All-on-4, explained without the sales pitch

The problem it solves

When back teeth are lost, the bone that held them resorbs. In the upper jaw the sinus drops into the space; in the lower jaw the nerve canal sits closer to the surface. Placing implants at the back of the jaw then requires grafting or a sinus lift, adding six to nine months and considerable cost.

All-on-4 sidesteps this. The two front implants are placed vertically where bone is usually good. The two rear implants are tilted, typically at 30 to 45 degrees, so they run forward through denser bone at the front of the jaw and emerge further back. This gives a wider support base without touching the sinus or nerve.

How the procedure runs

• Planning. A CBCT scan is used to plan each implant's angle, length and position against the actual bone available. Many surgeons then print a surgical guide from that plan.
• Extractions. Any remaining unsalvageable teeth are removed in the same appointment.
• Placement. Four implants per arch, the rear pair tilted. Two to three hours under local anaesthetic, with sedation available.
• Immediate bridge. Where primary stability is sufficient, a fixed provisional bridge is attached the same day.
• Integration. Three to four months, during which you wear the provisional.
• Final bridge. The definitive restoration is fitted on a second trip.

Who it suits

All-on-4 is designed for people who have lost most or all teeth in an arch, or whose remaining teeth are failing beyond repair. It also suits long-term denture wearers who want something fixed, and people with significant bone loss at the back of the jaw who want to avoid grafting.

It is generally not the answer if you still have several healthy, well-supported teeth. Extracting sound teeth to fit a full-arch protocol is a real risk with high-volume providers, and it is worth asking directly whether each tooth being removed genuinely cannot be saved.

When six implants is the better choice

Four implants carry the same bite force that would otherwise be spread across twelve to fourteen teeth. Each implant therefore takes considerably more load. That is acceptable in good bone, and less so otherwise.

• Soft bone, particularly D3 or D4 in the upper jaw.
• Heavy bite or bruxism, where lateral forces are high.
• Longer arches, where a four-implant bridge extends further behind the last implant.
• Redundancy. With four implants, losing one compromises the whole bridge. With six, there is margin.

All-on-6 costs roughly $3,000 more per the clinic price list. If a surgeon recommends six after seeing your scan, that recommendation is usually about your bone rather than about the invoice.

Recovery, honestly

This is real surgery and the recovery reflects it. Expect significant swelling and often bruising for up to a week, peaking around day three rather than day one. Painkillers and antibiotics are standard.

A strictly soft diet is required for six to eight weeks. The provisional bridge is fixed, but the implants beneath it are still integrating, and excessive force during that window is the main preventable cause of failure. Nothing that requires tearing or hard biting.

Cost

Featured clinics in Türkiye quote $7,040 to $12,880 for All-on-4 covering eight implants and twenty-four crowns, and $10,040 to $15,880 for All-on-6. The equivalent in the United States is commonly $25,000 to $30,000 per arch.

Ask specifically what the quote includes: the number of implants, the implant brand, whether the provisional and the final bridge are both covered, and what material the final bridge uses. Quotes that omit the final bridge are the most common source of unpleasant surprises.

Common questions