‘All on 6’ is a type of full-mouth implant restoration, involving the placement of fixed teeth on 6 implants in one jaw. These teeth can be either metal-supported or made of zirconium. It is one of the most preferred full-mouth treatment options, especially when the patient’s bone condition is suitable. ‘All on 6’ is a popular treatment in Turkey.
‘All on 6’ is performed on individuals who are edentulous, have multiple missing teeth, or are at risk of losing their teeth. Conditions like gum diseases or poor oral hygiene can sometimes lead to irreversible damage. In such cases, extracting all teeth and opting for full-mouth implants may be the best solution. ‘All on 6’ is more ideal for patients with good oral bone conditions. The procedure involves placing implants in the posterior regions of the jaw, making the sinus position crucial. Patients with sinuses closer than 8mm to the jawbone may require sinus lifting.
Both ‘All on 6’ and ‘All on 4’ are academically approved full-mouth treatment options. The patient’s age, chronic conditions, and bone condition are crucial factors. More implant numbers are generally preferred in full-mouth implant restorations, as a higher number distributes pressure more evenly and tolerates future implant losses better. If there is sufficient bone in the mouth and the patient’s health allows, ‘All on 6’ should be the first choice. It is more suitable for younger and healthier patients. If there is extensive bone and soft tissue loss, ‘All on 4’ may be a more economical option.
‘All on 4’ is often preferred for patients aged 65 and above. If there is not enough bone for ‘All on 4,’ ball attachment prostheses could be considered. Another difference between ‘All on 6’ and ‘All on 4’ is the type of fixed prostheses on implants. ‘All on 6’ can use zirconium or metal-supported prostheses, while ‘All on 4’ can use acrylic or metal-supported porcelain. Since zirconium is non-flexible, it might cause breakage in a 4-implant system or damage to implants. The best way to determine which treatment is suitable is through the surgeon’s decision based on X-rays or 3D tomography.
The ‘All on 6’ procedure starts with the surgical extraction of existing teeth, similar to other full-mouth implant treatments. Subsequently, 6 implants are placed in the lower jaw and 6 in the upper jaw. If necessary, sinus lifting and bone grafting are performed at this stage. Measurements are taken for temporary prostheses, which are delivered to the patient. This entire process takes about 3 days. A healing period of 3-6 months is required. The patient then returns for the second visit, and the fixed teeth are constructed, taking approximately 7 days. The patient needs to visit Turkey twice for ‘All on 6’ treatment and can have new teeth within 3-6 months.
If you are considering this, there should be a valid reason. Aggressive gum diseases or loose and mobile teeth are potential justifications. Esthetic concerns can often be addressed through smile design and veneers, avoiding the need for complete tooth extraction. Extracting all teeth is an aggressive and radical treatment. A detailed X-ray and examination should be performed before making such a decision. If the teeth are beyond salvage due to damage or mobility, full-mouth restoration may be the best option for you.
‘All on 6’ treatment is one of the most expensive full-mouth treatments. In Turkey, getting ‘All on 6’ done will cost an average of 4000€-4500€ for a single jaw. This amount can vary depending on each patient’s specific needs.
‘All on 6’ involves a substantial surgical operation. Placing a total of 12 implants in the jawbone can take around 3-5 hours. Since the procedures are done under local anesthesia, the patient does not feel pain, but it can be tiring. Post-operative swelling and discomfort from keeping the jaw open for an extended period may cause jaw muscle soreness. The first month of recovery can be relatively challenging, but pain is typically not a major concern.
If done correctly, ‘All on 6’ is a long-lasting treatment. A well-made ‘All on 6’ prosthesis can be used for 10-15 years. Implants have an even longer lifespan, with some patients using them for more than 20-25 years. Many European implant brands provide a lifetime warranty. When the ‘All on 6’ prosthesis needs replacement, if there are no issues with the implants, only the prosthesis is changed.