All-on-6 Implant Treatment İstanbul

Multidisciplinary scientific editor: Prof. Dr. Mehmet Oğuz Öztoprak – Specialist in Orthodontics and Dentofacial Orthopaedics
Clinical scientific review: The implant surgery and implant-supported prosthetic rehabilitation sections are, before publication, reviewed clinically by the relevant oral and maxillofacial surgery and prosthodontics physicians.
Last updated: 22 July 2026

All-on-6 implant treatment is a comprehensive oral rehabilitation method in which the fixed full-arch prosthesis to be prepared in place of all the teeth in the lower or upper jaw is supported by six dental implants.

In this treatment, the six implants placed with an appropriate distribution in the jawbone form support points for the fixed prosthesis. In some patients, the additional implants can help distribute the chewing forces over a wider area, allow the prosthesis to be designed in different sections and preserve treatment options should a problem develop in one of the implants in the future.

Nevertheless, a greater number of implants alone does not mean that the treatment will be more successful in every situation. The suitability of All-on-6 treatment must be determined by evaluating together the amount and quality of the jawbone, the positions where the implants can be placed, the teeth in the opposing jaw, bruxism, the shape of the prosthesis to be made, the patient's general health and long-term care capacity.

Scientific consensus reports have not shown a definite superiority in implant and prosthesis survival between fixed full-arch prostheses supported by fewer than five or more than five implants. The advantage of six implants is not only numerical; it is related to the correct distribution, the design of the prosthesis and the options it offers against complications that may occur in the future.

In the All-on-6 assessments carried out at Dentapolitan in Istanbul, in addition to the bone areas where the implants will be placed, the patient's facial appearance, lip support, speech, occlusal relationships, the cleansability of the prosthesis and long-term follow-up requirements are also included in the planning. All-on-6 is, in general terms, a full-arch application of dental implant treatment approaches.

What is All-on-6 implant treatment?

All-on-6 refers to a fixed full-arch prosthesis in one jaw being attached onto six implants. “All-on-6” is not the name of a specific implant brand, but a general expression defining the number of implants used and the full-arch prosthetic approach.

The treatment generally consists of the following components:

• Six dental implants placed in the jawbone
• Abutments that provide the connection between the implants and the prosthesis
• A temporary fixed prosthesis used during the healing period in suitable cases
• The permanent full-arch prosthesis prepared after bone and soft-tissue healing

The teeth seen in the mouth do not consist of six separate implant teeth. The implants together carry a connected full-arch prosthesis. The prosthesis can be designed to complete not only the lost teeth but, in patients who require it, also the lost gum and soft-tissue volume.

Who can All-on-6 treatment be applied to?

All-on-6 treatment can be considered in the following patient groups:

• Patients who have lost all their teeth in one jaw
• Those whose majority of teeth cannot be preserved due to advanced periodontal disease
• Those who have numerous fractured, decayed or failed restorations and whose existing teeth have an insufficient long-term prognosis
• Those who complain about the retention or movement of a removable full denture
• Suitable patients who want a fixed full-arch prosthesis
• Those with a bone structure that allows six implants to be placed in positions appropriate for the prosthesis
• Patients who can maintain oral care and regular professional check-ups
• Selected patients who can benefit from a wider implant distribution due to high chewing forces
• Cases in which segmenting the prosthesis may be beneficial

Extracting all the teeth present in the mouth is not a mandatory stage of All-on-6 treatment. If there are natural teeth that can be preserved in the long term, periodontal, endodontic and prosthetic treatment options must be evaluated before a decision to extract is made.

The International Team for Implantology also recommends that, when full-arch implant treatment is being considered, options in which the existing natural teeth can be preserved be explained to the patient.

Who may All-on-6 not be suitable for?

All-on-6 treatment may not be suitable in some patients or may be applied after existing health problems are brought under control.

The main situations that may affect the treatment are as follows:

• Uncontrolled diabetes
• Active and untreated gum disease
• Inadequate oral hygiene
• Heavy cigarette and tobacco use
• A bone structure that does not allow an appropriate distribution of the implants
• Some medications or diseases affecting bone metabolism
• A history of radiotherapy applied to the head and neck region
• Conditions that seriously affect the immune system
• Being unable to clean beneath the prosthesis daily
• Being unable to attend regular check-ups
• Uncontrolled clenching or grinding
• Unrealistic expectations regarding the surgical or prosthetic outcome

None of these conditions means an absolute obstacle. The patient's general health, medications and individual risks are, where necessary, evaluated together with the relevant medical physicians. Blood thinners or medications affecting bone metabolism must not be stopped by the patient on their own.

What assessments are made before All-on-6?

The success of All-on-6 treatment does not depend solely on implant surgery. The positions of the implants must be planned according to the final prosthesis to be made.

The following topics are evaluated at the first examination:

• General health and the medications used
• Cigarette and tobacco use
• The retainability of the existing teeth
• Periodontal health
• The width, height and density of the jawbone
• The position of the upper jaw sinuses
• The course of the lower jaw nerve canal
• The anterior-posterior distribution of the implants
• The vertical and horizontal relationship between the jaws
• Lip support and facial profile
• The smile line
• Speech and phonetic requirements
• Occlusal relationships
• Bruxism and the condition of the chewing muscles
• The patient's capacity to clean the prosthesis
• The characteristics of the natural tooth or prosthesis in the opposing jaw

A panoramic radiograph can assist the initial assessment. Cone beam computed tomography is used in patients who require it to examine in detail the three-dimensional positions of the implants, the sinuses, the nerve canal and the amount of bone.

Digital intraoral scans, facial and intraoral photographs, impressions and occlusal records contribute to designing the temporary and permanent prosthesis before surgery.

How is All-on-6 treatment performed?

Although the treatment process varies according to the patient's existing teeth, bone condition and temporary prosthesis plan, it generally consists of the following stages.

1. Prosthetic and digital planning

First, the position of the final teeth the patient will use is determined. The positions of the implants are then planned to support this prosthesis.

The following factors are taken into account at this stage:

• The size and shape of the teeth
• Lip support
• The smile line
• Occlusal height
• Speech
• Chewing forces
• The space required for cleaning beneath the prosthesis
• The anterior-posterior distribution of the implants
• Whether the prosthesis is made one-piece or segmented

Placing the implants only at points where bone is present can result in prostheses that are difficult to clean and biomechanically unfavourable. For this reason, the surgical plan must not be considered separately from the final prosthesis plan.

2. Extraction of teeth that cannot be preserved

If some of the existing teeth cannot be preserved, the extractions can be done in the same session as the implant surgery or beforehand.

When deciding to extract teeth, not only their current images but also the periodontal support, root structure, infection, restoration possibility, occlusal relationships and long-term prognosis must be evaluated.

3. Placement of the six implants

The procedure is mostly carried out under local anaesthesia. Depending on the extent of the surgery and the patient's level of anxiety, sedation options can additionally be evaluated in suitable cases.

The six implants are distributed along the jaw as evenly as possible. Depending on the anatomical conditions, some of the implants can be placed vertically and some at an angle.

The expression All-on-6 does not mean that all the implants must necessarily be parallel to one another. The angles and positions of the implants are determined according to the sinuses, the nerve canal, the amount of bone and the needs of the prosthesis.

4. Application of the temporary fixed prosthesis

When the implants reach adequate initial stability, a temporary fixed prosthesis can be attached to the implants on the same day or within a short time in suitable patients.

The factors affecting the decision on same-day loading are as follows:

• The initial stability of the implants
• Bone quality
• The distribution of the six implants over the jaw
• Whether a simultaneous bone graft is applied
• The rigidity of the prosthesis
• The teeth in the opposing jaw
• Chewing forces
• Bruxism
• The patient's compliance with soft-diet rules

If one or several of the implants do not achieve adequate stability, the application of a same-day fixed prosthesis can be postponed. Placing six implants does not guarantee a same-day fixed tooth.

5. Bone and soft-tissue healing

After the implants are placed, the surrounding bone remodels and integrates with the implant surface. This process is called osseointegration.

The presence of a temporary prosthesis in the mouth does not mean that the healing of the implants is complete. During the healing period, the prosthesis must be protected from excessive chewing forces, the patient must comply with the dietary rules and continue attending check-up appointments.

6. Preparation of the permanent prosthesis

When bone and gum healing reaches a sufficient level, digital or conventional impressions are taken for the permanent prosthesis.

The following elements are evaluated in the preparation of the permanent prosthesis:

• The positions of the implants
• The passive fit of the prosthesis
• Occlusal relationships
• The distribution of chewing forces
• The colour and shape of the teeth
• Smile and facial aesthetics
• Speech
• The cleansability of the underside of the prosthesis
• The durability and repairability of the material to be used

The permanent prosthesis can be prepared from metal-based acrylic, composite, zirconia or different hybrid materials. Each material has different characteristics in terms of aesthetics, weight, wear, fracture, repair and cost.

Can same-day fixed teeth be done?

In suitable patients, a temporary fixed prosthesis can be applied on the same day or within a short time. However, this prosthesis is mostly not the permanent prosthesis.

The temporary prosthesis applied on the same day:

• Is prepared to be used during the healing period.
• Can help share forces by connecting the implants to one another.
• Must be protected from hard foods and excessive forces.
• May require adjustment over time according to tissue changes.
• Is replaced with the permanent prosthesis after the bone heals.

The expression “teeth in a day” may describe that a fixed temporary tooth can be applied in a short time in some patients; however, it does not mean that all surgical and prosthetic treatment is completed in a single day.

What is the advantage of six implants in All-on-6 treatment?

Six implants can provide some planning advantages compared to four implants in suitable patients:

• Distributing the prosthesis support over more points
• Sharing the chewing forces among the implants
• Reducing the distances between the implants
• Allowing the prosthesis to be segmented in some cases
• Being able to reduce long posterior cantilevers
• Preserving alternative prosthetic options should a problem develop in one implant in the future
• Providing a different force distribution in patients with high chewing forces
• Being able to offer additional support in areas with lower bone density such as the upper jaw

However, for these advantages to be achieved, the implants must be placed in positions that are appropriate for the prosthesis and balanced. Six implants placed too close to one another or only in limited areas where bone is present are not necessarily more advantageous than four well-distributed implants.

What is the difference between All-on-6 and All-on-4?

The most notable difference between the two treatments is the number of implants used in one jaw:

• All-on-4: The fixed full-arch prosthesis is supported by four implants.
• All-on-6: The fixed full-arch prosthesis is supported by six implants.

All-on-6 treatment can be considered in the following situations:

• If there is sufficient bone along the jaw that allows an appropriate distribution of six implants
• If a wider spread of the implant support is desired
• If segmenting the prosthesis is planned
• If there are natural teeth or high chewing forces in the opposing jaw
• If it is desired to preserve additional support options against future mechanical or biological complications
• If additional implant support is deemed appropriate in the upper jaw

All-on-4, on the other hand, can be preferred in the following situations:

• If the bone volume is more limited
• If additional and advanced bone surgery would be required for six implants
• If anatomical structures can be avoided with angled posterior implants
• If four implants can be placed appropriately for the prosthesis and with sufficient distribution
• If a more limited surgical approach is advantageous for the patient's general condition

Scientific data do not show a definite superiority in survival between fixed full-arch prostheses supported by four or more implants. For this reason, it cannot be said that All-on-6 is “more successful in every situation” or that All-on-4 is “weaker”.

The decision must be made according to the requirements of the prosthesis and the patient's biological conditions, before the number of implants.

Is a bone graft necessary in All-on-6 treatment?

In order to distribute the six implants appropriately along the jaw, bone augmentation procedures may be required in some patients.

The supportive procedures that can be applied are as follows:

• Bone preservation at the extraction site
• Horizontal bone augmentation
• Vertical bone augmentation
• Particulate or block bone graft
• Sinus floor elevation in the upper jaw
• Soft-tissue thickening procedures

In All-on-6 treatment, a greater bone volume may sometimes be needed compared to All-on-4 in order to place the two additional implants in positions appropriate for the prosthesis.

Nevertheless, a graft is not required in every All-on-6 patient. The decision is made by evaluating the tomography and the prosthesis plan together.

Directing the patient to unnecessarily more extensive surgery merely to place six implants is not correct. The advantage that the additional implants will provide and the risk and healing time that the surgery will create must be evaluated together.

What treatments can be considered instead of All-on-6?

All-on-6 is not the only treatment option. Depending on the patient's anatomical conditions, health status and expectations, the following options can be evaluated:

• An All-on-4 fixed full-arch prosthesis
• A fixed prosthesis supported by five implants
• A fixed prosthesis supported by more than six implants
• An implant-supported removable overdenture
• A lower-jaw removable prosthesis supported by two implants
• An upper-jaw removable prosthesis supported by four implants
• A conventional full denture
• Rehabilitation combined with preservable natural teeth
• Segmented implant-supported bridges

For some patients, a removable implant-supported prosthesis may be more suitable than a fixed prosthesis in terms of cleansability, lip support, a more limited surgical requirement or ease of care.

What are the advantages of All-on-6 treatment?

The main advantages that All-on-6 treatment can provide in suitable patients are as follows:

• A fixed full-arch prosthesis can be used
• The prosthesis is supported by six implants
• The chewing forces can be distributed over a wide area
• Higher stability can be provided compared to a removable prosthesis
• A temporary fixed prosthesis can be applied in a short time in suitable cases
• Some prostheses can be segmented
• Lip and soft-tissue support can be rearranged
• Chewing and speech function are supported
• Additional prosthetic options may be available should a problem develop in a single implant in the future
• A fixed prosthesis that is not removed daily by the patient is used

It cannot be guaranteed that these advantages will be obtained to the same extent in every patient. The results depend on the initial bone and tissue loss, the jaw relationships, the muscle forces and the patient's care habits.

What are the risks of All-on-6 treatment?

All-on-6 is a comprehensive treatment with both surgical and prosthetic risks.

Surgical risks may include the following:

• Bleeding
• Swelling and bruising
• Infection
• Delay in wound healing
• One of the implants not being able to achieve adequate stability
• Osseointegration not occurring
• Damage to neighbouring anatomical structures
• Temporary or, rarely, permanent sensory change in the lower jaw
• Sinus-related problems in the upper jaw
• Complications related to the bone graft

Prosthesis-related problems may include the following:

• Temporary prosthesis fracture
• Screw loosening
• Wear of the prosthesis teeth
• Fracture in the acrylic, composite or ceramic material
• Difficulty adapting to speech
• Food accumulation beneath the prosthesis
• Difficulty cleaning
• The need to readjust the occlusion
• The permanent prosthesis requiring maintenance, repair or replacement

Peri-implant mucositis or peri-implantitis can also develop in the tissues around the implant. The EFP guideline recommends that the prevention of these diseases begin during implant planning and that, after the implants enter function, a regular care programme be created according to the patient's individual risks.

Is All-on-6 treatment painful?

The procedure is mostly carried out under local anaesthesia. During surgery, pain control is aimed for; the patient may feel pressure, vibration or touch.

After surgery, the following findings may be seen:

• Tenderness
• Swelling
• Mild bleeding
• Bruising
• Temporary limitation in mouth opening
• Sensitivity during chewing

The level of discomfort varies according to the number of teeth extracted, whether a graft was applied, the extent of the surgery and the patient's individual healing response.

Definite statements such as “it is completely painless” or “it is a very painful procedure” are not correct.

In the event of increasing pain, fever, a bad taste, discharge, uncontrolled bleeding, prolonged numbness or a noticeable sensation of movement in the prosthesis, the clinic that performed the treatment should be contacted.

How should one eat after All-on-6?

Even if a temporary fixed prosthesis has been applied on the same day, the integration of the implants with the bone continues. Excessive force must not be applied to the implants during this period.

The following types of foods can be preferred for the period recommended by the physician:

• Yoghurt and soft dairy products
• Eggs
• Well-cooked fish
• Soft pasta and rice
• Vegetable purees
• Warm soups
• Well-cooked vegetables
• Soft meats cut into small pieces

Hard nuts, ice, hard bread crusts, seeds, raw and hard vegetables, sticky foods and foods that would apply sudden force to the prosthesis should be avoided during the healing period.

The nutrition period and restrictions must be personalised according to the extent of the surgery performed and the stability of the implants.

How is an All-on-6 prosthesis cleaned?

The All-on-6 prosthesis is not removed daily by the patient. However, the underside of the prosthesis and the area around the implants must be cleaned regularly.

The following tools can be used for care, according to the patient:

• A soft-bristled toothbrush
• A single-tufted brush
• An interdental brush of a suitable size
• Special floss suitable for implant prostheses
• A floss threader
• An oral irrigator

An oral irrigator does not replace brushing and mechanical cleaning; it can be used as an aid to them.

The patient must be able to reach the cleaning areas beneath the prosthesis. The permanent prosthesis must be designed not only for aesthetic appearance but in a way that allows daily care and professional check-ups.

Can an All-on-6 prosthesis be removed?

The All-on-6 prosthesis is fixed from the patient's point of view and is not removed by the patient during daily use. However, when care, cleaning, screw checks or repair are required, it can be removed by the physician.

The implants within the bone are not removed during routine check-ups. If infection, implant loss or another medical necessity arises, the relevant implant can be removed surgically.

For this reason, the statement that “All-on-6 implants can never be removed” is not correct.

How long does All-on-6 treatment take?

The treatment duration varies according to the patient's initial condition.

The main factors affecting the duration are as follows:

• The number of teeth to be extracted
• The presence of active infection
• The need for a bone or soft-tissue graft
• The initial stability of the implants
• Whether a same-day temporary prosthesis can be applied
• Whether single-jaw or double-jaw treatment is carried out
• The patient's healing capacity
• The material and production method of the permanent prosthesis
• The need for try-in and adjustment

In suitable patients, the implants and the temporary fixed prosthesis can be applied on the same day or within a short time. For the permanent prosthesis, however, it is usually necessary to wait for the healing of the bone and soft tissues.

Using a fixed tooth on the first day does not mean that all the treatment is completed in a single session.

What is the lifespan of All-on-6 implants?

It is not scientifically correct to give a fixed usage period valid for all patients or a “lifetime guarantee” for All-on-6 implants.

The factors affecting the long-term condition are as follows:

• The position and distribution of the implants
• The health of the surrounding bone and gum tissues
• Oral hygiene
• History of periodontitis
• Smoking
• Diabetes control
• Bruxism
• The design of the prosthesis
• The teeth in the opposing jaw
• Regular professional care
• The patient's attendance at check-up appointments

While the implants remain healthy within the bone, the prosthesis, teeth, screws or connection parts on them may require maintenance and repair over time. For this reason, the survival of the implants and the maintenance-free usage period of the prosthesis are not the same thing.

Does clenching affect All-on-6 treatment?

Bruxism does not necessarily prevent All-on-6 treatment; however, it can increase the mechanical loads on the implants, screws and prosthesis.

In patients who clench their teeth, the following problems may be encountered more frequently:

• Temporary prosthesis fracture
• Wear of the prosthesis teeth
• Screw loosening
• Ceramic or acrylic fracture
• Change in occlusal contacts
• The prosthesis requiring more frequent maintenance

For this reason, before treatment the chewing muscles, tooth wear, jaw movements, occlusal relationships and jaw joint findings must be evaluated.

Six implants alone do not provide protection against clenching. The prosthesis material, implant distribution, occlusal scheme and, in patients who require it, a protective night guard must be planned together.

Why do All-on-6 implant prices in Istanbul vary?

The All-on-6 price does not consist only of the total of six implants. The surgery, temporary prosthesis, permanent prosthesis and supportive procedures determine the scope of the treatment.

The main elements that can affect the price are as follows:

• Single-jaw or double-jaw treatment
• The number of teeth to be extracted
• Bone graft or sinus procedures
• The scope of the temporary fixed prosthesis
• The material of the permanent prosthesis
• The implant and prosthetic connection system
• The types of abutments used
• Digital planning and surgical guide
• The need for sedation
• Whether the prosthesis is designed one-piece or segmented
• The check-up, care and repair programme

A standard price given without an examination and a three-dimensional assessment may not reflect the patient's real treatment need.

It is useful for patients researching All-on-6 implant treatment in Istanbul to ask clearly about the following:

• Is the temporary fixed prosthesis included in the price?
• From which material will the permanent prosthesis be made?
• If a bone graft is needed, will it be charged separately?
• Will the treatment be completed in one or two visit periods?
• What are the maintenance and repair conditions of the prosthesis?
• Will the brand, diameter and length information of the implants be given to the patient?
• How will the regular check-up programme be conducted?

Why is regular follow-up important in Istanbul?

All-on-6 is a rehabilitation that requires long-term follow-up after the surgical procedure.

The following topics are evaluated at check-ups:

• Bleeding or inflammation around the implant
• Plaque and tartar accumulation
• Peri-implant pocket depth
• Bone levels
• Cleaning beneath the prosthesis
• Screws and connection parts
• Wear or fractures in the prosthesis material
• Occlusal contacts
• Chewing muscles and bruxism findings

The EFP guideline recommends that, after the implant prosthesis enters function, a supportive implant care programme structured according to individual risks be applied.

When treatment is planned in Istanbul, access not only to the day of surgery but also to temporary prosthesis check-ups, permanent prosthesis try-ins and long-term care appointments must be taken into account. Dentapolitan provides services in Istanbul with its Bostancı, Ümraniye and Pendik clinics.

Personalised implant number and prosthesis planning

In full-arch implant treatment, the aim is not to place the greatest possible number of implants. The aim is to create a prosthesis that is appropriate for the patient's biological conditions, cleansable, repairable and able to carry the chewing forces in a balanced manner.

Six implants can provide an important support and planning advantage in some patients. In another patient, four well-distributed implants can be a sufficient and predictable solution with more limited surgery. In some cases, an implant-supported removable prosthesis can be more suitable than a fixed prosthesis.

For this reason, the All-on-6 decision must be made by evaluating together the clinical examination, three-dimensional radiological assessment, the prognosis of the natural teeth, the bone structure, the opposing jaw, bruxism and the patient's care capacity.

This content has been prepared for the purpose of general health information. It does not replace an examination, diagnosis or a personalised treatment plan.