Surgical — 7 min read
All on X / All on 6
A full arch of fixed teeth carried by four to six implants. It is the highest-value case in dentistry, which is exactly why it attracts clinicians who should not be doing it.
Screened and introduced free, usually within a few hours. Sunny Isles Beach, Florida and the surrounding corridor.
Indications
Full arch treatment is usually indicated when
All-on-X replaces an entire upper or lower arch with a single fixed bridge anchored to implants angled to use the bone you still have. The X is the implant count — four, five or six — chosen from your anatomy, not from a marketing package.
- Most teeth in an arch are loose, decayed or already gone
- You wear a full denture and want something that does not move
- Advanced periodontal disease has made the remaining teeth unsalvageable
- You have been quoted eight or more individual implants and want a comparison
- Years of denture wear have flattened the ridge and changed your facial profile
- You want to avoid the sinus lift that vertical implants would require
Good candidate if
- An arch is failing or already lost, rather than a few teeth
- You want fixed teeth rather than a removable denture
- You accept a soft-food period of several months
- You will attend maintenance visits to have the arch removed and cleaned
No cost, no obligation, no lead list.
The detail
Why four, five or six changes the answer
A full arch of fixed teeth carried by four to six implants. It is the highest-value case in dentistry, which is exactly why it attracts clinicians who should not be doing it.
Tilting the rear implants lets a surgeon anchor into dense bone at the front of the jaw and skip grafting entirely. Four implants can carry an arch, and in the lower jaw with good bone it often does. The upper jaw is softer, and many experienced surgeons prefer six there — the extra fixtures spread the load and mean the prosthesis survives if one implant is ever lost. A practice that quotes four for every mouth is quoting a product.
The prosthesis material matters as much as the surgery. Acrylic on a titanium bar is lighter and cheaper to repair; monolithic zirconia resists wear and staining far better but is less forgiving if the fit is imperfect. Both are legitimate. Being told there is only one option is the warning sign.
The sequence
What actually happens, in order.
Timings vary between practices and cases. The order does not — and a plan that skips a step is worth asking about.
Assessment and CBCT
Bone volume, sinus and nerve position, and a digital plan for implant angles and the final tooth position.
Surgery day
Remaining teeth removed, ridge shaped, four to six implants placed at planned angles. Usually IV sedation, two to four hours.
Immediate provisional
A fixed temporary arch is attached the same day where implant stability allows. You leave with teeth.
Healing
Three to six months of integration on a soft diet, with adjustments as the gum contours settle.
Final prosthesis
New scans, a verified fit, then the definitive zirconia or titanium-acrylic arch.
Getting the right hands
Who should be doing your all on x / all on 6.
This is the variable that decides your result, and it is the one you have least ability to assess from the outside.
Not years in dentistry. How many of these they do in a month, and what the difficult ones looked like.
Anyone can photograph a result on delivery day. We want to see it after it has been used.
CBCT, microscope, scanner, printer — whichever this case genuinely requires, on site rather than referred out.
For anything ceramic, the technician is half the result. A dentist who cannot name theirs is outsourcing blind.
All on X / All on 6 FAQ
What people ask us about all on x / all on 6.
Including the cost question, answered with a real range rather than a request to call.
Per arch, typically $22,000 to $35,000 including surgery, implants, the provisional and the final prosthesis. Zirconia finals sit at the upper end, and both arches together are often quoted at a discount. Ask specifically whether extractions, sedation and the final prosthesis are inside the number — that is where quotes diverge.
Neither is universally better. Lower jaws with dense bone are routinely and successfully restored on four. Upper jaws are softer, and six spreads load and provides redundancy. The correct answer comes out of your CBCT, and a surgeon who will not discuss the trade-off is worth leaving.
In most cases, yes — a fixed provisional arch is attached that day. It requires the implants to achieve enough initial stability at placement. Occasionally a surgeon judges stability insufficient and uses a temporary denture for a few weeks instead. That is good judgement, not a failure.
Under the arch, daily, with a water flosser and specialised brushes. The prosthesis is unscrewed and professionally cleaned once or twice a year. Neglect causes peri-implantitis, which is the leading cause of late failure.
Yes, deliberately. A full arch restores the facial height that tooth loss collapses, which typically softens deep folds around the mouth. The prosthetic try-in is where you approve that change before it is finalised.