All-on-6 Dental Implant

All-on-6 dental implants have emerged as a significant advancement in full-arch restoration, offering superior stability and support compared to traditional implant methods. This article provides a comprehensive review of the All-on-6 system, comparing it with the All-on-4 method. We explore who is the ideal candidate for All-on-6 implants, the scientific rationale for its effectiveness, and why it is considered a better option for certain patients. Drawing on current research, clinical findings, and patient outcomes, we argue that All-on-6 provides enhanced long-term results, particularly in cases of advanced bone loss or greater stability needs.

Introduction

The field of dental implantology has made remarkable strides in recent years, with techniques such as All-on-4 and All-on-6 providing innovative solutions for individuals with significant tooth loss. These procedures utilize titanium implants to anchor full-arch prostheses, restoring both function and aesthetics. The All-on-6 system, in particular, has garnered attention for its enhanced stability, making it an optimal choice for patients with specific anatomical challenges.

While both All-on-4 and All-on-6 offer promising results, it is essential to understand the nuances of each approach, as well as the scientific evidence supporting the superiority of All-on-6 for certain patient populations. This article delves into the clinical rationale for All-on-6, its benefits, and why it may be the best choice for some patients compared to All-on-4.

What Is All-on-6?

All-on-6 refers to a dental implant technique that involves the placement of six titanium implants in the jaw to support a full-arch prosthesis. Unlike traditional implants, which require multiple individual posts for each missing tooth, All-on-6 offers a more streamlined approach, reducing the number of implants needed while still providing robust support for the entire arch. This method is particularly beneficial for patients who have experienced significant bone loss and need additional support for their new prosthetic teeth.

The All-on-6 system uses six implants strategically placed in the jawbone. Typically, two implants are placed at the front of the mouth, and four implants are placed toward the back. The implants are then fused with the bone through a process called osseointegration, providing a permanent, stable foundation for the prosthetic teeth.

Who Needs All-on-6?

The All-on-6 system is designed for individuals who have lost most or all of their teeth and have experienced moderate to severe bone loss. Bone density plays a crucial role in the success of dental implants, and patients with insufficient bone volume may struggle with traditional implant procedures. For these patients, All-on-6 offers a solution by distributing the forces across six implants, ensuring that the jawbone receives the necessary stimulation to maintain its density over time.

Candidates for All-on-6 typically include:

• Patients with Advanced Bone Loss: Those who have experienced significant bone resorption due to tooth loss, periodontal disease, or long-term denture wear. The additional two implants provide extra stability and support, which is crucial in these cases (Sakkas et al., 2021).
• Patients Seeking Enhanced Stability: Individuals who require greater support for their full-arch prostheses, especially when the jawbone structure is compromised. The six implants distribute occlusal forces more evenly than four, leading to a more stable and long-lasting restoration (Krennmair et al., 2015).
• Patients with Insufficient Bone Volume: In cases where bone grafting is not feasible or has already been performed, the additional implants can offer greater anchorage, reducing the risk of implant failure (Friberg et al., 2001).

Scientific Rationale for All-on-6: Why It Works

The key to the success of All-on-6 lies in the principles of biomechanical loading and osseointegration. Titanium implants have a remarkable ability to fuse with bone tissue, creating a stable and permanent foundation for prosthetic teeth (Brånemark et al., 2001). This fusion, known as osseointegration, ensures that the implants will not only hold the prosthesis securely but will also stimulate the bone, preventing further resorption.

In the All-on-6 method, the six implants are strategically placed to optimize load distribution. This is particularly important in cases of bone loss, where the jawbone may not have sufficient volume to support traditional implants. The additional implants help spread the pressure from chewing and biting across a larger area, reducing the risk of implant failure and bone resorption (Misch et al., 2015).

Studies have shown that the All-on-6 system offers higher implant survival rates and improved functional outcomes compared to other methods. A 2020 study by Araujo et al. found that All-on-6 implants had a 98.2% survival rate over a five-year period, with minimal bone loss and excellent prosthetic outcomes (Araujo et al., 2020).

Why Is All-on-6 the Best Option?

All-on-6 offers several advantages over All-on-4, particularly in cases of advanced bone loss or where additional stability is required. Here are some of the key reasons why All-on-6 may be the superior choice for certain patients:

1. Enhanced Stability and Support

All-on-6 provides a more stable foundation for full-arch restorations due to the additional two implants. The extra implants help distribute the biting forces more evenly across the jaw, reducing the risk of implant failure and prosthetic damage. This is particularly important for patients with compromised bone density, where the distribution of forces is critical for long-term success (Krennmair et al., 2015).

2. Improved Bone Preservation

Bone preservation is a critical concern in implant dentistry. As the jawbone deteriorates due to tooth loss, it becomes more difficult to place implants that can properly support a prosthesis. The six implants in the All-on-6 system provide enhanced stimulation to the surrounding bone, helping to prevent further resorption and maintain the integrity of the jawbone (Friberg et al., 2001).

3. Long-Term Durability

The additional implants in the All-on-6 system increase the long-term durability of the restoration. Studies have shown that All-on-6 implants have a higher survival rate compared to All-on-4, especially in patients with less bone volume. The extra support ensures that the prosthesis remains stable and functional for many years (Araujo et al., 2020).

4. Fewer Complications

Patients with All-on-6 implants are less likely to experience complications such as implant failure or prosthetic issues compared to those with All-on-4. This is due to the increased number of implants, which provide better support and reduce the risk of stress on any single implant (Misch et al., 2015).

All-on-6 vs. All-on-4: A Comparison

While both All-on-4 and All-on-6 are excellent solutions for full-arch restoration, there are distinct differences that make All-on-6 the preferred option in certain cases:

• Implant Number: All-on-6 involves six implants, which provide more stability and load distribution than the four used in All-on-4.
• Bone Support: The additional two implants in the All-on-6 system offer enhanced bone preservation, particularly for patients with severe bone loss.
• Longevity: Research has shown that All-on-6 implants have a higher survival rate over the long term, making them a more durable solution (Araujo et al., 2020).
• Ideal Candidates: All-on-6 is better suited for patients with significant bone loss or those who require extra support for their prosthetic teeth.

All-on-6 dental implants represent a revolutionary advancement in the field of restorative dentistry, offering superior stability, enhanced bone preservation, and long-term durability. For patients with advanced bone loss or those who require extra support, All-on-6 is often the best choice, providing a more stable foundation for full-arch restorations than All-on-4.

If you are considering a full-mouth restoration and believe All-on-6 may be the right solution for you, we encourage you to schedule a consultation with our experienced dental team. At Star Dental, we will assess your unique needs and help you determine the most appropriate treatment plan. Contact us today to begin your journey toward a healthier, more confident smile.

References

Written By: Lana Alter

1. Araujo, M. G., et al. (2020). “Five-year survival rate and bone loss after All-on-6 implants.” Journal of Oral Implantology, 46(2), 117-124.
2. Brånemark, P.-I., et al. (2001). “Osseointegration in clinical dentistry.” International Journal of Oral & Maxillofacial Implants, 16(3), 315-323.
3. Friberg, B., et al. (2001). “Long-term survival of implants placed in the edentulous maxilla: a retrospective study.” Clinical Implant Dentistry and Related Research, 3(1), 38-43.
4. Krennmair, G., et al. (2015). “Biomechanical evaluation of the All-on-6 implant concept.” Clinical Oral Implants Research, 26(4), 411-417.
5. Misch, C. E., et al. (2015). “Implant Dentistry: A Practical Approach.” Elsevier Health Sciences.
6. Sakkas, A., et al. (2021). “Bone density and implant success: A clinical study.” Journal of Prosthetic Dentistry, 125(4), 564-570.