All-on-4 vs All-on-6 Dental Implants in Vietnam: Which Is Right for You?

If you are missing most or all of your teeth in one or both jaws, full-arch implant treatment offers a permanent, fixed solution that functions and feels like natural teeth. Two of the most widely used full-arch protocols are All-on-4 and All-on-6 — and choosing between them is one of the first and most important decisions you will make in your treatment journey.

Both procedures replace an entire arch of teeth (upper or lower jaw) using a fixed bridge supported by dental implants. The difference lies in the number of implants used, the bone requirements, the structural stability achieved, and the cost. Neither is universally better — the right choice depends on your bone density, jaw anatomy, long-term goals, and budget.

Vietnam has become a leading destination for both procedures, with internationally trained implantologists at clinics like Picasso Dental Clinic offering All-on-4 and All-on-6 at 60–75% below Australian, UK, and US market prices. This guide explains both procedures, compares them directly, and helps you understand which is likely to be recommended for your specific situation.

What Is All-on-4?

All-on-4 dental implants use four implants to support a complete fixed dental arch of 10–14 teeth. The protocol was developed by Nobel Biocare and extensively refined over two decades of clinical use. The defining characteristic of All-on-4 is the placement of the two rear implants at an angle of approximately 30–45 degrees — this angulation allows the implants to engage more bone and reach areas of higher density, making the technique viable even in patients with moderate bone loss who would not be candidates for conventional vertical implant placement.

The bridge (prosthesis) is typically fixed to the implants on the same day as surgery using an immediate loading protocol — this is the “teeth in a day” concept. Patients leave with a full set of functional teeth on the day of implant placement, though the final permanent prosthesis is fitted after a healing period of 3–6 months.

All-on-4 is well-suited for:

Patients with moderate bone loss, particularly in the back of the jaw
Patients who want to avoid bone grafting
Patients prioritising cost efficiency
Patients who are good candidates for immediate loading

What Is All-on-6?

All-on-6 uses six implants per arch rather than four. The additional two implants are typically placed in the posterior region of the jaw — the molars and premolars zone — in a more vertical orientation. This distributes biting forces across a larger number of implant-bone contact points.

The All-on-6 protocol requires more available bone than All-on-4, as the additional implants need adequate volume and density at multiple sites. It is not typically suitable for patients with significant posterior bone loss without prior bone grafting.

All-on-6 is well-suited for:

Patients with good bone volume across the full arch
Patients with higher bite forces (those who are heavy chewers or have parafunctional habits like bruxism/grinding)
Patients wanting the maximum structural foundation for their prosthesis
Patients who plan to use a premium prosthesis (full zirconia, monolithic zirconia) that benefits from increased support

Head-to-Head Comparison

Factor	All-on-4	All-on-6
Implants per arch	4	6
Implant angulation	2 vertical + 2 angled (30–45°)	All or mostly vertical
Bone requirements	Moderate — angled implants compensate for posterior bone loss	Higher — requires adequate posterior bone
Bone grafting needed?	Usually not	May require grafting if posterior bone is deficient
Cost (Vietnam)	$4,500–$8,000 per arch	$6,000–$10,000 per arch
Immediate loading?	Yes, in most cases	Yes, in suitable candidates
Prosthesis options	Acrylic hybrid, PEEK, zirconia	Acrylic hybrid, PEEK, full zirconia, monolithic zirconia
Biting force distribution	Good — across 4 points	Excellent — across 6 points
Ideal for	Moderate bone loss, budget-conscious, avoid grafting	Good bone volume, heavy bite, premium prosthesis
Long-term success rate	94–98% at 10 years (Nobel Biocare clinical data)	95–99% at 10 years (well-documented clinical series)
Treatment timeline	5–10 days (immediate loading)	7–14 days (immediate loading, more planning)

When All-on-4 Is the Better Choice

You have moderate bone loss in the back of the jaw. All-on-4’s angled rear implants are specifically designed to work around posterior bone loss. Most patients who have been missing teeth for some years will have experienced bone resorption in the molar area — All-on-4 was engineered precisely for this patient population. Choosing All-on-4 may allow you to avoid bone grafting entirely, which saves time (grafting adds 4–6 months to the overall treatment timeline), cost ($500–$3,000 depending on extent), and the surgical complexity of the procedure.

You are cost-conscious without sacrificing quality. The price difference between All-on-4 and All-on-6 is approximately $1,500–$2,000 per arch at Picasso Dental Clinic. For both arches (upper and lower), that is a potential saving of $3,000–$4,000. For most patients, All-on-4 provides sufficient structural support and outstanding long-term outcomes — the two extra implants in All-on-6 are not always clinically necessary.

Your case fits the standard All-on-4 profile. If your implantologist’s CT scan assessment confirms adequate bone at the planned All-on-4 implant sites and no contraindications to angled implant placement, All-on-4 is the more proven and widely practiced protocol — with decades of clinical evidence supporting its outcomes.

When All-on-6 Is the Better Choice

You have good bone volume across the full arch. If your CBCT scan shows healthy bone density throughout the jaw — including the posterior region — All-on-6 allows for full vertical implant placement without the biomechanical compromise of angulation. This is the ideal anatomical scenario for All-on-6.

You have a heavy bite or bruxism. Patients who grind their teeth (bruxism) or have naturally high bite forces place greater mechanical stress on their full-arch prosthesis. Six implants distribute this load across a wider base, reducing the risk of implant overload or prosthesis fracture over time. If you have been advised you grind your teeth, discuss this explicitly with your implantologist — it may influence the recommendation toward All-on-6.

You want a premium prosthesis. Full zirconia and monolithic zirconia arch prostheses are heavier and more rigid than acrylic hybrid bridges, and they place greater load on the implant system. All-on-6’s increased implant count provides a more stable foundation for these materials. If your primary goal is the most natural-looking, most durable prosthesis — and you want full zirconia — All-on-6 is generally the better platform.

Your implantologist recommends it based on your anatomy. Ultimately, the recommendation should come from a detailed CBCT scan analysis conducted by an experienced implantologist. Do not pre-select between All-on-4 and All-on-6 based on price or preference alone — let the anatomy guide the recommendation.

Cost Comparison: Vietnam vs USA vs Australia

Procedure	Vietnam (USD)	USA (USD)	Australia (USD)
All-on-4 (single arch)	$4,500–$8,000	$18,000–$30,000	$20,000–$35,000
All-on-4 (both arches)	$9,000–$16,000	$36,000–$60,000	$40,000–$70,000
All-on-6 (single arch)	$6,000–$10,000	$22,000–$38,000	$24,000–$42,000
All-on-6 (both arches)	$12,000–$20,000	$44,000–$76,000	$48,000–$84,000
Bone grafting (if needed)	$500–$2,000	$3,000–$8,000	$3,500–$9,000
Sinus lift (if needed)	$800–$2,500	$4,000–$10,000	$4,500–$12,000
Final zirconia prosthesis upgrade	$1,000–$2,500 per arch	$5,000–$10,000 per arch	$6,000–$12,000 per arch

For Australians, the saving on a full-mouth (both arches) All-on-4 treatment at Picasso versus Sydney or Melbourne private practice is typically $25,000–$50,000. Even accounting for flights and accommodation in Vietnam, the financial case for dental tourism is compelling.

For current Picasso pricing, see our dental costs page. For a broader comparison of All-on-4 costs internationally, see our cheapest countries for dental implants guide.

Patients choosing between All-on-4 and All-on-6 should also understand the full range of implant options — our guide to types of dental implants available in Vietnam covers single implants, implant-retained dentures, and mini implants alongside full-arch solutions. The surgical technologies that make both procedures safer are detailed in our dental implant surgery technology 2026 guide. For a direct comparison of All-on-4 against traditional multi-implant protocols, see All-on-4 vs traditional implants. Cost comparisons for UK patients can be found in our dental implant cost: Vietnam vs UK 2026 article, and for Australians in our All-on-4 cost: Vietnam vs Australia 2026 guide. Understanding dental implants’ long-term benefits and implant failure rates by brand will also help you make an informed decision.

Prosthesis Options at Picasso Dental Clinic

The prosthesis — the fixed bridge of teeth mounted on your implants — comes in several material options, each with different aesthetics, durability, and cost profiles.

Acrylic hybrid (PMMA): The most common immediate loading prosthesis. Lightweight, comfortable, and can be fabricated quickly. Used as the temporary prosthesis during healing and sometimes as the final prosthesis for patients prioritising cost. Expected lifespan: 5–8 years before replacement.

PEEK (Polyether ether ketone): A high-performance polymer with excellent shock absorption. Lighter than zirconia. Used as a permanent prosthesis at mid-range pricing. Expected lifespan: 10–15 years.

Zirconia hybrid: A combination of a zirconia framework with porcelain or composite veneering. Excellent aesthetics with good durability. The most common premium prosthesis choice.

Full monolithic zirconia: The highest-durability option. Milled from a single block of zirconia — no layered porcelain that can chip. Heaviest prosthesis type; requires All-on-6 or well-planned All-on-4 for adequate support. Exceptional longevity — 20+ years in clinical series.

At Picasso Dental Clinic

Picasso Dental Clinic is one of Vietnam’s leading full-arch implant providers, with 62,000+ patients treated across Hanoi, Ho Chi Minh City, and Da Nang. The implantology team uses Straumann, Nobel Biocare, and Osstem implant systems — the same tier-one brands used in Australian and American specialist practices.

The treatment process for international patients:

Pre-travel consultation: Send your dental X-rays or CBCT scans by email or WhatsApp (+84 989 067 888). Receive a detailed treatment plan and cost estimate in writing before confirming travel.
Arrival and CBCT scan: On arrival, a full 3D CBCT scan is taken to precisely plan implant placement. The implantologist reviews anatomy, bone density, and nerve positions in detail.
Treatment day: Implants are placed under local anaesthesia (or IV sedation if preferred). An immediate loading provisional prosthesis is fitted the same day in most cases.
Healing period: 3–6 months of osseointegration (the implants fuse with the bone). Patients return home after 5–10 days with a functional temporary prosthesis.
Final prosthesis: The permanent bridge is fitted on a second visit after healing is confirmed by X-ray. The final prosthesis can be PEEK, zirconia hybrid, or full monolithic zirconia depending on your preference and budget.

Picasso’s full-arch implant team has performed hundreds of All-on-4 and All-on-6 cases and can manage complex cases including simultaneous bone grafting and sinus lifts. See the All-on-4 dental implants service page for more detail.

Frequently Asked Questions

1. Can I decide between All-on-4 and All-on-6 before my CBCT scan?

Not with certainty. The recommendation should be based on your actual bone anatomy. Many patients arrive expecting one protocol and leave with a recommendation for the other — this is normal and appropriate. The implantologist’s job is to recommend the protocol best suited to your anatomy, not to confirm a pre-existing preference.

2. Is All-on-4 as strong as All-on-6?

In terms of clinical outcomes and long-term success rates, All-on-4 has an excellent evidence base — over two decades of published clinical data showing 94–98% survival rates at 10 years. All-on-6 may provide marginally higher mechanical stability for premium prostheses and heavy bite forces, but All-on-4 is not a “weaker” option — it is simply designed for a different patient profile.

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

Yes, once fully healed and fitted with your final prosthesis. During the healing phase (3–6 months), a soft diet is recommended to avoid placing excessive load on the implants while they integrate with the bone. After final fitting, most patients eat a normal, varied diet including most foods they were unable to eat with dentures.

4. What is the difference between All-on-4 and dentures?

Dentures are removable and sit on top of the gum. They can shift, cause gum soreness, and reduce bite force to approximately 20–25% of natural teeth. All-on-4 and All-on-6 are fixed — permanently anchored to implants — and restore bite force to approximately 70–80% of natural dentition. They do not need to be removed for cleaning. See our dental implants page for more on implants vs dentures.

5. Do I need to visit Vietnam twice for All-on-4 treatment?

For patients wanting the full protocol (implant placement + healing + final permanent prosthesis), two visits are required — typically 5–10 days for the first visit and 3–5 days for the second visit 3–6 months later. Some patients elect to have their final prosthesis fitted by a dentist in their home country using the detailed lab records and specifications from Picasso.

6. What happens if an implant fails?

Implant failure is uncommon — published failure rates for Straumann and Nobel Biocare implants are below 2% in most clinical series. In the event of failure, Picasso’s guarantee program covers implant replacement. Straumann and Nobel Biocare implants also carry manufacturer warranties. Contact +84 989 067 888 for guarantee terms.

7. Is All-on-4 or All-on-6 suitable for diabetics?

Well-controlled diabetes is not a contraindication to implant treatment. Poorly controlled diabetes significantly increases implant failure risk and may require stabilisation before proceeding. Your implantologist will review your medical history and HbA1c levels before recommending treatment. Discuss your diabetes management history fully during the pre-treatment consultation.

8. How do I compare Vietnam All-on-4 costs against other countries?

Our cheapest countries for dental implants guide covers All-on-4 pricing across Vietnam, Thailand, Turkey, Hungary, India, and the Philippines. For Thailand-specific comparison, see Vietnam vs Thailand for dental tourism. For a broader country comparison context, see Vietnam vs Thailand 2026.