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All-on-4 vs All-on-6 — which full-arch option is right for you?
All-on-4 vs All-on-6 for NZ patients: Picasso All-on-4 from NZD 8,333/arch, All-on-6 from NZD 12,000/arch vs NZ private NZD 28,000–55,000. May 2026 guide.
All-on-4 uses four implants per arch (two angled posteriors for load distribution) and is suitable for moderate bone loss at Picasso from NZD 8,333 per arch (Osstem, May 2026, 1 NZD = 15,000 VND), while All-on-6 places six implants for greater load distribution and suits patients with denser bone from NZD 12,000 per arch (Osstem); both use an immediate-loading protocol and require two trips, and Dr. Tran Thanh Phong determines which option is appropriate after reviewing the CBCT 3D scan at the first appointment.
For New Zealand patients facing full-arch tooth loss or needing to replace failing dentures, the two most common implant solutions are All-on-4 and All-on-6. Both attach a fixed full-arch prosthesis to a small number of strategically placed implants, and both use an immediate-loading protocol so you leave with functional teeth at the end of Trip 1. The difference is in the number of implants, the bone requirements, and the load distribution — and which is right for you depends on your CBCT, not your preference.
The quick comparison
| Feature | All-on-4 | All-on-6 |
|---|---|---|
| Implants per arch | 4 (2 straight anterior, 2 angled posterior) | 6 (anterior + distributed posteriors) |
| Load distribution | Moderate — angled posteriors compensate | Higher — 6 points across the arch |
| Bone requirement | Moderate — angled implants bypass sinus | Denser bone preferred for 6 sites |
| Immediate loading | Yes — provisional prosthesis same/next day | Yes — provisional prosthesis same/next day |
| Cost at Picasso — Osstem | NZD 8,333/arch | NZD 12,000/arch |
| Cost at Picasso — Nobel/Straumann | NZD 14,667/arch | NZD 20,000/arch |
| NZ private range | NZD 28,000–50,000/arch | NZD 35,000–55,000/arch |
| Trips required | 2 | 2 |
What is All-on-4?
All-on-4 is a full-arch fixed implant technique that uses four implants per arch to support a complete set of prosthetic teeth. The two anterior implants are placed vertically; the two posterior implants are angled (typically 30–45°) to maximise engagement with available bone and avoid the sinus or nerve structures.
The angled posterior placement is what makes All-on-4 suitable for patients with moderate bone loss — a situation that would otherwise require a sinus lift before straight-posterior implants could be placed. This is clinically significant for many patients who have had missing teeth for years, because bone resorption accumulates over time.
Dr. Tran Thanh Phong began performing All-on-4 with immediate loading in 2010 — the first clinician in Vietnam to adopt the immediate-loading protocol at that time — and has treated over 1,000 All-on-4 patients since. The provisional prosthesis is fitted the same day as implant placement, meaning you function with a fixed arch during osseointegration.
What is All-on-6?
All-on-6 places six implants per arch, providing greater load distribution across the prosthesis. The additional two implants spread the occlusal forces more evenly, which can reduce stress concentration at each individual fixture and may be preferable for patients with heavier bite forces or denser available bone that makes six well-placed implants straightforward.
All-on-6 is not simply a “better” version of All-on-4. In many cases of moderate bone loss, All-on-4 is the clinically appropriate option and adding implants in insufficient bone does not improve the outcome. The decision is anatomical — driven by what the CBCT shows — not a matter of one technique being universally superior.
Cost at Picasso (May 2026)
All prices per arch at 1 NZD = 15,000 VND.
| Option | Picasso price/arch | NZ private range/arch | Indicative saving/arch |
|---|---|---|---|
| All-on-4, Osstem | NZD 8,333 | NZD 28,000–50,000 | ~NZD 19,667–41,667 |
| All-on-4, Nobel/Straumann | NZD 14,667 | NZD 35,000–60,000 | ~NZD 20,333–45,333 |
| All-on-6, Osstem | NZD 12,000 | NZD 35,000–55,000 | ~NZD 23,000–43,000 |
| All-on-6, Nobel/Straumann | NZD 20,000 | NZD 40,000–65,000 | ~NZD 20,000–45,000 |
NZ ranges are indicative planning benchmarks. Most NZ patients require both arches — double the per-arch figure for a full-mouth estimate. See full pricing.
Who is a good candidate for All-on-4?
- Moderate bone loss in the posterior arch, particularly in the upper jaw near the sinuses.
- Patient wants a single-stage implant approach without sinus augmentation surgery.
- Case is better suited to fewer, strategically angled implants than to more straight ones.
- Upper arch with limited posterior height above the sinus.
- Patient who wants immediate loading and provisional function on the day of placement.
Who is a good candidate for All-on-6?
- Adequate bone volume across the full arch, allowing six well-distributed sites.
- Patient with heavier bite forces (history of bruxism, large bite, dense bone).
- Cases where the anatomy supports six placements without compromising any individual site.
- Patient for whom the treating clinician judges greater load distribution to be appropriate.
How we decide at Picasso
The CBCT 3D scan taken on day one of your visit maps the bone volume, density, and anatomy of each arch. Dr. Tran Thanh Phong reviews this personally before the treatment plan is written. He will recommend All-on-4, All-on-5, or All-on-6 based on what the bone shows — not based on price or assumption. If the upper arch requires a sinus lift before any posterior implant can be placed, that will be identified at this stage and included in the written plan.
The written plan provided before any irreversible work begins specifies: implant brand, number of implants per arch, whether extractions are needed, provisional prosthesis specification, and the final prosthesis material and warranty.
Timeline for both options
| Stage | What happens | Duration in Vietnam |
|---|---|---|
| Trip 1 — day 1 | CBCT, examination, treatment plan in writing | Consultation day |
| Trip 1 — day 2+ | Extractions (if needed), implant placement, provisional prosthesis | 6–8 nights total |
| Osseointegration | Healing at home in New Zealand | 3–6 months |
| Trip 2 | Final prosthesis fitting, bite refinement, records | 6–8 nights |
The provisional prosthesis gives you a functional, fixed set of teeth throughout the osseointegration period. It is not the final restoration — adjustments and refinements are made at Trip 2 when the final prosthesis is fabricated on the osseointegrated fixtures.
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About this page
Medically reviewed by
Dr. Tran Thanh Phong
Head of Implantology, Picasso Dental Clinic
DDS · 25+ years in practice · 15,000+ implants placed · 1,000+ All-on-4 cases
Clinical focus: Implantology · All-on-4 · Zygomatic implants
Dr. Tran Thanh Phong has practised since 2001 and leads implantology across the Picasso group. He was the first Vietnamese dentist to perform All-on-4 immediate loading (2010), placed over 15,000 implants across his career at roughly 600 per year, and has completed 400+ zygomatic implant cases since 2017. Loma Linda University-trained (2010). Clinical representative for Nobel Biocare in Vietnam since 2007.
Frequently asked questions
How much does All-on-4 cost at Picasso in NZD?
As of May 2026 (1 NZD = 15,000 VND): All-on-4 with Osstem implants costs NZD 8,333 per arch; with ETK/Neodent NZD 10,000 per arch; with Nobel Biocare or Straumann NZD 14,667 per arch. Most NZ patients treating both arches budget NZD 16,667–29,333 depending on the implant tier selected.
How much does All-on-6 cost at Picasso in NZD?
As of May 2026 (1 NZD = 15,000 VND): All-on-6 with Osstem implants costs NZD 12,000 per arch; with ETK/Neodent NZD 14,000 per arch; with Nobel Biocare or Straumann NZD 20,000 per arch. Most NZ patients treating both arches budget NZD 24,000–40,000 depending on implant tier.
How much does All-on-4 cost in New Zealand?
NZ private fees for All-on-4 typically range from NZD 28,000–50,000 per arch, depending on the clinic and implant brand. These are indicative planning benchmarks — not a quote from any specific NZ clinic.
Can All-on-4 be placed with bone loss?
Yes, in many cases. The two angled posterior implants in All-on-4 are designed to engage available bone and avoid the sinus, making the technique suitable for patients with moderate bone loss who would otherwise require a sinus lift before straight-posterior placement. Severe bone loss may still require grafting — confirmed on CBCT.
What is the difference between All-on-4 and All-on-5?
All-on-5 places five implants per arch — three straight anteriors and two angled posteriors. It provides more load distribution than All-on-4 and is used in cases where bone anatomy or bite forces sit between what All-on-4 and All-on-6 are designed for. Picasso offers All-on-5 from NZD 10,000 per arch (Osstem, May 2026).
Do All-on-4 and All-on-6 use immediate loading?
Yes. At Picasso, both All-on-4 and All-on-6 use an immediate-loading protocol: the provisional full-arch prosthesis is fitted the same day or the day after implant placement. You leave Trip 1 with a functional set of teeth. The final prosthesis is fitted at Trip 2 after osseointegration (3–6 months).
How long does each trip to Vietnam take for All-on-4 or All-on-6?
Trip 1 (assessment, extractions if needed, implant placement, provisional prosthesis): 6–8 nights minimum, sometimes up to 10 if extractions and healing require extra time. Trip 2 (final prosthesis fitting): 6–8 nights. Total time in Vietnam across both trips is typically 12–18 nights.
Who decides whether I need All-on-4 or All-on-6?
Dr. Tran Thanh Phong reviews every full-arch CBCT personally before any treatment plan is finalised. He has performed All-on-4 since 2010 with 1,000+ cases and uses the CBCT bone volume and density map to determine whether 4, 5, or 6 implants are the appropriate number for your arch.