All-on-6 vs All-on-4 in Istanbul

Dr Furkan
8 min read
All-on-6 vs All-on-4 in Istanbul
implants
all-on-4
all-on-6
All-on-6 vs All-on-4 in Istanbul exposed: Why paying €3K more for 2 extra implants might be pointless (or essential). Your jaw holds the answer.

All-on-6 vs All-on-4 in Istanbul: Making the Right Choice for Your Full Arch Restoration

You're missing most of your teeth, and you're tired of dealing with dentures that slip, click, and limit what you can eat. Or maybe your remaining teeth are failing, and you know it's time for a complete solution. You've discovered that Istanbul offers world-class dental implant treatment at a fraction of Western prices, but now you're facing another decision: All-on-4 or All-on-6?

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Here's what most comparison articles won't tell you—there's no universal "better" option. The right choice depends on your bone density, jaw anatomy, lifestyle, and, yes, your budget. After placing hundreds of these restorations, Dr. Furkan Küçük and his team have learned that success comes from matching the right solution to the right patient, not from pushing one system over another.

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This guide breaks down the fundamental differences between All-on-4 and All-on-6 dental implants, specifically in the context of getting treatment in Istanbul. You'll understand not just what separates these options, but how to think through which makes sense for your situation.

Understanding the Core Difference

Both All-on-4 and All-on-6 are complete arch restoration systems—they replace all your upper or lower teeth with an implant-supported permanent bridge. The numbers refer to how many implants support each arch.

Think of it like building a deck on your house. You could support it with four posts or six posts. Both can work beautifully, but the six-post version distributes weight differently and might handle certain conditions better, just as your jaw does.

All-on-4 uses four strategically placed implants, with the back two typically angled to make the most of existing bone while bypassing critical areas such as sinus cavities or nerve pathways. This angulation is clever engineering—it lets dentists work with less bone volume while still achieving solid support.

All-on-6 adds two more implants, usually placed straight up and down in the posterior region. These extra anchors create additional stability and distribute chewing forces across more points. It's like having two extra safety nets.

But here's where it gets interesting—and why you can't just assume more is automatically better.

The Anatomy Factor: Why Your Jaw Structure Matters

Your jawbone isn't just sitting there waiting for implants. It's a living structure that's been shaped by years of use, tooth loss, genetics, and overall health. Some jaws have thick, dense bone throughout. Others have areas where the bone has thinned or receded.

All-on-4 works brilliantly when you have good bone density in the front of your jaw but limited bone in the back. Those angled posterior implants let the surgeon bypass areas of bone loss while still achieving full arch support. It's particularly effective in upper jaws where the sinus cavity often limits implant placement options.

All-on-6 typically requires more widespread bone availability since you need six viable implant sites. But when you have that bone, those extra implants provide something valuable—redundancy. If one implant ever fails (rare but possible), you've got five others maintaining your restoration. With All-on-4, losing one implant is a bigger deal.

Dr. Küçük often tells patients that the decision is frequently made during the consultation. Once he examines your CT scan, your bone quality often clearly points toward one solution or the other.

What Recovery Actually Feels Like

Let's talk about what happens after surgery, because this is where the rubber meets the road.

With All-on-4, you're dealing with four surgical sites per arch. Most patients describe the first three days as "uncomfortable but manageable." You'll have swelling—think chipmunk cheeks—and you'll be on a soft food diet for several weeks. Pain medication effectively manages discomfort, and many patients are surprised it's not as bad as they expected.

All-on-6 involves two additional surgical sites, which can lead to slightly more swelling and a day or two of extra recovery time. But we're talking about the difference between a four-day recovery and a five or six-day recovery—not weeks of additional healing.

Here's what patients rarely mention online but always ask about in person: drooling. Yes, for the first day or two, you might drool a bit as your mouth adjusts. Your speech will sound different initially—like you're talking with something in your mouth, because you are. Within a week, most patients speak normally. Within two weeks, they forget their teeth aren't natural.

Both systems typically allow for "immediate loading"—you leave with temporary teeth attached the same day. These aren't your final teeth (those come after complete healing), but they look good and let you eat soft foods immediately. No walking around toothless.

The Money Question: Cost Differences in Istanbul

In Istanbul, All-on-4 typically costs 20-30% less than All-on-6. We're talking about a difference of roughly €2,000-3,000 per arch at most quality clinics. Compared to the €15,000-25,000 per arch you'd pay in London or New York, both options represent significant savings.

But don't let price drive this decision entirely. If your bone structure clearly suits one option over the other, paying a bit more (or saving a bit) shouldn't override clinical recommendations. A well-executed All-on-4 beats a compromised All-on-6, and vice versa.

The real financial consideration is long-term value. Both systems, when properly placed and maintained, should last decades. All-on-6's redundancy might mean fewer issues down the road, potentially saving money on future interventions. But All-on-4's track record is excellent too—millions of successful cases over 20+ years.

Travel costs to Istanbul remain the same regardless of which system you choose. You're typically looking at two trips: one for surgery and temporary teeth (5-7 days), another for final teeth after healing (3-4 days, usually 3-6 months later).

Real-World Performance: How They Handle Daily Life

After your mouth heals and you receive your final prosthetic, both systems perform remarkably similarly in daily use. You can bite into apples, eat steak, chew nuts—all the things dentures made difficult or impossible.

The difference in bite force is minimal from a practical standpoint. All-on-6 technically distributes force better, which might matter if you're someone who grinds their teeth or has a mighty bite. For normal eating, both work beautifully.

Where All-on-6 shows an advantage is in the posterior chewing area. Those extra implants provide more support exactly where your molars used to be—where the heaviest chewing happens. Some patients report this feels more "natural," though others don't notice a difference.

Cleaning is identical for both systems. You'll use special floss threaders or water flossers to clean under the bridge, and you'll see your dentist for professional cleanings. The extra implants in All-on-6 don't complicate hygiene—the bridge design is similar regardless.

Why Istanbul Has Become a Hub for Both Procedures

Istanbul's dental tourism boom isn't just about price. The city has invested heavily in dental technology and training. Clinics like Dr. Küçük's use the same implant systems (Nobel Biocare, Straumann) as top Western clinics. The CT scanners, surgical guides, and lab technology match anything you'd find in London or Los Angeles.

What's different is the patient experience. Turkish dental clinics often feel more like hotels than medical facilities. You get personal attention that's increasingly rare in Western healthcare. Your treatment coordinator stays in touch via WhatsApp, answering questions at all hours.

The concentration of cases matters too. A dentist in Istanbul might place more All-on-4 and All-on-6 systems in a month than a Western dentist does in a year. Experience counts in implant dentistry, and Istanbul clinics have it in spades.

Language barriers? Barely exists. Every major clinic has English-speaking staff, and many dentists are trained in part in the US or the UK. You'll communicate more easily than you might at your local dental office.

Potential Complications: An Honest Discussion

Both systems have excellent success rates—above 95% when properly executed. But let's discuss what can go wrong, because pretending these procedures are risk-free doesn't help anyone.

Immediate complications (rare but possible) include infection, implant failure to integrate with bone, or sinus problems with upper jaw implants. All-on-4's angled implants require precise placement—a millimeter off can cause problems. All-on-6 has more implants that could potentially fail, though having six means one failure isn't catastrophic.

Long-term, the prosthetic teeth themselves (not the implants) might need replacement after 10-15 years as they naturally wear down. Some patients experience minor bone loss around implants over time. Grinding or clenching can stress either system.

The medical tourism aspect adds a wrinkle: if you have a problem after returning home, your local dentist might be unfamiliar with your specific system or unwilling to touch another dentist's work. Good Istanbul clinics provide detailed records and support for your home dentist, but it's worth discussing emergency protocols before treatment.

Making Your Decision: A Practical Framework

Stop looking for the "best" option and start looking for your best option. Here's how to think through this:

Choose All-on-4 if:

  • Your bone volume is limited, especially in the posterior regions.
  • You want the most established track record (20+ years of data)
  • Cost is a significant factor.
  • Your dentist sees clear anatomical advantages to the angled implant approach.
  • You prefer the minimum surgical intervention that still achieves your goals.

Choose All-on-6 if:

  • You have good bone density throughout your jaw.
  • The redundancy of extra implants gives you peace of mind.
  • You grind or clench your teeth.
  • Your case is complex (severe bone loss in some areas but not others)
  • Your dentist recommends it based on your specific anatomy.

Red flags that suggest neither option (yet):

  • Active gum disease that hasn't been treated
  • Uncontrolled diabetes
  • Heavy smoking with no intention to quit or reduce
  • Severe bone loss requires extensive grafting first.
  • Unrealistic expectations about results or recovery

The consultation makes all the difference. A good dentist won't push one system—they'll show you your CT scan, explain what they see, and recommend what makes clinical sense.

Ready to explore which option might work for your situation? Check out the current treatment packages and pricing on the offers page, where you can see exactly what's included with each system. Dr. Küçük's team also offers virtual consultations to review your X-rays before you travel.

Frequently Asked Questions

With proper care, the implants themselves often last a lifetime—we have patients with implants 25+ years old still going strong. The prosthetic teeth attached to them typically need replacement every 10-15 years as they naturally wear down, though some last longer. All-on-6’s extra implants provide backup if one fails, potentially extending the overall lifespan of your restoration.

Possibly, but not always. The recommendation usually depends on the bone you have available. If you have sufficient bone density for six implants, getting a second opinion makes sense. However, if bone limitations drove the All-on-4 recommendation, placing more implants might require bone grafting first, adding time and cost.

Honestly, 1-2 extra days of noticeable discomfort with All-on-6. Most patients return to normal activities within a week, regardless of which system they choose. The bigger factor in recovery is your general physical condition and adherence to aftercare guidelines, not whether you have four or six implants.

Some insurance plans offer partial reimbursement for dental work abroad, but most don’t cover the full cost. Even with zero insurance coverage, the total cost in Istanbul (including flights and accommodation) often beats the out-of-pocket cost in Western countries. Check your policy’s “out-of-network” provisions—you might be surprised.

Typically, two trips. The first visit (5-7 days) covers implant placement and temporary teeth. After 3-6 months of healing, you return for a shorter visit (3-4 days) to receive your final, permanent prosthetic. Some patients combine these trips with a vacation, making the most of their time in Istanbul.

Quality clinics provide detailed documentation for your local dentist and often have partnerships with clinics in major cities worldwide. While implant failure is rare (less than 5%), having six implants with All-on-6 means one failure isn’t catastrophic—the remaining five can often support the prosthetic while you arrange treatment.

Generally, no. These are complete systems designed as integrated solutions. Adding implants later would require removing the prosthetic, placing new implants, waiting for integration, and creating an entirely new prosthetic—essentially starting over. Choose the right system initially based on your dentist’s recommendation.

Not at all. The prosthetic size and shape depend on your mouth anatomy and aesthetic goals, not the number of supporting implants. Both systems use similar prosthetic designs that should feel natural and look proportionate to your face. The only difference is what’s happening underneath—the support structure.

All-on-6 typically handles grinding (bruxism) better due to force distribution across more implants. However, both systems require a night guard if you’re a grinder. The real solution isn’t choosing more implants—it’s protecting whichever system you choose with proper accessories and, if necessary, addressing the underlying stress that's causing the grinding.

Istanbul’s major clinics regularly handle complex revision cases, often fixing work done elsewhere. Dr. Küçük’s clinic, for example, sees several revision cases monthly. The concentration of dental tourism means these dentists have extensive experience with both routine and complicated cases. Always ask about a clinic’s revision experience during your consultation—good clinics discuss this openly.