Modern methods of fixed prosthetics. All-on-4 and All-on-6:
stability and reliability
Dental prosthetics: relevance and modern approach
Fixed prosthetics today is the standard in orthopedic dentistry. It restores lost dental functionality and the aesthetics of a smile with constructions that are fixed in the patient’s mouth and feel like natural teeth. Unlike removable dentures, these solutions do not require regular removal, providing reliability and comfort when chewing. According to the European Association for Osseointegration (EAO), more than 60% of patients in Europe with partial or complete tooth loss choose fixed prosthetics (PubMed). In the CIS countries, interest in these methods is also steadily growing, especially in implantology and the All-on-4 and All-on-6 protocols.
Main types of fixed prosthetics
Fixed constructions include crowns, bridges, veneers, inlays, and implant-supported prostheses. Each type has its own indications and benefits, and the right choice depends on the clinical situation and the doctor’s recommendations. At Diplomat Med, modern CAD/CAM technologies are used, allowing the creation of individual constructions with high precision and biocompatibility.
Crowns
Crowns are used to restore severely damaged tooth crowns, protect them from further destruction, or improve aesthetics. They can be fixed on natural teeth or implants. Modern materials — ceramics, metal-ceramics, zirconium dioxide — make it possible to achieve an ideal balance of strength and visual appeal. Crowns are applied both for restoring chewing function and the aesthetics of the front teeth.
Bridges
A dental bridge is a fixed structure that replaces one or more missing teeth, attaching to adjacent supporting teeth or implants. The construction resembles a “bridge” made of artificial crowns connected together. This method restores smile aesthetics and chewing function but requires the preparation of adjacent teeth, which is its main drawback.
Types of bridges by material
There are metal-plastic bridges (metal framework with plastic crowns), ceramic bridges (aesthetic and biocompatible), and combined options, combining the strength of metal with the beauty of ceramics. This variety allows adaptation to different clinical situations and patient budgets.
Types by manufacturing technology
Bridges can be cast as a single metal structure, stamped by pressing, or adhesive, fixed with special cement requiring minimal preparation of supporting teeth. Each option has its own indications and limitations, defined by the condition of the teeth and the patient’s anatomy.
Types by design
Bridges may be solid (continuous) or segmented, consisting of separate elements. The latter is often used in complex cases when the prosthesis must be adapted to the dental arch. Thus, bridges remain one of the most popular types of fixed prosthetics.
Advantages and disadvantages of bridges
Key advantages include restoring chewing function, aesthetic appeal, and relatively quick installation. Bridges are firmly fixed, require no special care, and are more affordable than implants. However, their disadvantages include the need to prepare healthy supporting teeth and the requirement that these teeth be strong enough to bear the load. Bridges are indicated when one or more teeth are missing, especially when adjacent teeth are healthy and can serve as support.
Veneers
Veneers are thin shells fixed on the front surface of the teeth. They are used to correct aesthetic defects — chips, cracks, discoloration, or gaps. Modern ceramic veneers are stain-resistant and provide long-lasting results. They are an excellent way to achieve a perfect smile without major intervention in the tooth structure.
Inlays
Inlays are micro-prostheses used to restore severely damaged teeth when a filling is insufficient. They are made based on an individual impression and replicate the anatomical shape of the tooth. Inlays are highly durable, precise, and allow preservation of maximum healthy tooth tissue.
Implant-supported prosthetics: All-on-4 and All-on-6
Implant prostheses are the most modern method of fixed prosthetics, allowing replacement of a single tooth or a full dental arch. Implants are integrated into the bone and act as artificial roots. This method prevents bone atrophy, restores natural functions, and ensures the most natural appearance. The All-on-4 and All-on-6 protocols are based on this technology.
The essence of the All-on-4 system
The All-on-4 protocol involves placing four implants: two vertically in the front part of the jaw, where the bone is denser, and two angled in the posterior areas. This arrangement provides high initial stability and even load distribution. Within a few hours, the patient receives a temporary fixed prosthesis, later replaced by a permanent construction. All-on-4 is especially relevant for patients with limited bone volume, as it avoids the need for sinus lifting or bone grafting.
The essence of the All-on-6 system
The All-on-6 system follows the same principles but involves six implants. Additional support points provide stronger fixation and allow for higher chewing loads. This is particularly important for the upper jaw, where bone density is lower, and for patients with advanced atrophy or when a larger prosthesis must be installed. All-on-6 ensures even load distribution and long-term stability, making it the best option for complex clinical cases.
The main difference between the two systems is the number of implants. All-on-4 is less invasive and more affordable, making it suitable for patients with limited bone volume. All-on-6 offers higher reliability and durability, reducing the risk of overload and increasing the prosthesis lifespan. Studies show implant survival in both systems exceeds 95% after 10 years (PubMed), with All-on-6 showing better outcomes under higher chewing loads and in the upper jaw.
Procedure steps
The procedure begins with diagnostics: CT scan, bone analysis, and planning using CAD/CAM technologies. Implant placement follows under local anesthesia or sedation. On the same day, the patient receives a temporary fixed prosthesis, restoring chewing function and aesthetics. After 4–6 months, once osseointegration is complete, the temporary prosthesis is replaced with a permanent, customized construction.
Advantages of All-on-4 and All-on-6
Both systems offer numerous advantages: quick restoration of a full smile, preservation of bone tissue through implant stimulation, even load distribution, and high aesthetics. Patients appreciate the ease of care, no need to remove the prosthesis, and the ability to return to normal life within days. These protocols are particularly beneficial for former denture wearers who experienced discomfort.
All-on-4 and All-on-6 in Europe and CIS
According to the EAO, over 200,000 All-on-4 and All-on-6 procedures are performed annually in Europe. In the CIS countries, their popularity is also growing: clinical studies in Moscow, Kyiv, and Minsk show that up to 30% of implantology cases are performed using these protocols. This is explained by their high predictability and significant improvement in patients’ quality of life.
Who are these methods indicated for?
All-on-4 and All-on-6 are indicated for total edentulism, severe tooth mobility due to periodontitis, inability to undergo conventional implantology, or refusal of removable dentures. These protocols are suitable for middle-aged and older patients who want to restore dental function quickly. The final decision is made by the doctor after a comprehensive diagnosis that considers bone density, jaw anatomy, and chewing load.
Conclusion
Fixed prosthetics include different types of constructions, each with specific indications and benefits. Bridges, crowns, veneers, and inlays remain widely used solutions, but implant prosthetics and All-on-4/All-on-6 protocols are the most modern and reliable methods today. They provide high aesthetics, durability, and full restoration of dental function. At Diplomat Med, patients receive personalized solutions based on digital diagnostics and innovative technologies.
Why choose Diplomat Med Center?
At Diplomat Med Center, we offer modern prosthetic solutions — from dental implants and All-on-4 and All-on-6 protocols to crowns, bridges, and veneers. We use advanced diagnostic technologies, including panoramic imaging and X-rays, to ensure precision and predictable outcomes.
Before prosthetic installation, we carry out mandatory preparation: treatment of caries, periodontitis, extraction of unrestorable teeth, and professional cleaning. This comprehensive approach provides a solid foundation for long-term success.
Diplomat Med Center stands for personalized care, state-of-the-art equipment, and experienced doctors who help restore the health and beauty of your smile.