All-on-Six is a treatment approach designed for completely edentulous jaws or jaws with teeth that require extraction, aiming to restore permanent dental function with a fixed bridge supported by six implants. Ideal candidates are patients with good general health, who can maintain oral hygiene, who have sufficient bone volume and quality, and who prefer fixed prosthetic solutions. If the existing teeth in the jaw have a poor prognosis, extraction and implant placement can be planned in the same session.
The success of the treatment depends on proper indication, precise surgery, optimal distribution of chewing forces, and the biomechanical design of the prosthesis.
During candidate evaluation, a detailed clinical examination, CBCT-based 3D imaging, digital impressions, and bite analysis are performed. If bone volume is sufficient, distributing six implants in strategic positions provides better anterior–posterior spread, which improves load distribution. All-on-Six can generally be performed safely in patients whose chronic conditions—such as diabetes, hypertension, or osteoporosis—are well controlled. Uncontrolled systemic diseases, active infections, heavy smoking, severe bruxism, and poor hygiene are factors that reduce success; in such cases, pre-treatment preparation and habit modification are essential.
Can Completely Edentulous Patients Receive All-on-Six Implants?
Complete edentulism is the most common indication for All-on-Six. Long-term edentulous patients may experience reduced bone height and width. Therefore, bone mapping is done during planning, implant angulation and length are determined using 3D imaging, and guided surgical templates can be prepared when needed. If bone volume is below required limits, preparatory procedures such as sinus lifting, bone grafting, or ridge expansion can be performed. In some cases, angled implants in the posterior region allow avoidance of the sinus and nerve areas.
A major concern for fully edentulous patients is “being without teeth.” If adequate primary stability is achieved, a temporary fixed bridge can be delivered within 1–2 days, allowing patients to maintain social comfort even during treatment. The final bridge is fabricated after osseointegration. Soft diet, proper hygiene under the prosthesis, and follow-up appointments are mandatory for predictable results.
Are Patients with Weak Bone Structure Suitable for All-on-Six?
Bone quantity and quality are key determinants of implant success; however, “weak bone” is not an absolute contraindication for All-on-Six. Bone density and thickness are assessed during the initial evaluation. Treatment planning may include: using angled implants to avoid critical anatomical structures, choosing short or wide-diameter implants to improve primary stability, or performing sinus lifting and bone grafting when necessary. In weak bone, immediate loading decisions are made cautiously; if sufficient torque and stability cannot be achieved, loading may be postponed, and in rare cases temporary removable prostheses may be used.
In the presence of osteoporosis, the patient’s medication history—especially intravenous bisphosphonates—must be carefully reviewed. When systemic risks are controlled and surgical trauma is minimized, implant success remains high. The strategic placement of six implants may offer biomechanical advantages over All-on-Four in weak bone. Nevertheless, personalized planning is essential for every case. (Implant number may vary—All-on-4-5-6-7-8.)
Can Elderly Patients Receive All-on-Six Implants?
Age alone is not a contraindication. In elderly patients, the goal is to provide safe, comfortable rehabilitation that quickly improves nutrition, speech, and quality of life. Evaluation includes assessing systemic disease control, medications, bleeding and healing capacity, manual dexterity, and oral hygiene motivation. Local anesthesia is usually sufficient; sedation options can be considered for anxious patients. Tissue-friendly techniques and guided surgery shorten operation time and improve comfort and healing in older adults.
Bone resorption and soft tissue changes may vary in advanced age. Therefore, during try-in stages, lip support, phonation, vertical dimension, and occlusion must be carefully assessed. With proper care and regular follow-ups, implants and bridges can be used for many years. As age increases, attending maintenance appointments becomes essential for preventing small problems from progressing.
Can Patients Who Previously Had Implants Receive All-on-Six?
Patients who have undergone previous implant treatment can transition to full-arch fixed rehabilitation with All-on-Six. The first step is evaluating the position and health of the existing implants. If stable and ideally positioned, and biomechanically compatible with the new plan, they may be incorporated. However, implant brand compatibility, connection type, implant location, bone health, and availability of prosthetic components must be evaluated. If problems such as peri-implantitis, bone loss, or fractures are present, they must be treated first; problematic implants may be removed and replaced in correct positions.
The reasons behind previous implant or prosthetic failure must be analyzed—such as occlusal overload, poor hygiene, bruxism, smoking, design errors, or irregular follow-up. The new All-on-Six plan is created to eliminate these risks. Night guards, polished prosthetic bases, and hygiene aids such as interdental brushes and water irrigators are incorporated into the treatment routine when necessary.
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For diagnosis and treatment, you must consult your dentist.