Choosing Between All-on-4 & 3-on-6 Dental Implants

Take a look at our previous work

Check out our gallery below to see the results of our work, both in terms of aesthetics and functionality.

See our work & make a first step

Before & After, All-on-4
Before & After, All-on-4

Trust Dr. Tsvetov for advanced oral surgery

If you’re weighing the options between All-on-4® and Three-on-Six implants, watch the video below to fully understand your options. Dr. Tsvetov discusses the benefits and importance of the All-on-4® treatment, helping you make a well-informed choice that truly fits your needs.

Understanding the difference between All-on-4® & 3-on-6 implants

Let’s discuss two options to replace a full upper or lower arch of teeth. The two most commonly discussed options are Three-on-6 or All-on-4®. Both options give you fixed (non-removable) teeth on implants. The difference is that with Three-on-6 implants, you get only teeth. With All-on-4®, you get teeth and artificial gums (gingiva). Three-on-6 is being talked about as the more esthetic and more conservative option. That is the key proposition being advertised to patients as to why Three-on-6 dental implants are better than All-on-4®.

3 separate bridges on 6 implants (2 per bridge) (Teeth only)

One long bridge on 4 implants (Teeth and gums)

Should I get Three-on-Six dental implants?

There are a lot of things that are not being talked about when it comes to  3-on-6 dental implants.

Patient eligibility

In fact very, very few people are truly candidates for Three-on-Six. In order to be a candidate, you need to have bad teeth that need extraction but at the same time have jaw bone that’s in pristine condition. That is a combination that very rarely happens.

In addition, the underlying bone needs to be of sufficient quality and quantity to be able to accept the implants. Majority of people who need all the teeth removed also have bone that is receded and infected.

If bone is receded and 3-on-6 is done, the teeth will end up being longer to compensate for the loss/recession of the bone. Implants are placed deeper, where the bone is and the teeth are therefore longer. That’s a bad aesthetic outcome.

Stability and reliability

Three-on-Six is less stable, especially if one of the implants fails. With 3-on-6, you have three separate bridges supported by two implants each. Look at the picture above. Imagine one of the implants in the middle fails to heal. Since the 4 teeth of the middle bridge cannot be supported by just one implant, you now have the whole middle section of 4 teeth missing. Not a good outcome esthetically.

Now, imagine the same scenario where the middle implant fails on the All-on-4® bridge. That’s not a problem, because the one solid bridge can still be supported by three other implants, while a replacement middle implant is placed and is healing under the gum.

Surgical considerations

3-on-6 surgery is harder and it’s less likely to have teeth the same day. With Three-on-Six implants, the surgeon places implants into newly created teeth extraction sites. The bone is softer and often infected. Even after the infection is cleaned out, the implants are still placed into the softer bone and it’s much harder to get the implants to be stable and solid enough to have the temporary teeth attached to them the same day.

The surgeon has to place six implants at exactly the same depth, angulation and have all the implants achieve perfect stability in order to get three on six done successfully and have the teeth attached the same day. That is one difficult task to achieve. Oftentimes 3-on-6 implants are placed but because they are not stable enough to have the teeth attached to them, they are covered back up by the gum tissue and the denture is given to the patient for 3 months.

With the All-on-4®, on the other hand, the implants are placed deeper, into the denser bone, with a higher likelihood of achieving needed stability to allow the patient to have fixed teeth the same day as the surgery.


If you had dentures for a while, you are missing bone and gum tissue, and Three-on-Six is not an option at all. Wearing traditional dentures even for a short period of time results in bone resorption and gum shrinkage.

With that being the case, if you still opt for 3-on-6 dental implants, you are bound to end up with longer teeth, since the implants are placed higher on the top and lower on the bottom, because that’s where bone and gums are at the time of surgery.

If you start out missing teeth and gums, it should be replaced with teeth and gums (All-on-4®) in order to aesthetically rebuild your smile. If you do Three-on-Six, you end up with really long teeth that attempt to compensate for the bone and gum loss and end up looking unnatural.

Hygiene challenges

Hygiene is more challenging with Three-on-Six dental implants. With 3-on-6, you have three separate bridges with a highly uneven surface to mimic natural tooth anatomy. Trying to clean under those bridges is hard and it takes a lot of manual dexterity to be able to do it well and keep the gums healthy. On the other hand, cleaning the uniformly even undersurface of the Al-on-4® bridge is technically easier.

Anatomic factors

Upper jaw Three-on-Six implants may not be possible due to anatomic factors (large maxillary sinuses). We all have maxillary sinuses above our upper teeth. That is part of our anatomy. Maxillary sinuses extend from upper molar teeth sometimes as far forward as canine (eye) teeth. What that means is that maxillary sinuses take up the space of the jaw bone and limit the length of the implants that can be placed with 3-on-6. If only shorter implants can be placed in the back because of the large sinus cavities, the back bridges will not be as well supported.

That is not an issue with All-on-4® since the implants are placed with an angle to avoid the sinus cavity and give more support to the bridge toward the back.


What our patients are saying


Or Schedule Your Free

Minimize the risks with our expert care

When it comes down to it, you have to ask yourself whether you prefer a quick fix or a quality, lasting solution. At Temecula Facial Oral Surgery, we prioritize doing things right. Dr. Tsvetov uses only top-quality, branded dental implants and collaborates with leading dental labs. This partnership ensures meticulous pre-surgical computer planning and expert fabrication of the bridge restoration. We’re committed to excellence and stand by our work, hoping you’ll choose us for your All-on-4® procedure and avoid the risks associated with less reliable methods like Three-on-Six dental implants.

Your preferred choice for the All-on-4® procedure in Temecula

Been going back and forth trying to decide on the right dental treatment for you? Feel free to schedule a free consultation with Dr. Tsvetov—it’s your chance to fully restore and change your smile for the better.

Our practice caters to patients of all ages, even those with complex health conditions. While we don’t offer 3-on-6 dental implants due to their subpar features, we provide expert All-on-4 and All-on-6 procedures in Temecula. So, whether you’re seeking teeth-in-a-day or a new natural-looking smile, we offer the expert care and follow-up advice you need. Contact us today to get started!