All-on-4 vs All-on-6 in Albania: Which Should You Choose? Dr. Gersi's Guide (2026)

Full-Arch Implant Solutions: Understanding Your Options

If you are facing the prospect of replacing an entire arch of teeth, All-on-4 and All-on-6 are the two leading implant-supported solutions. Both deliver a permanent set of fixed teeth that look, feel and function like natural teeth. But which is right for you?

This guide is written by Dr. Gersi Vercani, Co-Founder of Empire Dental Clinic and implantology specialist. It compares All-on-4 and All-on-6 on the dimensions that matter clinically — bone requirements, surgery time, immediate loading, long-term durability, recovery and total trip cost — and explains how Empire Dental decides between them for each patient. The decision is based on your CBCT 3D scan, not on what we happen to recommend everyone.

All-on-4: The Proven Standard

Developed by Dr. Paulo Maló in collaboration with Nobel Biocare in the late 1990s, the All-on-4 concept uses four strategically placed implants to support a full-arch fixed bridge. The key innovation is the angling of the two posterior implants at 30-45 degrees, which maximises contact with available bone and often eliminates the need for bone grafting.

• 4 implants per arch (2 straight anterior + 2 angled posterior)
• Works with less bone — the angled implants engage longer bone areas
• Same-day teeth — provisional bridge fitted the day of surgery
• 10+ years of published data with success rates above 97%

All-on-6: Maximum Support

All-on-6 follows the same concept but uses six implants instead of four. The additional implants provide more support points and distribute chewing force more evenly.

• 6 implants per arch (typically all placed straight)
• Requires adequate bone — straight placement needs sufficient bone height and width
• Same-day teeth — provisional bridge on the same day
• Greater load distribution — beneficial for patients with strong bite forces

Head-to-Head Comparison

Factor	All-on-4	All-on-6
Number of implants	4	6
Bone requirement	Lower (angled implants)	Higher (straight implants)
Need for bone graft	Rarely	More often
Surgery duration	1–1.5 hours per arch	1.5–2 hours per arch
Immediate loading	Yes	Yes
Long-term success rate	97–98%	97–99%
Best for	Patients with some bone loss	Patients with adequate bone

How We Decide at Empire Dental

The choice between All-on-4 and All-on-6 is clinical, not commercial. After your CBCT 3D scan, Dr. Gersi Vercani evaluates bone volume, density and distribution to recommend the optimal approach. Sometimes the answer is All-on-4 on one arch and All-on-6 on the other — we treat each arch independently based on its specific bone profile.

Recovery and What to Expect

Whichever option you choose, the recovery follows the same general pattern:

• Day of surgery: Procedure performed under local anaesthesia (sedation available on request) lasting 1.5-3 hours per arch. You leave the clinic with the provisional fixed bridge in place — no period without teeth.
• First 48 hours: Mild swelling and tenderness, managed with prescribed painkillers. Most patients describe it as comparable to having a wisdom tooth extracted. Ice packs, soft cold foods.
• Days 3-7: Swelling subsides. You can eat warm soft foods comfortably. Light activity is fine.
• Weeks 2-4: Fully back to normal activity. Implant sites are healing beneath the gum.
• Months 3-6: Osseointegration completes. The provisional bridge is replaced with the permanent zirconia bridge during a second visit of 3-4 days.

Total Trip Cost: How Many Visits, How Many Days

The All-on-4/6 protocol typically requires 2 trips to Tirana:

• Trip 1: 5-7 days. CBCT 3D scan, surgical implant placement, immediate-load provisional fixed bridge. You leave with functional teeth.
• 3-6 months at home: Osseointegration completes. Remote follow-up via WhatsApp with photo check-ins at agreed intervals.
• Trip 2: 3-4 days. Digital impressions, fitting and bonding of the permanent zirconia bridge, final adjustments.

Total clinical time in Tirana: typically 8-11 days across the two trips. Indicative savings vs UK private prices are 65-80% on the implant + bridge treatment, with savings substantially exceeding the cost of two return flights, hotel and meals — particularly for full-arch reconstructions where the absolute saving is large.

For package details, visit our dental tourism page. For a personalised assessment, send us your panoramic X-ray — we respond within 24 hours with a written treatment plan recommending All-on-4 or All-on-6 based on your bone anatomy.

Frequently Asked Questions

What is the difference between All-on-4 and All-on-6?

All-on-4 uses four implants per arch, with the two posterior implants angled at 30-45 degrees to maximise contact with available bone. All-on-6 uses six implants — typically all placed straight — distributing chewing forces across more support points. All-on-4 was developed by Dr. Paulo Maló (Nobel Biocare, 1998) and has 25+ years of clinical evidence; All-on-6 is the higher-support option when bone allows.

Is All-on-6 better than All-on-4?

Not necessarily — they suit different cases. All-on-4 has excellent clinical evidence with 10-year survival above 97% in independent studies. All-on-6 offers more support points but requires more bone height and width (especially in the posterior region) to place six straight implants safely. The best choice depends on your bone volume after CBCT 3D assessment, the strength of your bite and the lower jaw vs upper jaw context.

Can I get teeth on the same day with both options?

Yes. Both All-on-4 and All-on-6 support immediate loading: you receive a fixed provisional bridge on the same day as surgery, so you never leave Tirana without teeth. The permanent zirconia bridge is placed after 4-6 months of healing, during a second visit of 3-4 days. The provisional bridge is fully functional for normal soft-food eating during the healing period.

How much do All-on-4 and All-on-6 cost in Albania?

Both options offer indicative savings of 65-80% compared to UK private prices, using the same Nobel Biocare or Straumann implants. There is no single fixed price: cost depends on implant brand, bridge material (zirconia monolithic vs ceramicated), whether bone grafting is needed, and whether one or both arches are treated. Empire Dental provides a personalised quote within 24 hours of receiving your panoramic X-ray.

How long do All-on-4 and All-on-6 last?

The implants themselves are designed to last for life — premium-brand titanium implants placed correctly into healthy bone have 10-year survival rates of 97-99%, and many last 20-30+ years. The fixed bridge (the visible teeth) typically lasts 15-25 years before needing replacement due to wear or aesthetic refresh. Empire Dental provides a 5-year written guarantee covering implants and bridges.

What is the recovery period like?

Surgery is performed under local anaesthesia (sedation available if requested) and takes 1.5-3 hours per arch depending on complexity. The first 48 hours involve mild swelling and tenderness managed with prescribed painkillers — most patients describe it as comparable to having a wisdom tooth extracted. By day 4-7, swelling subsides; by week 2, you are back to normal activity. Full osseointegration (bone-implant fusion) completes over 3-6 months while you wear the fixed provisional bridge.

Can I eat normally with All-on-4 or All-on-6?

After osseointegration completes and the permanent zirconia bridge is fitted, yes — you can eat all the foods you ate with natural teeth, including steak, apples and nuts. During the 3-6 month healing phase with the provisional bridge, we recommend a soft-food diet (no hard nuts, no ice biting, no very crunchy foods) to protect the implants while bone bonds. The permanent zirconia bridge has chewing forces equivalent to or stronger than natural teeth.

What are the alternatives to All-on-4 and All-on-6?

Alternatives include: (1) traditional removable dentures (lowest cost, lowest stability, bone loss continues), (2) implant-retained overdentures (snap-on dentures supported by 2-4 implants — removable for cleaning, more stable than dentures but not as comfortable as fixed), (3) individual implants and bridges (more implants per arch, longer treatment, higher cost than All-on-4/6), and (4) All-on-8 (rare, very specific cases with high bite forces or full bony reconstruction). Empire Dental assesses all options during the free consultation.

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Article updated May 2026 by Dr. Gersi Vercani, implantology specialist and co-founder of Empire Dental Clinic, Tirana. Clinical references: All-on-4 original protocol (Maló, 1998, Nobel Biocare); Straumann 10-year survival data (Buser et al., Clinical Oral Implants Research). Survival rates, protocols and recovery timelines cited reflect peer-reviewed implantology literature and Empire's clinical experience, accurate as of May 2026.