All-on-4 versus All-on-6: A Comparative Analysis of FullArch Implant Rehabilitation

Abstract

The optimal choice between All-on-4 and All-on-6 full-arch implant systems is debated. All-on-4, despite high implant survival (94 97% at 10 years), presents significant prosthetic complication rates. This review aimed to comparatively analyze these systems, synthesizing 11 studies from major databases (2020-2023) on biomechanics, survival, and complications. Biomechanical analyses consistently show All-on-6 offers superior stress distribution and lower maximum principal stress compared to All-on-4. All-on-4 exhibits prosthetic complication rates of 35-50% (five years), with significant mechanical and biological issues, while All-on-6 provides redundancy. These findings suggest All-on-6 offers enhanced biomechanical stability and potentially reduced long-term complications, guiding clinical decisions.