All-on-6 Dental Implants in Turkey

Complete or extensive tooth loss:

Those with complete edentulism or those who have lost most or all of their teeth in the arch are usually unable to be treated with conventional prostheses. In this case, All-on-six is a good choice.

When there is not enough bone in the jaw:

If there is sufficient bone in the jaw or mandible for the implants to be fixed, or in patients with moderate bone loss, All-on-6 can also be used and can reduce or completely avoid the need for bone grafting due to strategic implant placement. However, a minimum bone volume is required for proper fixation of the implants. Dentists usually prefer All-on-6 when there is sufficient bone volume in the posterior region.

In cases of dissatisfaction with removable dentures:

All-on-six is also preferred for those who are not satisfied with the "lisp" due to the slipping of the dentures or the contact of the dentures to the palate.

To prevent complications due to bruxism (teeth clenching/grinding):

All-on-6 significantly reduces the risk of technical complications in patients with bruxism, especially in temporary dentures.

In case the patient wants a prosthesis up to the second molars:

All-on-6 can be used when it is desired to extend the denture to the second molars to optimize chewing ability and load-bearing area.

The All-on-6 technique is a full arch restoration method using six implants, which allows a fixed temporary denture to be fitted, usually on the same day, and completed with a permanent fixed denture after healing. The implants are placed in specific positions to ensure maximum contact with the bone and evenly distribute the pressure exerted by the fixed denture. The aim is to maximize the use of available bone, reduce the need for bone grafting, provide immediate function, and reduce stress on the implants by distributing chewing forces over a larger area.

The all-on-6 dental restoration technique may not be a suitable option for every patient. People who may not be suitable for this technique or who may have higher risks include

Those with severe bone loss:

The All-on-6 technique requires sufficient quantity and quality of bone for the placement of implants. Although All-on-6 can be performed in patients with moderate bone loss, in cases of severe bone loss, additional procedures such as bone augmentation or sinus lift may be required. These additional procedures increase the cost and recovery time.

Patients with serious systemic health problems:

Patients with conditions such as uncontrolled diabetes, autoimmune diseases, or serious cardiovascular conditions may be at higher risk for postoperative complications and failure of the implant to integrate into the bone (osseointegration failure), so it is important to ensure that such conditions are under control prior to All-on-6 treatment. Patients with active infections are also not suitable for implant placement. The infection must be treated first.

Patients with uncontrolled hematological diseases are also not suitable candidates for implant treatment.

Patients who do not practice meticulous oral hygiene and fail to keep regular follow-up appointments:

The long-term success of treatment depends on strict adherence to these recommendations.

To avoid the risk of complications such as peri-implantitis, an inflammation of the tissues around the implant, a strict postoperative oral hygiene protocol and regular dental check-ups are essential. Poor oral hygiene can lead to increased biological complications. Hygiene care may be more difficult, especially for the elderly, disabled, or patients with certain mental disorders.

Patients with uncontrolled hematological disease. People with this type of disease are also not suitable candidates for implant treatment.

Patients who have recently undergone chemotherapy or radiotherapy:

Patients who have received chemotherapy or radiotherapy within the last 12 months are not suitable for implant surgery, including All-on-6.

The dental implant system consists of the dental implant body, abutment, abutment fixing screw and crown.

The All-on-6 procedure consists of the following stages.

Preparation and planning:

Clinical examination:

• The general health status of the person who wants to have All-on-6 is determined and whether there is a systematic disease that is not under control.
• Gum health (periodontal status) is checked.
• The need for extraction of existing teeth is evaluated.

3D Imaging (CBCT and digital scanning):

• Bone density, nerve pathways, and anatomical risks are analyzed.
• Implant angles and positions are determined with computerized implant planning (navigated surgery).

Denture design:

• Lip support, tooth color, and form are planned according to the facial features of the patient.
• Temporary and permanent dentures are designed.

Surgical procedure:

Anesthesia:

The procedure can be performed under local or general anaesthesia depending on the patient's condition Sedation can be applied if the patient has anxiety.

Implant Placement:

The implants are positioned to provide better prosthetic support by distributing the chewing pressure over a larger area. Two straight implants in the mandible (usually in the first/second molar region) and short/wide implants inclined 30-40 degrees anteriorly at the jaw angle can be used.

• Anterior region: 4 implants are usually placed vertically.
• Posterior region: 2 implants are placed inclined 30-45° (according to nerve and sinus anatomy).
• If tooth extraction is necessary, implants can be placed in sockets immediately after extraction if appropriate.
• Bone grafting (bone augmentation) can be performed in the same session if necessary.

Temporary denture installation (same day):

• In most cases, patients can leave the clinic on the day of surgery with a temporary denture that provides immediate function and aesthetics.
• The temporary denture provides the patient's chewing function and aesthetics while at the same time helping to mold the tissues around the implant.
• A healing period of 3 to 6 months is usually required for the implants to fuse with the bone (osseointegration). During this period, a temporary prosthesis is used.

Healing process (Osseointegration):

• The implants are expected to fuse with the bone for 3-6 months.
• At 1 week, 1 month, and 3 months, implant stability is checked.
• Adjustments can be made to the temporary denture.

Permanent denture phase:

• After osseointegration is complete and the tissues have healed (e.g., after 6/8 months), new measurements are taken for the construction of the permanent prosthesis.
• The permanent denture can be designed and manufactured in a way that the patient accepts and replicates the shape and dimensions used in the temporary denture phase. Different materials such as zirconia can be used.
• The permanent denture is fixed to the implants with screws.
• After the denture is placed, occlusal (closing) adjustments are made.
• Bite and aesthetic tests are performed.

Care and considerations after All-on-6 treatment:

Proper care is important for the longevity of your All-on-6 implants and to avoid complications.

First 48 Hours after surgery :

Do not brush your teeth for the first 24 hours; just do a saltwater mouthwash (1 teaspoon of salt + 1 glass of warm water). From the 2nd day, brush gently with a soft toothbrush.

Bleeding Control:

• Apply light pressure with gauze (bleeding may last 1-2 hours).
• Do not spit; swallowing blood is not harmful.

Swelling and pain management:

• Ice compress (apply for 10 minutes and break for 10 minutes).
• Prescription painkillers
• Antibiotics, if available, use regularly.

Nutrition:

• For the first 3 days, only cold/soft foods (yogurt, pureed soup, custard).
• Avoid hot and hard foods.

First 2 Weeks (Use of temporary dentures):

• Use a special implant brush or soft-bristle brush.
• Clean around the implant with an interdental brush.
• Use antibacterial mouthwash.
• Distribute chewing pressure evenly.
• Avoid hard, sticky, and crusty foods (nuts, bagels, chewing gum).
• Take small bites to avoid breaking the temporary denture.

First 3-6 months (Osseointegration period):

• Go to the doctor in the 1st week, 1st month, and 3rd month. Check the tightness of the prosthesis screws.
• Clean between implants with dental floss (superfloss).
• You can use a water spray mouth shower (water flosser).
• Smoking and alcohol increase the risk of implant loss 3 times. Quit if possible.

Long-term care after permanent dentures:

Daily Cleaning:

• You can use an electric toothbrush (low speed).
• Implant-specific toothpaste (non-abrasive).

Professional care:

• Every 6 months a dentist check and professional cleaning are important.
• Prosthesis screws should be checked once a year.

Long-term prohibitions:

• Chewing ice, biting a pen (damages implants)
• Excessively hard foods (dried meat, hard bread crust, etc.)

Advantages

Comprehensive and effective restoration:

It is a modern and effective solution for complete tooth restoration in patients who are completely edentulous or have lost most of their teeth.

Long-lasting and durable

Titanium implants integrate into the bone through the process of osseointegration and can last for decades (15-20 years or more with good care). This stability allows patients to chew, speak, and laugh in a similar way to natural teeth.

There is a lower risk of implant loss compared to All-on-4.

Prevention of bone loss:

Implants help to prevent bone resorption (resorption) by stimulating the jawbone. This prevents changes in facial physiognomy.

Applicability in case of bone deficiency:

In patients with moderate bone loss, strategic implant placement can reduce or eliminate the need for additional procedures such as bone grafting (bone augmentation), making treatment less invasive.

Better stress distribution:

The use of six implants distributes chewing pressure over a larger area, increasing prosthetic support and reducing stress on the implants. It can be particularly beneficial in patients with bruxism (clenching/grinding) or when there are natural/fixed teeth in the opposite jaw.

Fast Function and aesthetics:

In most cases, patients can leave the clinic on the day of surgery with a temporary prosthesis, which provides immediate function and aesthetics, helping patients return to their normal activities quickly. The high-quality materials used (such as zirconia or acrylate) mimic natural teeth, providing an aesthetically pleasing appearance. It improves quality of life and self-confidence by providing a p and natural-looking smile.

Comfort:

Unlike traditional removable dentures, All-on-6 does not require adhesives, does not put pressure on the gums, and offers a higher level of comfort.

Reduced risk of implant loss (in some cases):

In patients over 60 years of age, the risk of implant failure is lower than with All-on-4.

Replacement Implant Possibility:

Even if 1 or 2 implants are lost in All-on-6, the remaining 4 or 5 implants can still support the prosthesis with minor modifications. In All-on-4, loss of a single implant can render the entire prosthesis unusable.

Disadvantages

Has a relatively higher initial cost compared to conventional removable prostheses. The initial investment can be a barrier for some patients. Costs include surgery, pre-assessments, materials, and follow-up afterwards.

• It is a surgical procedure and may deter patients who have a fear of surgery or have health conditions that increase the risks of surgery. Although minimally invasive, it requires discomfort and recovery time after surgery.
• There is usually a recovery period of 3 to 6 months for the implants to integrate into the bone (osseointegration). During this period, there is a small risk of complications such as infection or osseointegration failure.
• A certain amount and quality of bone is required for the placement of implants. For patients with severe bone loss, additional procedures such as bone augmentation or sinus lift may be required. These additional procedures increase the cost and recovery time.

Prices may vary depending on the clinic, city, materials used, and extent of treatment, so average ranges are given:

Country	Price Range (Euro)
Turkey	€7,000 – €12,000
UK	€15,000 – €25,000
USA	€25,000 – €40,000

Is the All-on-4 procedure painful?

Since the procedure is performed under local anesthesia, no pain is felt during the procedure. There may be mild pain and swelling during the recovery period; these are normal.

How long does it take to complete All-on-6 treatment?

• Examination & Planning: 1-3 days
• Surgical Procedure: 1 day
• Temporary denture: Same day
• Bone Fusion :Time 3-6 months
• Permanent denture: +1-2 weeks
• Total: 3-6 months
• Total duration: 6-8 months if bone grafting or sinus lifting is required.

How long does All-on-6 last?

With proper care and regular checkups, it can be used for 20 years or more without any problems.

Can the dentures be removed?

All-on-6 dentures are usually fixed, i.e., not removable. However, cleaning is easy, and oral health is maintained with professional care.

When can I return to my normal life after All-on-6?

Most patients can return to their daily activities within 1-2 days after the procedure. As the pain and swelling decrease, eating and speaking return to normal.

What materials are used for All-on-6?

Implants are made of titanium or titanium alloys; prosthetic teeth are made of durable materials such as acrylic, porcelain, or zirconium.

Can I do sports with All-on-6?

• Light sports such as walking and swimming can be done immediately
• Contact sports (boxing, wrestling) are not recommended for the first 3 months
• Diving sports require physician approval

Do All-on-6 implants prevent MR?

No. They are not affected by the magnetic field. It is not affected by magnetic fields. It does not cause problems in MR imaging.

Only if the denture contains metal should the radiologist be informed.

Can teeth whitening be done with All-on-6?

• Denture teeth cannot be whitened (colour does not change)
• If you have natural teeth, whitening should be done first
• Denture colour can be adjusted according to whitened teeth

Will my speech be affected after All-on-6?

• Slight lisp is normal for the first 1-2 weeks
• Natural speech improves from the 3rd week
• Adaptation can be accelerated with language exercises

Will I have problems with All-on-6 during pregnancy?

• If it was done before pregnancy, there is no problem.
• Implant application is not recommended during pregnancy
• Treatment can be done during breastfeeding

Is gum recession possible with All-on-6?

• The risk is very low with good care.
• Peri-implantitis (inflammation around the implant) should be prevented
• Regular professional cleaning is essential.

Do all-on-6 dentures have any effect on the sense of taste?

• Much better than palatal dentures (because the palate is exposed)
• Taste may be slightly affected in the first 1 month during the adaptation period
• Completely normalised after the 3rd month