All-on-4 and All-on-6 are two full-arch implant restoration protocols — designed for patients who have lost all their teeth (or have hopelessly compromised teeth) on one or both arches. Both deliver a fixed arch of teeth on the same day, but they differ in the number of implants, clinical indications and costs.
What Is All-on-4?
The All-on-4 protocol, developed by Prof. Paulo Maló, uses 4 implants per arch to support a fixed prosthesis with 10–12 teeth. The two posterior implants are inserted at a 30–45° angle, allowing anchorage in the available bone — even in cases with moderate bone loss.
Key features:
- 4 implants per arch (8 total for both arches)
- Tilted posterior implants (30–45°)
- Immediate loading — fixed provisional prosthesis on the same day
- Bone grafting (sinus lift) not always required
- Over 20 years of clinical evidence (success rate: 95–98%)
What Is All-on-6?
The All-on-6 protocol uses 6 implants per arch, providing additional support points for the distribution of chewing forces. The implants are positioned more evenly along the arch, including the posterior region.
Key features:
- 6 implants per arch (12 total for both arches)
- More uniform force distribution
- May require bone grafting in the posterior area
- Recommended for the upper jaw (less dense bone)
- Superior long-term biomechanical stability
Head-to-Head Comparison: All-on-4 vs All-on-6
| Criterion | All-on-4 | All-on-6 |
|---|---|---|
| Implants per arch | 4 | 6 |
| Surgical time | Shorter (~2 h) | Longer (~3 h) |
| Bone grafting needed | Rarely | Possibly (posterior area) |
| Force distribution | 4 points | 6 points |
| Biomechanical stability | Good | Superior |
| Price per arch (Romania) | €3,500–6,000 | €4,500–8,000 |
| Price per arch (Western Europe) | €12,000–20,000 | €15,000–25,000 |
| Success rate | 95–98% | 96–99% |
| Primary indication | Sufficient anterior bone | Insufficient posterior bone |
| Recovery time | 3–6 months | 3–6 months |
When Should You Choose All-on-4?
All-on-4 is recommended when:
- You have moderate bone loss in the posterior region and want to avoid bone grafting
- Budget is an important factor — All-on-4 costs 20–30% less
- Your general health requires a shorter, less invasive procedure
- You need a solution for the lower jaw (mandible), where bone is generally denser
- You want a proven protocol with over 20 years of clinical evidence
When Should You Choose All-on-6?
All-on-6 is recommended when:
- Treatment is on the upper jaw (less dense bone, different force dynamics)
- You have sufficient bone and the surgeon can place 6 implants without major grafting
- You want maximum long-term stability and optimal force distribution
- You have eating habits that involve intense chewing
- The surgeon recommends redundancy — if one implant fails, the prosthesis remains functional on the remaining 5
Can I Choose All-on-4 on One Arch and All-on-6 on the Other?
Yes — this is actually a common approach. Many implantologists use:
- All-on-4 on the lower jaw (the mandibular bone is denser; 4 implants are sufficient)
- All-on-6 on the upper jaw (the maxillary bone is more porous and benefits from additional anchorage points)
The final decision always belongs to the surgeon, based on the CBCT (3D computed tomography) scan and clinical evaluation.
Step-by-Step Process
Regardless of the protocol chosen, the stages are similar:
- Consultation + CBCT — bone evaluation, digital planning
- Guided surgical planning — 3D-printed surgical guide for precise placement
- Surgery day — extractions (if needed) + implant placement + fixed provisional prosthesis
- Osseointegration period — 3–6 months with the provisional prosthesis
- Final prosthesis — definitive restoration in zirconia or composite on a titanium framework
All-on-4 vs All-on-6 Prices in Romania 2026
| Package | Indicative price |
|---|---|
| All-on-4 single arch (including provisional) | €3,500–6,000 |
| All-on-4 both arches | €7,000–11,000 |
| All-on-6 single arch (including provisional) | €4,500–8,000 |
| All-on-6 both arches | €9,000–15,000 |
| Final zirconia prosthesis (per arch) | €2,000–4,000 additional |
| Sinus lift (if required) | €500–1,500 per side |
Compared with Western Europe, savings are 50–70% for the same implant brands (Straumann, Nobel Biocare, Neodent).
Frequently Asked Questions
How long does the final prosthesis last? With proper maintenance (oral hygiene + check-ups every 6 months), the implant-supported prosthesis lasts 15–25 years. The implants themselves can last a lifetime.
Is it painful? The procedure is performed under local anaesthesia or conscious sedation. Post-operative discomfort is manageable with standard anti-inflammatory medication and lasts 3–5 days.
Can I eat normally? With the provisional prosthesis: soft diet for 2–3 months. With the final prosthesis: you can eat almost anything, including hard foods.
Conclusion
Both All-on-4 and All-on-6 are excellent solutions for a complete smile restoration. The main difference lies in the number of implants and the clinical indication. There is no “absolute winner” — the right choice depends on your bone condition, the arch being treated and your surgeon’s recommendation.
Want to compare All-on-4 and All-on-6 offers from verified clinics in Romania? Request a free quote through ClickDent — you’ll receive a response within 24 hours.