All-on-6 Dental Implants

Where it may be suitable

• No teeth left in the jaw, or the remaining teeth cannot be saved (advanced decay, root fractures, advanced gum disease)
• People who cannot manage or do not want a removable full denture
• Enough bone in the front of the jaw for six implants. Where the back is thin, tilted implants may reduce the need for grafting in some patients
• General health that allows surgery and healing

What is associated with higher risk

The figures below are pooled results of observational studies. They show association, not proven causation.

• Smoking. In people smoking more than 20 cigarettes a day, the risk of losing an implant was about 2.5 times that of non-smokers per implant¹. Per patient it was about 4 times¹. For early failure, a review of 32 observational studies gave an odds ratio of about 2.6 per implant². That figure comes from the 21 cohorts analysed per implant. It compares odds, not risk, so it does not mean 2.6 times as likely. The 2020 review found no number of cigarettes a day that carried no extra risk.
• A history of periodontitis. Periodontitis is gum disease that has damaged the tissues and bone supporting the teeth. Across 14 prospective studies the rate of implant loss over follow-up was about 1.75 times higher³ (a hazard ratio). After fast-progressing disease it was about 6 times higher. Peri-implantitis, inflammation around an implant with loss of the supporting bone, was about 3 times more common. For inflammation of the soft tissue alone, no significant difference was found. These were treated patients; implants are not placed while the disease is active.
• Clenching or grinding. The 27 studies in one review compared people judged likely to clench or grind their teeth with people who do not. The odds of implant failure were about 2.2 times higher⁴ in the first group (an odds ratio). Whether a night guard prevents that was not tested.
• Diabetes. The findings are mixed. Two of three reviews found no significant difference in implant failure (2021 review⁵; 2016 review⁶), and one found a higher rate⁷. All three found more bone loss⁶ around implants in people with diabetes. Blood-sugar control and regular reviews matter.
• Bone-strengthening medicines (bisphosphonates, denosumab). The risk depends on why, at what dose and for how long the medicine is taken. Whether it is given by drip, by injection or by mouth does not on its own decide it. At the high doses used in cancer treatment implants are usually not appropriate, and the decision is made with your oncology team. The doses used for osteoporosis are assessed separately. A 21-study review looked at people taking bisphosphonates. Implant loss was about 1.7 times more likely per implant⁸. Osteonecrosis of the jaw, where an area of jawbone dies and does not heal, was about 3.5 times more likely per patient. The per-patient analysis of implant loss found no significant difference. These figures are for bisphosphonates and cannot be generalised to denosumab; the certainty of the evidence is very low. Tell us about every medicine you take, and do not stop one without asking the doctor who prescribed it.
• Radiotherapy to the head and neck. Implants fail more often in irradiated bone. Extractions and implant surgery in an irradiated jaw carry a risk of bone that does not heal (osteoradionecrosis). We ask about the field and dose of the radiotherapy, and planning involves your oncology team.

Where another step comes first

• Active infection, untreated gum disease, uncontrolled medical conditions: treated first.
• Very little bone in the upper jaw: a sinus lift, a graft or zygomatic implants may be needed instead; see bone grafting. Zygomatic implants are explained at the consultation.
• A jaw that is still growing: implants wait until growth is complete.
• A fixed bridge may not suit. Space for the bridge may be too small, or its edge at the gum may show when you smile. Your lip may need support from a removable denture, or you may be unable to clean under the bridge every day. More implants do not solve these; a removable implant-retained denture may suit better.

Suitability is decided at an examination with a 3D scan and your medical history. An assessment made from photographs or X-rays you send is preliminary, not a treatment plan.

The evidence does not pick a side. A 2026 review of 55 studies of All-on-4 and All-on-6 looked at results at five years and beyond. It found about 98 in 100 All-on-4 implants and about 97 to 98 in 100 All-on-6 implants⁹ still in place. The numbers do not all point one way. All-on-6 had the higher survival in the first year and less bone loss at five years (0.94 mm versus 1.28 mm). All-on-4 had slightly higher pooled survival in the medium and long term. An umbrella review of seven systematic reviews found that the number of implants did not significantly affect implant or bridge survival¹⁰. The International Team for Implantology consensus states that the literature supports various implant numbers¹¹ for full-arch fixed prostheses.

The comparisons in these reviews rest mostly on pooled results from different patient groups. They do not prove that one design is better than, or equivalent to, the other. The reviews cited here do not measure what happens to the bridge when one implant is lost, out of four or out of six. That is the practical argument for six: if an implant fails, the bridge may be easier to rescue. It is clinical reasoning, not a measured advantage. The number depends on the amount and position of bone and on which jaw it is. The opposing jaw, clenching and the length of the bridge also count. The same design on four implants is explained on the All-on-4 page.

If you are told "six is safer" or "four is enough", ask for the reasoning on your own scan.

This is the usual sequence at our clinic. Times vary by patient, and your plan is given in writing. How these stages fit into visits to Antalya is explained in "Visits to Antalya, and the time between them" below. If you are considering sedation, see sedation and anaesthesia.

Risks

• Implant loss. In studies about 2 to 3 in 100 implants⁹ were lost at five years and beyond. Smoking, a history of periodontitis, clenching and some medicines are associated with that risk (above). Replacing a lost implant and keeping the existing bridge is not always possible. Further surgery, a new bridge or a removable prosthesis may be needed.
• Inflammation around implants. Peri-implant mucositis is inflammation of the soft tissue around an implant. Peri-implantitis is that inflammation with loss of the supporting bone; its treatment may need surgery, and if it progresses the implant can be lost. Reviews of full-arch bridges report peri-implantitis at 4 to 18 per cent¹⁰, as stated in the review abstracts. Whether that counts patients or implants could not be checked in the full text. A 57-study review of implant patients in general found it in about 20 in 100 patients¹². The rate depends on the definition and the time in function. It is easier to treat early, which is why the review programme is part of the treatment.
• Bone loss. About 1 mm on average at five years⁹ around the implants; "no bone loss" is not true.
• Technical problems with the bridge. Reviews report screw loosening at 5 to 15 per cent¹⁰. Chipping of the porcelain layer on veneered zirconia bridges was reported at 15 to 35 per cent¹⁰. Fracture of the bridge's framework was under 5 per cent¹⁰. These rates are as given in the review abstracts, which cover 5 to 15 years of follow-up. Whether each rate counts patients, bridges or implants could not be verified in the full text. Bridges of solid (monolithic) zirconia had fewer technical problems¹⁰ than veneered zirconia. Loose screws can be tightened and chipped porcelain repaired. Some bridges have to be remade, which counts as losing the original bridge.
• Surgical risks. Bleeding, swelling, bruising, infection. In the lower jaw, the nerve canal brings a risk of numbness of the lip and chin. It is usually temporary; rarely, it does not go away. In the upper jaw: tearing of the sinus membrane, sinusitis or an opening between mouth and sinus. The 3D scan shows these structures, and the position and angle of each implant are planned to avoid them. Complications are still possible.
• Immediate loading. Fixed provisional teeth within days (immediate loading) can work well in selected patients. But a review of 39 randomised trials found slightly lower implant survival¹³ with immediate loading. The Cochrane review found no convincing difference¹⁴ within one year. Placing an implant straight into an extraction socket is a separate question. There, survival was lower than in healed bone: 95.2 versus 98.4 per cent¹⁵. These figures are not specific to All-on-6. The decision is made for each patient; nobody is promised same-day teeth.
• Speech and adaptation. Speech and chewing habits change in the first weeks. The junction of the bridge and the gum is the hardest place to keep clean.

Benefits

• A fixed bridge can improve retention and chewing comfort, and the palate stays uncovered. Sensation, speech and the feel of the teeth are not the same as natural teeth, and the result varies by person and design.
• An international consensus report of implant dentists covers people with no teeth left. It recommends implant prostheses to help preserve the jaw bone and the chewing muscles¹⁶. That is a consensus view, not a measured effect, and some bone loss around implants is still expected (see "Bone loss" above).
• Where the anatomy allows, tilted back implants can reduce the need for a bone graft, which shortens treatment for those patients.
• The dentist can remove the bridge, so cleaning and repair are possible.

The first days

• Swelling and bruising increase for 48 to 72 hours, then settle. Use cold packs and the medicines prescribed.
• Eat soft, lukewarm food for the first weeks. While the provisional bridge is in place, until the implants have fused, do not chew hard or sticky food; this protects the healing.
• If you had sedation, do not drive or operate machinery for as long as the sedation team tells you. UK standards require an escort¹⁷ for every form of sedation except inhalation sedation in adults. The escort, a responsible adult, takes you back to where you are staying and stays with you as instructed.
• Smoking is associated with poorer healing and with losing implants; at the least, avoid it during the healing period.

Daily care

• Clean under the bridge every day with bridge floss (superfloss), interdental brushes or a water flosser; we show you which works in your mouth.
• Brush twice a day with a soft brush and fluoride toothpaste, with particular attention to the line where the bridge meets the gum.
• If you clench, a night guard may be advised. It has not been shown to prevent implant loss; its purpose is to protect the bridge from the forces of clenching.
• Attend reviews at the interval set for your risk, with measurements around the implants and X-rays when needed. The bridge can be removed for professional cleaning at intervals.

After surgery, or at any time later, contact us and see a dentist near you in these cases.

• Pain or swelling increases after the third day, or bleeding does not stop
• Numbness of the lip or chin lasts beyond the expected duration of the anaesthetic
• The bridge moves, a screw feels loose, or a piece cracks or breaks
• Bleeding, bad smell, discharge or gum recession around the bridge
• Pain on biting, or the bite feels high
• Nasal discharge, blockage or sinus pain (upper jaw)
• A high temperature, or feeling generally unwell

In the UK, if you cannot get an urgent dental appointment, call NHS 111¹⁸ for a problem that is not an emergency.

Emergencies. Do not wait for our reply if you have difficulty breathing, speaking, swallowing or opening your mouth. A lot of swelling in your mouth is an emergency too. So are swelling around your eye or in your neck¹⁹, a swollen or painful eye, and sudden problems with your sight. In the UK call 999 or go to A&E¹⁸; in Turkey call 112.

The figures below are results from published studies, not from our own records, and they are not promises. What happens in your case depends on bone, habits and care; no treatment lasts for life.

• Implants. In the 55-study review, about 97 to 98 in 100 implants⁹ were in place at five years and beyond (per implant).
• Bridge. In the umbrella review of seven systematic reviews, bridge survival over 5 to 15 years was about 90 to 97 per cent¹⁰. That is as given in the review abstract; whether it counts bridges or patients could not be checked in the full text. A 2012 review covered full-arch fixed prostheses on four to six implants. In the upper jaw, about 97 in 100 bridges were in use at five years and 95 at ten²⁰. In the lower jaw the figures were 98 and 96.
• Maintenance. Being in use does not mean no repair was needed. Over the years screws may need tightening and porcelain repairing. Some bridges have to be remade, which counts as losing the original bridge. Before you start, ask what these cost and who will carry them out once you are back in the UK.

We have found no good research comparing implant treatment compressed into a few days with treatment staged over months. So the questions are practical ones. How is healing checked? Who do you contact if something goes wrong? Which aftercare does the plan include?

First visit: surgery and the provisional bridge

The examination, 3D scan, extractions, implants and provisional bridge take place on the first visit. How many days it needs depends on your plan, and is stated in writing before you book travel. If your examination and 3D scan are on the same visit, you can still decide not to go ahead. You can say no, or ask to stop, at any stage; once a tooth has been extracted, that step cannot be undone. A 2023 review suggests waiting at least 72 hours²¹ after implant placement before flying. After a sinus lift it suggests at least two and ideally six weeks. The authors call these a starting point for the dentist's decision, and note that the research is limited and drawn mainly from military aircrew. Your dates are planned around this. Ask whether the wound and the provisional bridge are checked before you fly home.

At home: healing before the final bridge

The implants need time to fuse with the bone before the final bridge is made. How long depends on the bone, whether a graft was done and how you heal; you are told after the examination. You spend this time at home with a fixed provisional bridge. If the implants were not firm enough for a fixed one, you wear a removable temporary denture. Soft food and daily cleaning under the bridge protect the healing. The final bridge waits until healing is confirmed; do not shorten this period to fit travel plans.

The GDC suggests speaking to your own dentist before you go²², because they need to know your plan in case of later complications. Ask them now whether they will see you between the visits and afterwards. If you do not have a regular dentist, find one before you travel. You can also ask a UK dentist for an independent opinion. Ask whether you need this treatment, how many implants you need, and whether to have it in the UK instead. A check with a dentist in the UK between the visits can be written into your plan.

Second visit: the final bridge

After healing, new impressions are taken and the shape and shade are agreed at try-ins. The final bridge is then screwed in and the bite adjusted. Some plans need a further visit, for example when a try-in shows that a change is needed. You leave with your records and a written review interval.

Once you are back in the UK, the first person to see a problem may be a dentist near you rather than us. Plan for that before you travel.

• A loose screw or chipped porcelain. These are the usual technical problems (see "Risks and benefits" above). Contact us through the route in your plan, and see a dentist near you with your records. Whether the repair is done in the UK or on another visit to Antalya depends on the problem.
• An implant that fails. Keeping the existing bridge is not always possible. Further surgery, a new bridge or a removable prosthesis may be needed, and that may mean another visit to Antalya.
• Who pays. Our written remake terms state what is covered, and who pays for further treatment and travel (see "Is the work guaranteed?" below).
• Reviews. Your review interval is set by your risk. Reviews can be done in Antalya or, where your plan says so, with a dentist in the UK. Ask who will do yours and who pays for them.

What the NHS does and does not do

NHS guidance for dentists in England and Wales says a patient treated abroad is dealt with like any patient previously treated by another provider. If you are accepted for NHS care, treatment that is clinically necessary within NHS mandatory services is provided, with your consent. But some entitlements do not apply where another provider did the original work. These are further treatment within two months, free repair or replacement, and the Regulation 11 replacement appliance²³. That guidance does not say an implant bridge will be repaired or remade on the NHS. The NHS also states that it is not liable for negligence or failure of treatment²⁴ you receive abroad.

Insurance

The NHS says that most travel insurance policies will not cover you for planned treatment abroad²⁴, so you may need specialist cover. Ask your insurer, in writing, before you book.

If you already have implant work from elsewhere that has failed, see replacing previous dental work.

The UK General Dental Council lists thirteen questions²² to ask before dental treatment abroad, and the NHS has its own checklist. Below are the ones that matter most for All-on-6, each with our answer. Where our answer is a commitment rather than something you can check today, it says so. Ask us the full list, and ask for the answers in writing.

Who will treat me, and how can I check their registration?

We name the dentist who will treat you, in writing, before you commit. In Turkey a dentist in private practice must register with the local dental chamber²⁵ within a month of starting, and cannot practise privately without it. The Turkish Dental Association's website offers a search of registered dentists by name and province²⁶. Ask us for the treating dentist's registration details.

How often do you do this, and what are your complication rates?

The GDC suggests asking how many times the procedure has been carried out, and the success, complication and infection rates²². The figures on this page come from published reviews, not from our own patient records. Ask us for our own All-on-6 figures, how complications were defined and over what period.

Is the clinic licensed and regulated?

In Turkey a dental clinic cannot open without a licence or treat patients without an operating permit. It is inspected at least once a year²⁷. To treat international patients, a facility also needs an authorisation certificate from the Ministry of Health²⁸. The Ministry publishes a register of authorised facilities²⁹ that you can check yourself. We give you our authorisation details before you commit. A licence or authorisation is a legal minimum, not a statement about the result of your treatment. The GDC itself cannot guarantee that a regulator like it exists in another country, or that standards are the same²².

Will I get the plan in writing?

Yes. The GDC says you should be assessed by a qualified dentist before being given a treatment plan and cost estimate²². Your written plan states the number of implants and why, the alternatives, what it covers and does not cover, and how many visits are needed. A plan made from photographs or X-rays you send is preliminary. It is confirmed after the examination and 3D scan, and we tell you before anything in it changes.

Is the work guaranteed?

The GDC suggests asking whether the work is guaranteed and for how long²². It also suggests asking whether further treatment is included if there are complications, and who pays for extra flights, hotel and remedial work²². Before you commit, we give you our complication route and remake terms in writing. They state what is covered, for how long and what is excluded. They also state what you must do to keep the cover, such as attending reviews, and who pays for further treatment and travel. Read that document before you decide, rather than relying on the word "guarantee" on any web page.

Is there insurance if something goes wrong?

The GDC list also asks about insurance²². In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre²⁸. That does not by itself tell you whether your implant surgery is covered, so ask which procedures in your plan fall under it. Ask us too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, and what it covers. Travel insurance is covered under "If an implant fails or the bridge breaks after you are home" above.

Who do I contact after treatment?

Your written plan names the contact route for questions and problems once you are home, and your review interval. For urgent symptoms, get emergency care where you are first (see "When to contact a dentist" above).

What records will I take home?

The NHS lists exchanging medical records and arranging aftercare back home²⁴ among the things to consider. In Turkey you are entitled to an itemised bill, and on request to free copies of the records of materials, tests and imaging²⁸. You may also examine your file and take a copy³⁰. At the end of treatment we give you your records in a form a UK dentist can use. They include the plan, X-rays and scan, the implant system and parts used, and the baseline measurements.

What if I am unhappy, and where can I complain?

We give you our written complaints procedure before treatment. A complaint goes to the clinic first; private dental polyclinics, centres and hospitals in Turkey must have a patient rights unit²⁷. If the clinic does not resolve it, you can apply in writing to the provincial health directorate's Patient Rights Board³⁰. The Board decides within thirty days, but it does not assess allegations of medical error. The dental chamber can also open disciplinary proceedings²⁵ against a dentist. Do not expect the UK regulator to settle it. The GDC states that it cannot resolve complaints or help with refunds³¹; its investigations are about whether dental professionals are fit to practise.

Will the team speak English?

The GDC suggests asking whether the team speaks your language and, if not, whether a translator is provided²². We confirm in writing, before you commit, who will explain the plan, the consent form and the aftercare instructions to you in English.

Warning signs, including for us

The NHS checklist names five signs to think twice about before booking. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare³². Apply them to us too. If you feel pushed to decide quickly, wait.

No prices are shown on this page. The main factors are the number of extractions and any bone reshaping, and the number and type of implants. Then come the provisional bridge and the material of the final bridge (monolithic zirconia, veneered zirconia, acrylic on titanium). Sedation, the number of visits, the review programme and the remake terms also count. Ask, in writing, what the plan includes, and who pays for further treatment and extra travel if there is a complication. Add your own travel for every visit, and reviews with a dentist in the UK, to see the whole cost.