All-on-4, All-on-6, All-on-X – Full-Arch Dental Restoration

A traditional removable denture covers the palate, dulls taste and slips. The jawbone underneath it gradually disappears year after year. There is, however, a solution that lets you walk out with fixed teeth on the very day of the procedure — palate uncovered, steak back on the menu, full smile restored. It is called All-on-X, and at Esthesion in Prague we offer it as a concept built around the highest level of comfort and stability. In this article you will learn how the method works, when 4 implants are used (All-on-4) and when 6 or more (All-on-6, All-on-X), who is a suitable candidate and how this approach differs from a hybrid prosthesis.

Two paths to restoring teeth with implants

When restoring teeth with implants, we distinguish between two fundamentally different prosthetic solutions. They differ not only in construction but also in comfort, function and the way the patient uses them. They are not “cheaper” and “more expensive” versions of the same product — they are two distinct types of restoration, and the choice depends on the patient’s anatomy, lifestyle and expectations.

1. Fixed bridge on implants (All-on-4, All-on-6, All-on-X)

A fixed solution the patient never removes at home. A Brånemark bridge is screwed onto the implants — a fixed bridge carrying the full arch of teeth that behaves like the patient’s own dentition. This category includes All-on-4, All-on-6 and All-on-X; the names differ only in the number of supporting implants:

All-on-4 — a fixed bridge on 4 implants. Typically two upright implants in the anterior region plus two angled implants in the posterior region (30–45° tilt) that bypass areas of weak bone and the maxillary sinus. Indicated mainly when the patient has insufficient bone in the posterior parts of the jaw — otherwise bone augmentation or a sinus lift would be required.
All-on-6 — a fixed bridge on 6 implants. Chosen when the patient has sufficient bone in the posterior region for standard upright implants. Six pillars mean a more even distribution of chewing forces and higher overall stability.
All-on-X — a general term for a fixed bridge supported by a variable number of implants (5, sometimes more), determined by the individual anatomy.

All three variants share three things: they are fixed (the patient never takes them out), they are carried by a Brånemark bridge (a titanium framework with an aesthetic superstructure) and they restore not just the smile but also the ability to eat and speak normally.

2. Hybrid prosthesis on implants

The hybrid prosthesis, by contrast, is a removable, snap-on denture supported by several implants (most often 2–4). The patient takes it out at night and cleans it outside the mouth. It holds far more securely than a traditional removable denture, but it remains a removable solution.

A hybrid prosthesis can be a “golden middle path” for patients who, for medical, financial or personal reasons, do not want or cannot proceed with a fixed bridge. It must not, however, be presented as a cheaper version of All-on-4 — it is a different prosthetic solution, with different stability, comfort and daily use.

Fixed bridge vs. traditional removable denture

A fixed bridge is screwed onto the implants and does not move; a traditional denture remains unstable, requires adhesives and tends to press and rub. With a fixed bridge the palate stays free and the natural taste experience is preserved, whereas a traditional denture covers the entire palate with an acrylic plate and dulls subtle flavours. With implants the jawbone is continuously stimulated and preserved; under a denture it gradually resorbs year by year, which is why the denture stops fitting after a few years and needs to be relined or remade. A well-maintained All-on-X feels like the patient’s own teeth, and the implants themselves typically last 20+ years (often for life), while a traditional denture has an average lifespan of 5–7 years before bone resorption forces another remake.

Beyond bone preservation, the difference is social and functional. Instability means avoiding certain foods, hesitating in conversation, smiling cautiously — a fixed bridge removes all of these limitations.

Who is the ideal candidate

A fixed All-on-4, All-on-6 or All-on-X bridge is primarily intended for:

Patients with an edentulous jaw — all teeth are missing in one or both jaws.
Patients with terminal dentition — most or all teeth are in an irreversibly poor condition.

Which variant is chosen is determined by a 3D CBCT scan and assessment of the anatomy:

Insufficient posterior bone → All-on-4 with angled posterior implants. The patient avoids a sinus lift or augmentation.
Sufficient posterior bone → All-on-6 or All-on-X with evenly distributed implants. The result is greater stability and a better transfer of chewing forces.

Age is not a barrier. Seniors are an ideal group — it is precisely they who experience the most dramatic improvement in quality of life from a fixed bridge. Well-managed diabetes and osteoporosis are not automatic contraindications. The method is not suitable during active oncological treatment with head-and-neck irradiation, in uncontrolled diabetes, or in severe cardiac disease without cardiology clearance.

The treatment process at Esthesion

The entire process is led by a single clinician from the first consultation through to the fitting of the definitive Brånemark bridge — no handovers between specialists.

A fixed bridge on 4 or 6 implants is, in the hands of an experienced surgeon, an elegant and predictable procedure. Treatment planning, the tilted posterior implants and immediate loading of a temporary bridge all demand experience. In less experienced hands the same procedure can quickly turn into a complicated journey. The method matters — and so does the person performing it.

Consultation and planning. CBCT 3D imaging, clinical examination, evaluation of bone volume and full medical history. Digital planning of the position and number of implants (4, 6 or more). You leave with a transparent financial plan.
Day of the procedure — fixed teeth the same day. The procedure is performed under conscious sedation (analgosedation) and takes 2–4 hours per jaw. The sequence: extraction of unsalvageable teeth → implant placement → fitting of a temporary fixed bridge. You walk out the same day with fixed teeth. The immediate-loading protocol is safe and clinically well documented.
Osseointegration (3–4 months). The implants fuse with the bone while you continue your normal life wearing the temporary bridge. The first 6–8 weeks call for a softer diet; afterwards you gradually expand it.
Definitive Brånemark bridge. Once osseointegration is complete, we fit the definitive bridge — a titanium framework with acrylic teeth (or a resin-based superstructure).

Longevity and outcomes

Maló et al. (2019), in Clinical Implant Dentistry and Related Research, followed 1,884 implants in 471 patients over 10–18 years. The cumulative prosthetic survival rate was 98.8 % and the implant survival rate 93 %. With consistent home hygiene, the implants can be expected to last 20+ years, often for life.

The Brånemark bridge itself (the superstructure) may need minor refurbishment after 10–15 years — while the implants underneath continue to serve. Day-to-day care is not complicated: a toothbrush, interdental brushes or an oral irrigator.

Price in Prague — an investment in quality of life

For a single jaw, a fixed bridge (All-on-4 / All-on-6 / All-on-X) starts from 150,000 CZK (approx. €6,100); for both jaws, from 280,000 CZK (approx. €11,400). The price includes CBCT diagnostics, implant placement, the temporary and the definitive bridge and all check-ups during the osseointegration phase.

Compared with 8–12 individual implants restored with separate crowns, an All-on-X solution is significantly more economical. Against a traditional removable denture the initial investment is higher, but the denture has to be remade every 5–7 years, whereas a fixed bridge can last a generation.

Frequently asked questions

Is the All-on-4 / All-on-6 procedure painful?

Thanks to a combination of local anaesthesia and conscious sedation (analgosedation), the patient feels no pain during the procedure. Mild swelling and pressure for a few days afterwards are normal and subside quickly. You leave with a prescription for pain relief.

Will I be able to eat normally with a fixed bridge?

Yes — that is the principal advantage. For the first 6–8 weeks you keep to a softer diet; once the definitive bridge is fitted you can eat virtually anything. The palate is uncovered, so taste is fully preserved.

Is this suitable for seniors too?

Age itself is not a barrier — overall health is what matters. Patients aged 70+ are completely routine clients for us, and they are often the ones who experience the most dramatic change in quality of life.

What is the difference between All-on-4 and a hybrid prosthesis?

All-on-4 (along with All-on-6 and All-on-X) is a fixed bridge that the patient never removes. A hybrid prosthesis is a removable, snap-on denture supported by implants; the patient takes it out at home to clean it. Different comfort, different function, different type of solution — not a cheaper version of All-on-4.

Does one doctor handle the whole treatment?

Yes — one and the same clinician leads the entire process, from the first consultation through to placement of the definitive bridge. For a procedure whose elegance and complexity depend so much on the surgeon’s experience, we do not consider this a luxury but a standard.

Conclusion

A traditional removable denture is a compromise: it covers the palate, slips, presses and does nothing to stop bone resorption. A fixed All-on-4, All-on-6 or All-on-X bridge resolves all of these problems in a single procedure. At Esthesion Prague the whole journey is delivered by a single clinician at a single location, and you leave with fixed teeth on the very day of the procedure.

If you are weighing up whether a fixed bridge or a hybrid prosthesis is the right option for you, book a consultation. We will assess the state of your dentition, walk you through your 3D treatment plan and propose an individualised approach — with no obligation.