For patients who have been told they have too little bone for standard implants — All-on-4 and All-on-6 change the equation entirely. These techniques were specifically developed for full arch rehabilitation in cases of significant bone loss, where placing individual implants in the posterior region of the jaw is no longer viable.

The principle is biomechanically sound: by strategically angling implants in the anterior jaw — where bone density and volume are typically preserved even after years of tooth loss — a full arch of fixed teeth can be supported on just four or six implants. The result is a permanent, non-removable restoration that eliminates the denture completely.

How It Works

Dr. Habib Zarifeh — Head of Oral Surgery at CMC Hospital Beirut (Johns Hopkins International affiliated) — plans each All-on-4 and All-on-6 case using full 3D Dentascan imaging. Bone volume, nerve anatomy, sinus position, and implant angulation are mapped precisely before surgery. Nothing is improvised.

The standard protocol for most cases is:

• Upper jaw (All-on-6): Six implants placed in the anterior maxilla, avoiding the sinus region where bone is often depleted. The anterior bone zone provides reliable anchorage for a full upper arch bridge.
• Lower jaw (All-on-4): Four implants placed in the anterior mandible, in the inter-foraminal zone — the most predictable implant site in the mouth even in patients with significant bone loss.
• Temporary restoration: A fixed temporary prosthesis is delivered at the time of surgery or shortly after. The patient never leaves without teeth.
• Final fixed bridge: After osseointegration — typically several weeks to a few months — final impressions are taken digitally and a definitive screw-retained porcelain or zirconia bridge is fitted and torqued into place.

All-on-4 / All-on-6 vs. Standard Full Mouth Implants

Where bone volume is adequate, Dr. Zarifeh always evaluates whether individual implants or a larger number of supporting implants would deliver a superior long-term outcome. All-on-4 and All-on-6 are powerful techniques — but they are not universally the first recommendation.

At this clinic, these protocols are recommended when they represent the most appropriate clinical solution for the patient's anatomy and condition — not simply because they require fewer implants. Every plan is driven by what is best for the patient's long-term oral health, function, and aesthetics.

Who Is a Candidate?

All-on-4 and All-on-6 are most suitable for patients who are currently wearing a complete upper or lower denture, have been living with total tooth loss for an extended period, have been told they lack sufficient posterior bone for conventional implants, or wish to convert from a removable prosthesis to a fixed solution in a single surgical episode. A Dentascan is mandatory before any treatment plan is confirmed.