A full arch of fixed teeth can rest on as few as four implants. Many patients do well with four, but six often spreads the load further when the jawbone allows it.
If you are weighing All-on-4 dental implants, our implant dentist in Shelby Township, MI can show you what your own bone supports.
Here's what you need to know about choosing four or six implants.
What "All-on-4" Actually Means
All-on-4 is a way to hold a complete upper or lower arch of teeth on four implants. Two sit near the front of the jaw, and two sit farther back.
The teeth are one connected bridge that screws onto the implants. You do not take it out at night, and only your dentist can remove it.
Why the Back Implants Are Tilted
The back of the jaw often has less bone, and the upper jaw has the sinus right above it. Tilting the rear implants lets them reach solid bone farther forward.
A describes this design as a way to avoid a sinus lift or bone graft in many cases. The same review notes that the technique is precise and works best in good-quality bone.
What Six Implants Add
With six implants, the bridge has more anchor points along the arch. Each implant carries a smaller share of the force from chewing.
Dr. Nazarian has expanded the four-implant concept to six whenever the patient's bone allows. He places six to eight implants when bone conditions permit, because more support helps protect long-term bone health.
What the Research Shows
A 2024 compared bridges on four and six implants. Implant and bridge survival were high in both groups, with no meaningful difference.
The bone around the implants told a different story. The four-implant group lost more bone at the implant edges, about 1.02 mm compared with 0.46 mm for six.
Your Bone Decides the Number
The right count depends on how much healthy bone you have and where it sits. That is why a 3D scan comes before any plan.
Dr. Nazarian uses CBCT-guided implant placement to map bone height and density across the whole arch. In one case on the practice's site, a patient received six upper implants and seven lower implants of different sizes to work around uneven bone.
Fixed Teeth or Snap-In Dentures
A fixed bridge is not the only full-arch option. Implant-supported dentures snap onto implants with ball-and-socket or bar attachments, and you remove them to clean.
Fixed All-on-4 or All-on-6 teeth stay put and are cared for much like natural teeth. Your choice may depend on bone, budget and how you feel about taking teeth out each night.
Who Is a Good Fit
Full-arch implants often help people who need to replace every tooth in an arch. They also suit denture wearers whose plates slip or who have lost bone and gum tissue.
Same-day treatment may be possible too, as covered in our look at how same-day implants work. See the full list of implant services for every option.
Frequently Asked Questions
Can I switch from my current dentures to fixed implant teeth?
Yes, many denture wearers make that switch. Premier Dental Center lists people whose dentures slip and people with bone or tissue loss under their dentures as good candidates for full-arch implants.
An exam and 3D scan show whether your jaw can hold four, six or more implants. If you are deciding between the two, compare implants and dentures first.
Will I go home with teeth on the day of surgery?
In most cases, yes. Dr. Nazarian's one-appointment approach means patients at Premier Dental Center leave with a full set of new teeth, even when extractions and implant surgery happen at the same visit.
Follow-up visits are still scheduled to check healing and place the final restoration. Most full-arch patients are eating complete meals by that evening or the next morning.
Am I awake during full-arch implant surgery?
You do not have to be. Premier Dental Center offers IV sedation with a Licensed Anesthesiology RN, so many patients feel relaxed or barely aware of the procedure.
Oral sedation is another option for people who only need help staying calm. With sedation, a long appointment often seems to take about 15 or 20 minutes, and your jaw muscles stay comfortable.
What if I have too little bone for even four implants?
You may still have options. Bone grafting can rebuild thin areas of the jaw before or during implant surgery, and angled implants can reach bone that straight implants would miss.
The angled implant review notes that tilting works best in good-quality bone. For severe loss, Dr. Nazarian also uses specialized grafting products and other anchoring methods to rebuild support.
How do I clean fixed All-on-4 teeth at home?
Brush the bridge twice a day like natural teeth, paying close attention to the gumline where the bridge meets the gums. Because fixed teeth do not come out, cleaning underneath them takes a little extra care.
Your dental team can show you which floss threaders or brushes reach under the bridge. Regular checkups let your dentist clean and inspect the implants and the bridge.
Schedule a Full-Arch Implant Consultation
Four implants or six, the goal is the same: a strong, fixed smile that protects your jawbone for years. A scan and an honest talk with our implant team in Shelby Township, MI will show which plan fits you.
Call Premier Dental Center today at (248) 457-0500 or request an appointment online.