Four or six implants is not a package choice. Your bone, your bite and the design of the bridge decide the number, and a 3D plan should show why.
The consultation includes an examination and a review of what your bone allows. A CBCT 3D scan is taken when implants are being planned.
Both replace all the teeth in one jaw with a fixed bridge screwed onto implants. All-on-4 uses four implants, with the back two usually tilted to avoid the sinus or the nerve; All-on-6 uses six, spreading the bite over more support but needing more bone. At Creative Arts in Dubai, the number of implants per arch is decided by CBCT planning of your bone and bite, not chosen from a menu.
Timings are typical ranges and depend on your bone, health and healing.
A general comparison drawn from mainstream implant practice. Your CBCT scan and bite decide which points apply to you.
| All-on-4 | All-on-6 | |
|---|---|---|
| Implants per arch | Four | Six |
| Implant angle | Front two upright; back two usually tilted | Mostly upright; tilting used where needed |
| Bone needed | Works with less bone; tilting avoids the sinus or nerve | Needs adequate bone at more points along the arch |
| Bone grafting | Designed to reduce the need for it | More likely where bone at the back is thin |
| Support at the back | Back teeth often extend beyond the last implant (a short cantilever) | Support usually reaches further back, with less extension |
| If one implant has a problem | Fewer reserves; the whole bridge is usually affected until it is resolved | More supports can leave more options while one implant is treated |
| Surgery | Fewer implant sites | More implant sites; usually a longer procedure |
| Daily cleaning | Fewer implants to clean around | More implants to clean around |
| Cost direction | Fewer implants and components | More implants and components, unless grafting is avoided elsewhere |
Neither option is a better product in general. Well-planned bridges on four or on six implants can both serve for many years; maintenance and bite control matter as much as the number.
The names All-on-4 and All-on-6 describe a count, not a different kind of treatment. Some clinicians simply say All-on-X, because the right number for an arch can also be five, or more than six. These are the factors that set it:
If upper-jaw bone is severely reduced, other routes come into the discussion, such as a sinus lift or, for severe bone loss, zygomatic implants, which are assessed by Dr. Firas Osman.
Typical patterns, not rules. Many arches could be treated either way, and the plan explains why one was preferred.
Four implants, back two tilted
Six implants spread along the arch
Every implant needs healthy bone around it and room to clean. An extra implant forced into thin bone, or placed only after grafting that was not otherwise needed, adds surgery and cost without necessarily adding strength. The question is not how many implants you can have, but how many your arch needs.
Full-arch cases at Creative Arts follow the same sequence, whatever the final count.
Remaining teeth, gums, bite, medical history, smoking and any previous implants or dentures.
Visit 1A CBCT 3D scan maps bone, the sinus and the nerve; an intraoral scan and photographs record teeth and bite.
RecordsThe final tooth positions are planned before the implants, so implants are placed where the bridge needs support.
DesignImplant positions are planned against the bone. Where the case calls for it, a 3D-printed surgical guide is made.
PlanningYou receive the recommended number of implants, the alternatives considered and the cost of each.
Before you commitImplants are placed under local anaesthesia, with sedation if agreed. The final bridge follows once the implants have integrated.
Treatment
Whether a bridge sits on four implants or six, it has to seat passively on every implant at once, with screw channels placed where the dentist can reach them. Creative Art Dental Lab, in our building, designs and makes full-arch frameworks and bridges, including pink gingival ceramic where gum and bone have been lost. The lab team can see the bite and smile in person rather than from photographs.
Want to see how a full-arch bridge is planned, placed and maintained at Creative Arts?
Read about All-on-4Full-arch cases are planned by Dr. Firas Osman, Oral & Maxillofacial Surgeon & Implantologist, with Dr. Khalid Saeed and Dr. Kinan Bonni, who also plan and place implants. The lab makes the bridge.
Six implants share the biting load between more supports, which can help in softer bone or with a heavy bite. That does not make All-on-6 stronger for everyone: a well-planned All-on-4 in good bone is a robust solution. The bone, bite and bridge design matter more than the label.
Yes, when there is enough bone at the front of the upper jaw. The back implants are tilted to avoid the sinus. Because upper-jaw bone is usually softer, some upper arches are planned with more than four implants, or need a sinus lift first.
Not always. If the CBCT scan shows enough bone at all six positions, no grafting is needed. Where bone at the back is thin, the choice is between grafting to allow more implants and tilting fewer implants to avoid grafting; the plan explains which suits you.
Not necessarily, but with four implants every one matters. The bridge usually needs attention until the problem implant is treated or replaced, and a temporary arrangement may be needed. With more implants, there may be more options while one is managed.
You can always discuss it. The surgeon will explain whether your bone supports six implants and whether the extra support justifies more surgery and cost. At Creative Arts the number of implants per arch is decided by planning, and the reasoning is written into your plan.
There is no simple winner. Both can serve for many years when they are well planned and maintained. Longevity depends more on daily cleaning, regular professional reviews, controlling grinding and not smoking than on whether the arch has four or six implants.
Usually, because it involves more implants and components. The difference can narrow if four implants would need grafting that six would not, or the other way round. Your written plan itemises implants, any grafting, the provisional and the final bridge for your case.
Not by you. Both are fixed bridges screwed onto the implants. You clean around and under them at home with a brush, floss designed for bridges or a water flosser, and the dentist can unscrew the bridge at maintenance visits when needed.
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A consultation ends with a diagnosis and a written, itemised plan — not a sales pitch. Book online, message us on WhatsApp, or call the clinic.
