All-on-4 vs All-on-6Which Is Right for You?
- The choice between All-on-4 and All-on-6 depends on your bone anatomy, arch dimensions, opposing dentition, and clinical preference - not on which sounds better.
This guide explains the evidence behind each, the cost difference, and how Dr.
Head-to-Head Comparison
| Factor | All-on-4 | All-on-6 |
|---|---|---|
| Implants per arch | 4 | 6 |
| Cost per arch at SD | NZD $5,500–$8,000 | NZD $6,500–$9,000 |
| Both arches at SD | NZD $10,000–$14,000 | NZD $12,000–$16,000 |
| Posterior implant design | Tilted 30–45° | Vertical or slightly tilted |
| Cantilever length | Longer (extends further back) | Shorter (more conservative) |
| Force distribution | Concentrated on 4 points | Distributed across 6 points |
| Bone requirement | Less (tilting bypasses atrophy) | Slightly more |
| Evidence base | Largest (30+ years, 98.2% @ 18yr) | Growing (15+ years, 97%+ success) |
| Suitable for majority? | Yes - most edentulous patients | Yes - if bone permits |
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When All-on-4 Is the Better Choice
- Standard to moderate arch dimensions
- Adequate anterior and posterior bone for tilted posterior placement
- Posterior implants can be successfully tilted to avoid sinuses and inferior alveolar nerve
- Cost-conscious patients seeking optimal value without compromising outcomes
- Patients suitable for either protocol - All-on-4 is efficient and proven
- The majority of fully edentulous New Zealand patients
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When All-on-6 Is Preferred
- Larger arch dimensions requiring extended posterior support
- Opposing natural dentition creating higher occlusal forces (>80 N biting)
- Cases where longer cantilever (All-on-4) would create excessive stress
- Bruxism or clenching history - six implants distribute forces more conservatively
- Bone quality and density adequate for six implants without compromising implant spacing
- Patient preference for additional implant redundancy and long-term margin of safety
Curious about costs and timelines?
The Decision Process at Stunning Dentistry
Protocol selection is based on clinical analysis, not cost pressure or marketing preference.
Both protocols deliver excellent long-term outcomes (>95% success at 10+ years). The difference is biomechanical optimization, not success/failure.
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Cost Comparison
| Scenario | All-on-4 | All-on-6 |
|---|---|---|
| One arch at SD | NZD $5,500–$8,000 | NZD $6,500–$9,000 |
| Both arches at SD | NZD $10,000–$14,000 | NZD $12,000–$16,000 |
| Travel (flights + hotel) | NZD $1,500–$2,500 | NZD $1,500–$2,500 |
| Total from New Zealand | NZD $11,500–$16,500 | NZD $13,500–$18,500 |
| New Zealand alternative (both arches) | NZD $50,000–$70,000 | NZD $56,000–$80,000 |
| Typical savings | NZD $33,000–$63,000 | NZD $37,500–$66,500 |
Questions about this procedure?
Specialist-only treatment planning
- Remote file review before travel
- Evidence-led treatment checkpoints
No waiting list for eligible cases
- Remote file review before travel
- Evidence-led treatment checkpoints
Trip coordinated with care timeline
- Remote file review before travel
- Evidence-led treatment checkpoints
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Frequently Asked Questions
Is All-on-6 inherently better than All-on-4?
No. Both are evidence-based protocols with excellent outcomes. All-on-6 offers more conservative force distribution, which benefits some patients (larger arches, heavy bite). All-on-4 is efficient and optimal for standard anatomies. The 'better' choice is the one matched to your anatomy and goals.
Can I switch from All-on-4 to All-on-6 later?
Theoretically possible but not routine. Better to get the recommendation right at assessment. If you have a clinical reason to add implants later (bone loss, implant failure), this can be discussed. Most patients are satisfied with their initial choice for 20+ years.
Does All-on-6 cost more because it's better?
All-on-6 costs more because you're getting two additional implants (and associated lab costs). More implants = higher cost. But 'more' doesn't always mean 'better' - it means better for specific anatomies. Your case determines the optimal choice, not budget.
What is the biggest difference between them functionally?
For patients suitable for either: All-on-4 has longer posterior cantilever (extends further), All-on-6 has shorter cantilever with more implant support points. Both feel and function identically to patients - the difference is biomechanical, not experiential. Long-term outcomes are essentially equivalent.
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This tool will help you understand potential structural and aesthetic changes before finalizing treatment decisions.
