Understanding full-arch implant options

If you have lost most or all of your teeth in one jaw, or your remaining teeth are failing, you may have heard of "All-on-4" or "full-arch implants". These terms describe different ways of replacing a whole set of teeth using dental implants. Here is what they mean.

Fixed or removable?

The first big distinction is whether your new teeth are fixed (only removed by your clinician) or removable (taken out at home for cleaning).

• Fixed full-arch bridges are attached to several implants. Approaches include All-on-4, All-on-6 and other All-on-X configurations.
• Implant-supported dentures (overdentures) clip onto a smaller number of implants. They are removed daily for cleaning but are much more stable than a conventional denture.

All-on-4

Four implants support a full arch of fixed teeth. The back implants are often angled to make the most of available bone, which can reduce the need for bone grafting in some people.

All-on-6

Six implants support the bridge, spreading biting forces across more implants. This may be recommended when there is enough bone or for larger arches.

All-on-X

A general term for full-arch treatment where the number of implants is tailored to the person, rather than fixed in advance.

What determines the right option?

• The amount and quality of your jawbone
• The size and shape of your jaw and your bite
• Your general health, including conditions such as diabetes and whether you smoke
• Your preferences for fixed or removable teeth
• Your budget and the long-term maintenance involved

Important things to understand

Full-arch implant treatment is major surgery. Risks include infection, swelling, nerve injury, sinus complications and implant failure. Your new teeth will need daily cleaning and regular professional maintenance, and may need repairs over time.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Questions worth asking

1. Why are you recommending this number of implants for me?
2. Will I have teeth on the day of surgery?
3. What happens if an implant does not integrate?
4. What maintenance will I need, and how often?
5. What are the alternatives, including non-implant options?