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- All-on-4 uses 4 implants per arch (2 straight, 2 angled); All-on-6 uses 6 (all straight or slight angle).
- All-on-4 was designed to minimize bone grafting — better for patients with significant bone loss.
- All-on-6 may offer marginally more stability with adequate bone, but requires more bone volume.
- Las Vegas costs: All-on-4 runs $20,000–$28,000/arch; All-on-6 runs $24,000–$35,000/arch.
- Both have 20+ year documented success rates when properly placed and maintained.
- The right choice depends on your bone volume, bite load, and clinical candidacy — not marketing.
If you've been researching full-arch dental implants, you've almost certainly encountered both "All-on-4" and "All-on-6" — often marketed as distinct products competing with each other. In reality, they're variations of the same concept: replacing an entire arch of teeth with a fixed prosthetic bridge anchored to a small number of implants. Understanding the actual structural differences helps you have a more informed conversation with your dentist and avoid getting upsold on something that doesn't serve your specific situation.
The Basic Architecture
In both procedures, a full-arch prosthetic (a complete set of teeth on one jaw) is anchored to titanium implants placed in the jawbone. The key structural difference is the number of implants and how they're positioned.
All-on-4: Four Implants, Two Angled
The All-on-4 technique, originally developed and extensively studied by Nobel Biocare and Dr. Paulo Maló, uses four implants per arch. The two front implants are placed vertically. The two rear implants are inserted at an angle — typically 30–45 degrees. This angling is deliberate: it allows the posterior implants to reach denser bone toward the front of the jaw, avoiding areas where bone has resorbed (shrunk), and it increases the antero-posterior spread (the distance between front and back anchors), which is a key factor in prosthetic stability.
All-on-6: Six Implants, More Distributed
All-on-6 uses six implants, typically placed in a more distributed pattern across the arch. The additional two implants provide more anchor points and can distribute bite forces across a broader base. The tradeoff is that this approach generally requires more bone volume — both in terms of height and width — because the additional implants need adequate bone to engage.
Who's a Better Candidate for Each?
| Factor | Better for All-on-4 | Better for All-on-6 |
|---|---|---|
| Bone volume | Reduced (especially posterior) | Good to excellent throughout |
| Bone grafting preference | Wants to avoid grafting | Willing to undergo grafting if needed |
| Bite load | Average chewing force | Heavy bite, bruxer (grinder) |
| Number of missing teeth | Full arch loss | Full arch loss |
| Budget | Lower overall cost | Higher (additional implants) |
| Clinical data available | 30+ years, extensive | Good but less extensive than All-on-4 |
Important: The "right" procedure is determined by your clinical workup — a cone beam CT scan that maps your bone density, height, and width. No reputable implant dentist should commit to either procedure without that imaging. If a practice quotes you for All-on-6 over the phone without any imaging, that's a red flag.
Does All-on-6 Actually Perform Better?
This is where patients often get misled by marketing. All-on-4 has an enormous body of clinical literature — 20+ years of peer-reviewed studies showing long-term success rates of 95–98% per implant and high patient satisfaction. The angled implant design has been specifically validated for patients with bone loss, which is the majority of full-arch candidates.
All-on-6 does have documented success as well, and for patients with excellent bone volume and heavy bite loads, the additional implants can distribute force more evenly. But there is not clear evidence that All-on-6 routinely outperforms a well-executed All-on-4 in typical candidates. What matters most is proper case planning, skilled placement, and appropriate patient selection — not simply having two extra implants.
Cost Comparison in Las Vegas (2026)
| Procedure | Typical Las Vegas Range (per arch) | Both Arches (estimate) |
|---|---|---|
| All-on-4 | $20,000 – $28,000 | $38,000 – $52,000 |
| All-on-6 | $24,000 – $35,000 | $46,000 – $66,000 |
| All-on-4 w/ bone graft (if needed) | $22,000 – $32,000 | $42,000 – $60,000 |
These ranges vary based on the specific practice, the type of prosthetic material (acrylic vs. zirconia), and whether any additional procedures like extractions or bone grafting are required. See our full Las Vegas dental implant cost guide for a deeper breakdown.
Questions to Ask Your Implant Dentist
- Based on my cone beam CT, do I have adequate bone for All-on-6 without grafting?
- Are you recommending All-on-6 because of a clinical reason specific to my case, or as a default?
- What's your practice's documented success rate for each procedure?
- What implant brand and prosthetic material are you using?
- Is the quoted price all-inclusive, or are there fees for extractions, bone work, or follow-up?
Get a Free Consultation with a Las Vegas Implant Specialist
Many Las Vegas practices offer free All-on-4 / All-on-6 consultations including a cone beam CT assessment. Use our directory to find a vetted provider near you.
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