All-on-4 and All-on-6 Dental Implants in Midtown Manhattan

Who All-on-4 and All-on-6 can help

This treatment replaces the teeth of a whole jaw, upper or lower, and both jaws can be treated. It may suit you if you:

• are missing all or most of your upper or lower teeth
• have remaining teeth that are failing from severe decay, advanced gum disease or repeated breakage
• wear a full denture that slips, rubs or makes eating difficult
• want teeth that stay in your mouth instead of coming out at night

You need general health that allows oral surgery and enough bone to hold the implants securely. Smoking, poorly controlled diabetes, some medicines that affect bone and heavy grinding can affect healing and the long-term result, so we discuss them openly at the start. For some people, a removable denture or a few individual implants is the better fit. Our dentures page covers removable options, and our dental implants page covers replacing one or a few teeth.

What All-on-4 and All-on-6 are

Both are ways to support a fixed full-arch bridge, sometimes called a hybrid denture or fixed implant denture. It is one piece that holds a full row of teeth and, where needed, gum-colored material that replaces gum and bone lost over the years. The bridge is fastened to the implants, usually with small screws, so only a dentist can take it off.

The difference is the number of implants in each jaw:

• All-on-4 uses four implants: two placed straight in the front of the jaw and two toward the back, usually at an angle. The angle helps the back implants make use of the available bone while avoiding the sinuses in the upper jaw and the main nerve in the lower jaw.
• All-on-6 uses six implants, which spreads chewing forces across more supports. It needs enough bone for six implants in good positions.

Neither option is better for everyone. The choice depends on the amount and quality of your bone, the shape of your jaw, the strength of your bite and the condition of the opposing teeth. Dr. Avner recommends one after your examination and X-rays and explains why.

Benefits and what to expect

• Fixed teeth. No adhesive and nothing to take out at night.
• Steadier chewing. Because the teeth are anchored to implants, they don't shift the way a denture resting on the gums can.
• An uncovered palate. An upper full-arch bridge doesn't cover the roof of your mouth the way a full upper denture does.
• Support for the bone. The implants carry chewing forces into the jaw, which helps preserve bone where they sit. Under a removable denture, the jawbone tends to shrink over time.
• Fewer implants. A full arch rests on four or six implants rather than one implant for each tooth.

Surgery is done with anesthesia so the area is numb. Afterward, expect swelling and soreness for several days and a soft diet while the implants heal. Speaking and chewing can feel different at first, and it takes some time to adjust.

Over the long term, the bridge needs daily cleaning, including underneath, plus regular professional maintenance. The gums around implants can become inflamed, and the teeth on a bridge can chip or wear. Results vary, and we'll talk through the risks before you decide.

Your treatment, step by step

1. Consultation and examination. We examine your mouth, review your health history and medications, and take X-rays to assess your bone. We also ask what bothers you about your current teeth or denture.
2. Planning. Dr. Avner recommends four or six implants for each jaw being treated, explains which teeth need to come out and plans the shape, shade and length of the new teeth with you. You get the expected timeline and fees before anything starts.
3. Surgery. With the area numb, the remaining failing teeth are removed and the implants are placed.
4. Temporary teeth. When the implants are stable enough, a temporary bridge is attached for the healing period.
5. Healing. Over the next several months, the implants bond with the bone. We see you for checkups and adjust the temporary teeth as needed.
6. Your final bridge. We take impressions, check the fit and appearance with you, and then attach the final bridge.
7. Maintenance. Regular visits let us check the implants and gums, clean the areas you can't easily reach and, when needed, remove the bridge for cleaning or repair.