What is the difference between all on 4 and all on 6?

The implant count is only part of the equation. All-on-4 was developed by Paulo Malo and refined through Nobel Biocare's clinical data to maximize use of anterior bone, making it the go-to protocol when posterior atrophy rules out straight implants. The angled posterior placement increases the anteroposterior spread, which is what drives primary stability in a single-stage workflow. For a lot of patients with moderate to severe posterior resorption, All-on-4 eliminates the 4-6 month graft-and-wait cycle entirely.

All-on-6 adds two more fixtures, usually placed axially in the posterior when sufficient bone height exists, typically 10mm or more. The extra anchorage points matter most on high-bite-force cases: bruxers, patients transitioning from heavy natural dentition, or cases where the lab is delivering a heavier zirconia framework. The prosthetic design has to match the surgical plan, which is exactly where lab collaboration before the first surgical appointment saves remake cycles later.

For the oral surgeons and prosthodontists managing these cases, the prosthetic decision and the implant count need to be resolved together, not sequentially. A lab that joins the case planning call, reviews the CBCT, and flags framework thickness requirements before implant placement closes the gap where most full-arch complications originate. Turnaround from implant placement to final delivery runs 4-6 months at facilities coordinating surgery and prosthetics through a single workflow.