Tooth loss combined with severe bone resorption in the jaw poses a major challenge for full mouth restorations. Traditional implants may not be viable due to insufficient bone volume. This is where All-on-4 and All-on-6 implant systems become game-changing solutions.

But which one is better in cases of advanced bone loss?

In this in-depth article, we compare All-on-4 vs All-on-6 and analyze:

  • Structural support and biomechanics

  • Indications for patients with bone atrophy

  • Long-term success rates

  • Surgical techniques and recovery time

  • Cost comparisons

  • Why patients are choosing Albania for advanced implant treatments

Understanding All-on-4 and All-on-6 Implant Techniques

What Is All-on-4?

The All-on-4 technique involves four dental implants strategically placed into the jaw (two vertically in the front and two tilted in the posterior). These implants anchor a full arch of prosthetic teeth — typically made of zirconia or hybrid acrylic.

This method is especially designed to maximize contact with existing bone, reducing or eliminating the need for bone grafting.

What Is All-on-6?

The All-on-6 system uses six implants per arch, offering greater distribution of force and enhanced long-term durability. It is often recommended when bone structure allows for more implant anchorage.

All-on-6 can also allow for stronger fixed prostheses, particularly for patients with high bite pressure or bruxism.

Severe Bone Loss: Clinical Challenges

When bone density is significantly reduced (common in long-term edentulous patients or those with periodontal disease), traditional implants become less predictable. The following issues may occur:

  • Lack of posterior bone for implant anchorage

  • Sinus expansion in the upper jaw

  • Mandibular nerve proximity in the lower jaw

  • Compromised primary stability

In such cases, clinicians must assess whether the patient can be rehabilitated without bone grafting using angled implants (as in All-on-4), or if additional implants (All-on-6) can improve structural support.

All-on-4 vs All-on-6: Which Is More Suitable for Severe Bone Loss?

Criteria All-on-4 All-on-6
Bone Requirements Minimal, graftless in most cases Requires more bone density and volume
Implant Distribution Four implants (2 straight, 2 tilted) Six implants (mostly vertical)
Surgical Invasiveness Less invasive Slightly more invasive
Load Distribution Good, but concentrated on fewer implants Better stress distribution across more implants
Ideal for Severe Bone Loss? Yes – especially with zygomatic or tilted implants Sometimes – depending on bone availability
Cost More affordable Slightly more expensive
Long-term Stability High (with proper planning) Very high – especially for heavy biters

Expert Insight

“All-on-4 is often the preferred method for patients with severe posterior bone loss because it avoids sinus lifts or grafting by tilting implants into available bone.”
— Dr. Paulo Malo, inventor of the All-on-4 protocol

Diagnostic Imaging and Planning Are Essential

For patients with bone loss, 3D imaging (CBCT scans) is essential. It allows clinicians to assess:

  • Remaining bone volume and density

  • Ideal angulation for tilted implants

  • Potential need for zygomatic implants (extreme cases)

  • Sinus position and nerve path

At Medaljon Dent, all full-mouth implant cases include advanced digital planning, which enhances precision and reduces complications.

When Is All-on-4 the Better Choice?

All-on-4 is usually the first option when:

  • There is advanced bone loss, especially in the posterior maxilla

  • The patient needs to avoid sinus lift or bone grafting

  • Treatment must be fast and cost-effective

  • The patient desires immediate load (teeth-in-a-day)

Thanks to angulated posterior implants, bone contact is maximized even in cases where vertical volume is reduced.

When to Choose All-on-6 Instead?

All-on-6 may be preferable if:

  • The patient has moderate bone resorption, with sufficient volume

  • There’s a need for greater prosthetic stability

  • The patient has parafunctional habits like grinding or clenching

  • A more robust metal-ceramic or zirconia bridge is planned

All-on-6 spreads occlusal forces across six implants, reducing mechanical stress.

Cost Comparison: Albania vs Other Countries

Country All-on-4 (per arch) All-on-6 (per arch)
Italy €10,000 – €14,000 €13,000 – €18,000
UK £9,000 – £15,000 £12,000 – £17,000
USA $20,000 – $28,000 $25,000 – $35,000
Albania €4,500 – €5,500 €5,500 – €6,500

In Albania, clinics like Medaljon Dent offer the same European-certified implants (Straumann, Megagen, Bego) and digital protocols at up to 70% less than in Western Europe — with no compromise on quality.

Recovery, Success Rate and Maintenance

  • All-on-4 allows immediate loading in most cases, meaning temporary teeth can be placed the same day. Healing is rapid, with full integration in 3–6 months.

  • All-on-6 may allow immediate load or require 2–3 months of healing before the final bridge.

  • Both systems show success rates of over 95% at 10 years, especially with proper hygiene and regular check-ups.

At Medaljon Dent, every case includes a post-op care plan, digital record of implant placement, and annual check-up options.

Why Choose Medaljon Dent for Full-Arch Implants

Located in Durrës, Albania, Medaljon Dent is a trusted clinic for international patients seeking advanced dental implant solutions — especially in complex cases like bone loss.

What sets us apart:

  • European-trained surgeons with implantology specialization

  • Use of certified materials (CE/FDA) only

  • Full digital workflow: from 3D diagnostics to CAD/CAM prosthetics

  • Fixed teeth in 72 hours (in qualified cases)

  • Transparent pricing with no hidden costs

  • Free initial consultation and travel assistance

Request a Free Consultation

📍 Medaljon Dent – Durrës, Albania
🌐 https://medaljondent.com
📧 info@medaljondent.com

You can send us your panoramic x-ray or CBCT scan for a free online evaluation. Our team will respond with a full treatment plan, duration, and quote — no obligation required.

Final Thoughts

In the debate of All-on-4 vs All-on-6 for severe bone loss, the best option depends on your anatomy, goals, and lifestyle. While All-on-4 is ideal for minimal bone conditions and cost-efficiency, All-on-6 offers greater prosthetic support and long-term comfort when bone allows.

A personalized diagnostic evaluation is essential to making the right choice.

At Medaljon Dent, we’re ready to guide you through every step — from planning to your new, confident smile.