All-on-6 — Six Implants, More Support

Safety and load distribution — when there’s a reason. Six implants reduce the load on each one, allow a longer bridge further back, and leave a safety margin: if one implant out of six doesn’t take, the bridge usually keeps working on the five until it’s replaced. With four, losing one is a quarter of the support, and sometimes the bridge has to come off temporarily. When we’d suggest six: the upper jaw, where the bone is softer; people who grind or chew hard; a bridge facing strong natural teeth in the opposite jaw; anyone who wants teeth up to the second molar. When not: a lower jaw with good bone — there, two extra implants are two more drill holes and more money for no real benefit.

Yes. With four, the back implants are tilted and use the bone at the front; with six, the two extra implants go further back, and there has to be bone there — enough height and width, and in the upper jaw a reasonable distance from the sinus floor. If it isn’t there, the options are a sinus lift (closed, when 2–4 mm are missing, usually at the same visit; open when more is missing, which adds months), or simply four tilted implants with no preparation. So “six” isn’t always just the more expensive option — sometimes it’s the longer one too. The CT shows it in millimetres, and at the consultation you see on screen where there’s room and where there isn’t.

Because every implant is another drill hole, more bone that has to be there, more surgery time and more money — and in a lower jaw with good bone, four hold exactly like six. Two implants “for safety” where they aren’t needed are two unnecessary small operations, and sometimes an unnecessary sinus lift to make room for them. We suggest six when there’s a reason we can show you on the CT: an upper jaw with soft bone, grinding, a long bridge up to the second molar, or an opposite jaw with strong natural teeth. Not as a default, and not to pad out a quote. If we suggest six, you’ll see why on screen; if we suggest four, it’s because that’s enough.

Technically yes; in practice it isn’t worth it. The bridge is designed for a particular number of anchor points and their positions, and it’s made as a single unit. Adding two implants after healing means a new bridge — planning, scan, manufacture — and that costs more than two implants placed from the start in the same operation. The bone too: the spot where the extra implants would have gone keeps resorbing during the healing months, and what was possible on the day of surgery isn’t always possible a year later. So we decide at planning, on the CT, once. If there’s any doubt — borderline bone, grinding — we’d rather go for six from the start. What does happen in practice: an implant that doesn’t take is replaced with a new one, and that’s covered by the warranty. But that’s a replacement, not an addition.