What is All-on-X treatment?

In this video Dr. Dt. Kıvanç Türkoğlu and Dr. Dt. Gürcan Çetin discuss fixed teeth on a small number of implants for a jaw that has lost all its teeth or is about to. The article below summarises the topics in the video and lists what someone considering this treatment should know.

What the video covers

• Why people struggling with removable dentures ask for fixed teeth.
• How angled implants make use of the areas where bone remains, why this is called All-on-X, and how the X stands for a number that varies with the jaw and the person.
• The convenience of fixed temporary teeth for daily use and cleaning.
• The role of digital scanning in taking impressions for the bridge.
• How, after major bone loss, the bridge replaces both teeth and lost tissue, and why getting used to this volume can take some time.

What does the name All-on-X mean?

Names such as All-on-4 or All-on-6 describe replacing all the teeth in one jaw with a single fixed bridge resting on a set number of implants. Because the number is not the same for everyone, All-on-X is used as a general name.

In this approach the back implants are often placed at an angle. This lets them take support from areas where bone is fuller without coming close to structures such as the sinus or the nerve canal. In some patients this can remove the need for a separate bone-building procedure.

Who is it discussed for?

People whose removable denture moves, or who find chewing or speaking difficult with it, often ask about this treatment. People whose remaining teeth cannot be saved because of advanced gum disease are also in this group.

Suitability is assessed with an examination and a CT scan. Bone volume, general health, smoking and the ability to keep up daily cleaning are all considered. More detail is in the All-on-4 and All-on-6 section.

What is assessed in planning?

Planning starts by deciding where the teeth of the bridge will sit. The smile line, lip support and the opposing teeth matter for this decision. The CT scan is merged with an intraoral scan and implant positions are chosen to suit these teeth. Digital impressions can make it easier to check how the bridge components fit.

Same-day fixed temporary teeth

When conditions allow, screw-retained temporary teeth can be fitted on the day of implant placement or shortly after. The deciding measure is how firmly the implants sit in the bone. This is measured during surgery and the decision is made then.

Fixed temporary teeth avoid the pressure of a removable denture resting on healing gums. Soft food is still advised while the implants continue to bond with the bone.

What does daily care involve?

The fixed bridge stays in at night. Cleaning is done in the mouth with a toothbrush, interdental brushes and a water flosser. The underside of the bridge and the area around each implant need particular attention.

Regular check-ups examine the tissue around the implants and the screws. When needed, the clinician removes the bridge, cleans it and refits it.

Getting used to the new bridge

In a jaw that has been without teeth for a long time or has lost a lot of bone, the bridge fills the space of missing gum and bone as well as the teeth. This can create more volume in the mouth than natural teeth.

In the first weeks, while the tongue adapts, some sounds may feel different for a while. For most people this eases with time. When bone loss is small, this adjustment is usually shorter.

Frequently asked

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

The main difference is the number of implants carrying the bridge. The right number is chosen by looking at the bone, the condition of the opposing teeth and biting force.

Can I take the fixed bridge out at home?

No. It is screwed to the implants. The clinician removes it at check-ups when needed.

Will I definitely get teeth on the same day?

This cannot be promised in advance. The decision is made during surgery, based on how stable the implants are when placed.

Related section and videos

• Section on the expertise page: All-on-4 and All-on-6 (fixed teeth on implants)
• Can fixed temporary teeth be fitted in the same session as implants?
• How is the number of implants decided?
• How long do implant and bridge treatment take?
• What is a dental implant and what are the stages of treatment?

This information is for general guidance and does not replace an examination. Rapidly spreading facial swelling or difficulty swallowing or breathing is an emergency. Go to a hospital emergency department.