribution can be an advantage for patients with strong bites, for longer prosthetic arches, and in the softer bone of the upper jaw. It also adds a measure of redundancy to the overall design.
That doesn’t make All-on-4 the “lesser” option. It is a well-documented technique with decades of clinical use, and when the four implants are planned and placed precisely, patients eat, speak, and smile with full confidence. Here’s how the two compare at a glance:
Who Is a Candidate for Each?
All-on-4 tends to suit patients who are missing most or all teeth in an arch and have some degree of bone loss — including long-time denture wearers. Because it works with the bone you have, it often allows treatment to move forward quickly, and many patients receive a fixed temporary arch on the same day as surgery.
All-on-6 tends to suit patients with good bone volume throughout the arch, patients replacing teeth in the upper jaw where bone is naturally softer, and those who want maximum distribution of biting forces. Good overall health matters for both procedures, and smoking can compromise healing in either case.
The treatment journey is nearly identical for both: a planning consultation with 3D imaging, implant placement under local anesthesia and sedation, a healing period of roughly three to six months while the implants fuse with the bone, and finally the placement of your custom permanent arch.
How Dr. Nam Decides: CBCT-Guided Planning
At ID Dental Implant Center, this decision is never made by eye. Every full-arch case starts with a CBCT 3D scan — a cone-beam CT image that maps your bone height, width, and density in three dimensions, along with the position of nerves and sinuses. Combined with a 3D intraoral scan of your gums and bite, it gives Dr. Nam a complete digital model of your mouth before any surgery is planned.
From there, the question answers itself: if the scan shows six sites with strong bone, All-on-6 is on the table. If bone is limited in the back of the jaw, an angled All-on-4 design may deliver an excellent result without grafting. Dr. Nam — a USC dental school graduate certified through the Harvard implant program, with 12+ years of experience — walks you through your own scan so you can see the reasoning, not just hear the recommendation. Consultations are available in both Korean and English.
What About Cost?
Neither procedure has a fixed price, because no two cases are the same. The cost depends on your bone condition, the number of implants placed, the materials chosen for your final arch, and whether additional procedures such as extractions or grafting are needed. The only honest way to quote a full-arch case is after an exam and a CBCT scan.
To keep treatment accessible, we offer financing through CareCredit and Proceed Finance, and we verify your insurance benefits for free before treatment begins. Book a free consultation and we’ll give you a clear, personalized treatment plan — including which full-arch option fits your anatomy and your goals.