All-on-4, All-on-6, All-on-8 and zygomatic implants all do the same job: replace a full arch of missing teeth with a fixed, implant-supported bridge that stays in your mouth. If you are trying to work out which one applies to you, you are not alone — and the honest answer is probably not the one you expect.
These are not four grades of the same treatment, and more implants is not automatically better. They are four answers to different amounts of bone. The number of implants your case can take is decided by what a 3D scan shows, not by what you are willing to spend — and a well-planned All-on-4 in the right case outperforms an All-on-8 forced into bone that cannot support eight implants.
This guide breaks down what each protocol involves, the bone each one needs, and how to tell which conversation you should be having.
Understanding Full-Arch Implant Rehabilitation
Full-arch rehabilitation replaces an entire set of teeth in one jaw using titanium implants placed into the bone as anchors, with a fixed bridge secured on top. The implants integrate with the bone; the bridge is what you see and chew with.
Compared with a removable denture, patients choose it because:
- It stays put. No adhesives, no movement while eating, no removing it at night.
- Chewing function is closer to natural teeth, because the load goes into bone rather than resting on gum.
- It slows bone loss in the treated area. Bone resorbs where there is no root loading it; implants restore that loading. It does not stop resorption everywhere, but it changes what happens under the bridge.
- The evidence base is long. A longitudinal study of full-arch cases — 561 patients and 2,364 implants followed for 3 to 17 years — reported implant survival of 97.4% in the upper jaw and 98.9% in the lower,1 and a meta-analysis put dental implant survival generally at around 94.6% at 20 years.2
Those are population figures across implant treatment, not a promise about your case. What moves an individual result is bite design, hygiene and regular maintenance — set out in what determines implant lifespan and why implants fail. One correction worth making to a common claim: full-arch implant treatment costs more up front than a denture. What it buys is fixed function, not a cheaper bill.
The Four Protocols
Each one exists because a particular bone situation calls for it. Read them as indications, not as a ladder.
All-on-4
All-on-4 uses four implants to carry a full fixed arch — typically two placed vertically at the front and two angled at the back. That angulation is the point of the design: it lets the rear implants engage the bone that is still available at the front of the jaw and avoid the sinus and nerve, which is why it often works without bone grafting where other configurations would need it.
Typically chosen when: there is adequate bone at the front of the jaw but limited bone at the back; where the patient would otherwise need extensive grafting; and where a shorter overall treatment path matters.
As Dr Şükran Baycan, Oral and Maxillofacial Surgeon at DentSpa with over ten years of experience, puts it: “Many patients tend to choose the All-on-4 procedure as their top option. As standard practice, we first examine their bone quality, and if it’s strong enough, we proceed without the need for additional grafting.”
All-on-6
All-on-6 follows the same principle with two additional implants, spreading the chewing load across six anchor points rather than four and giving the bridge more support along its length.
Typically chosen when: there is enough bone height and width at six sites; where the bite is heavy or there is a history of grinding; and where a longer or fuller arch benefits from intermediate support.
The extra implants are an advantage only where the bone can host them properly. Six implants placed into inadequate bone is a worse plan than four placed into good bone — which is the whole reason this is decided from a scan.
All-on-8
All-on-8 distributes the arch across eight implants, so each one carries less force and the load pattern sits closer to a natural dentition.
Typically chosen when: there is sufficient bone height and width at eight separate sites without extensive grafting — which is the real gatekeeper, and the reason most patients are better served by All-on-4 or All-on-6. It is also considered for heavy bite forces and full-mouth reconstruction cases.
It requires more planning and more surgical sites, and if a clinic recommends All-on-8 without imaging that shows the bone is there, that is worth questioning.
Zygomatic implants
Zygomatic implants anchor into the cheekbone rather than the upper jaw. The zygomatic bone is dense and tends to retain its volume even where the maxilla has resorbed heavily, so it provides anchorage when the jaw no longer can.
Configurations vary with how much upper jaw is left: commonly two zygomatic implants, one on each side, combined with conventional implants at the front where anterior bone remains; in more severe cases, four zygomatic implants carry the arch alone. The exact arrangement is planned from the scan for that patient — it is not a fixed formula.
Typically chosen when: there is severe resorption of the upper jaw, previous implants have failed for lack of bone, or extensive grafting is not wanted or not viable. See what happens when there is not enough jawbone.
Being clear about this one: zygomatic placement is the most demanding surgery on this page — the implants are long, the anatomy around the sinus and orbit is unforgiving, and it belongs with a surgeon experienced specifically in it. It is a solution for patients who would otherwise be told implants are impossible, not a shortcut or an economy option.
Comparison: Indication, Not Ranking
Read across the rows rather than looking for a winner. Each column treats a bone situation the others cannot.
| Key feature | All-on-4 | All-on-6 | All-on-8 | Zygomatic |
|---|---|---|---|---|
| Implants per arch | 4 | 6 | 8 | Usually 2 zygomatic plus anterior implants, or 4 zygomatic in severe cases |
| Placement | 2 vertical at the front, 2 angled at the back | Spread across the arch, vertical or mixed angles | Spread evenly across eight sites | Anchored in the cheekbone rather than the upper jaw |
| Bone required | Adequate anterior bone; limited posterior bone acceptable | Enough height and width at six sites | Enough height and width at eight sites | Works where the upper jaw has resorbed severely |
| Grafting | Often avoided by design | Sometimes needed, depending on the scan | May be needed to reach eight viable sites | Avoids grafting the jaw entirely |
| Surgical complexity | Moderate | Moderate | Higher — more sites to plan | Highest — requires specific surgical experience |
| Typically chosen when | Front bone good, back bone limited | Six viable sites, heavy bite | Eight viable sites, heavy bite, full reconstruction | Severe upper jaw loss, or previous failure for lack of bone |
On cost: more implants means a higher price, and zygomatic treatment is priced as complex surgery rather than as a budget alternative. But cost is an outcome of the plan, not an input to it — the bone decides the protocol, and the protocol decides the cost. Any figure you find online is an approximate range rather than a quote; yours is confirmed in writing after a scan and assessment. See full-mouth implants abroad and dental treatment prices in Turkey.
How the Right Protocol Is Actually Chosen
The decision is made from a 3D CBCT scan, not from a photograph and not from a price list. What the scan and examination establish:
- Bone volume and density, site by site. How much height and width exists at each potential implant position, and where the sinus and nerve sit — covered in how much bone you actually need.
- Whether grafting or a sinus lift changes the options, and whether that is worth doing versus a design that avoids it.
- Your bite. Heavy function or grinding changes how the load has to be distributed.
- General health and medication, which affect healing and integration.
- What you can maintain. A fixed full arch has to be cleaned under and around every day; that is part of choosing it.
Timing is confirmed by imaging rather than promised in advance, and it is normal for the plan to move once the scan is read. If a protocol is recommended before anyone has looked at your bone in three dimensions, ask what it is based on.
Am I a Candidate for Full-Arch Implants?
The general picture of a straightforward candidate:
- An adult with a fully grown jaw
- Reasonable general health, with any long-term conditions well managed
- No untreated decay in remaining teeth, and no active infection in the mouth — both are treated first rather than being a refusal
- Gum health under control, since the same tissues have to hold the implants
- A realistic plan for daily cleaning and follow-up appointments afterwards
Not meeting one of these is usually a sequencing question rather than a closed door. As Dr Baycan puts it: “Very few people truly can’t get implants. We work with patients’ doctors to improve conditions. Most medical issues just need careful planning.”
Smoking, uncontrolled diabetes and some medications affecting bone are the factors most likely to change the plan or the timing, and they are worth raising early rather than at the appointment. If you have been told elsewhere that you have too little bone for implants, that is precisely the situation the zygomatic and grafting routes exist for — and rebuilding the jawbone is sometimes an option too.
Why Choose DentSpa
- Straumann implant systems — Swiss-manufactured, among the most extensively documented implant systems in the world, with published long-term data behind them.
- The protocol chosen from a 3D scan, including the answer that fewer implants suits your bone better than more.
- PhD-level specialist dentists and oral and maxillofacial surgeons, with professors and associate professors involved in complex full-arch cases.
- The bite designed with the surgery, since load distribution is what a full arch lives or fails on.
- Costs set out in writing before treatment, alongside the number of visits.
- Full A–Z care from your online consultation through to aftercare.
You don’t have to take our word for the standard. DentSpa was named best dental clinic in Europe in the odontology category at the European Awards in Medicine,3 is licensed by the Turkish Ministry of Health, certified to ISO 9001 and ISO 10002, and a member of the Turkish Dental Association. For treatment planned from abroad it also holds the Certification for Excellence in Medical Travel Patient Experience from Global Healthcare Accreditation.4 More than 50,000 international patients have been treated since the clinic was founded in Istanbul in 2018 — see real cases in the smile gallery and read the verified reviews.
Book a free consultation or message us on WhatsApp. Send your scan if you have one, and you will get an assessment of which protocol your bone actually supports — including where that is fewer implants than you came in expecting. If you are comparing clinics, the questions worth asking any of them are in how to find a dentist in Turkey.
Frequently asked questions
Is All-on-8 better than All-on-4?
How is the right protocol chosen?
What are zygomatic implants and who needs them?
Will I need a bone graft?
How long do full-arch implants last?
I have been told I do not have enough bone. Is that the end of it?
Is a fixed arch cheaper than dentures?
What does maintenance involve afterwards?
Sources
- Longitudinal study of full-arch implant-supported rehabilitations — 561 patients, 2,364 implants, 3 to 17 years’ follow-up.
- Long-term survival of dental implants: systematic review and meta-analysis — survival at 20 years.
- The European Awards in Medicine — DentSpa Clinic — European Award in Medicine in Odontology
- Global Healthcare Accreditation — DentSpa Strengthens Global Trust in Turkey’s Dental Services with GHA Certification
70% 
