All-on-X: A Full Arch of Fixed Teeth

If you have lost most or all of the teeth in a jaw, or you are heading that way, a full arch of fixed teeth on implants is the alternative to a denture that moves. You will see it called All-on-4, All-on-6, All-on-X or simply full-arch implants. They describe the same idea with a different number of anchors.

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What the X Means

The X is the number of implants holding the arch. Four is the most common and the most widely marketed, which is why All-on-4 is the name most people arrive with. Six is used where the arch is larger or the bone is softer and the load needs spreading further. All-on-X is what you call it before that decision has been made.

That decision belongs to the scan. Every one of our clinics has a cone beam CT, so we can see how much bone there is and where it sits before committing to a number. Planning the placement on the scan first is what guided surgery means, and it is the difference between designing a case and improvising one.

Four or six

• Four implants means less surgery, fewer sites to heal and usually a lower fee. It relies on angling the back implants to find solid bone, which is the whole idea behind the technique.
• Six implants spreads the bite across more anchor points. It can suit a bigger arch, heavier bite forces, or bone that is less dense than we would like.

Neither is a better product. One of them is a better fit for your jaw, and you should expect us to show you why on the scan rather than assert it.

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Teeth on the Day

In most cases a temporary fixed bridge goes on at the time of surgery, so you do not go home without teeth. It is fixed, not removable, and you eat carefully on it while the implants fuse. The final set is made once things have healed and settled, usually several months later.

Whether same-day loading is safe depends on how firmly the implants sit the moment they are placed. That is judged on the day, and we will have told you beforehand what happens if the answer turns out to be no.

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Where It Is Done

Full-arch work is available at all six clinics: Ingham, Innisfail, Bohle Plains, Townsville (Kirwan), Bowen and Emerald. Each has its own cone beam CT and intra-oral scanner, so the planning happens where you are rather than somewhere else.

Dr Ricky Sandhu travels up from the Gold Coast to perform All-on-X and the more involved surgical work. A visiting anaesthetist attends the clinics, so sedation can be arranged for a long appointment.

The complex end of it, where there is very little bone to anchor into, is handled at Bohle Plains and Kirwan. That is where zygomatic and pterygoid implants are done.

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If You Have Been Told No

Plenty of people are told they have lost too much bone for implants and are offered a graft and a long wait, or nothing at all. Bone grafting and sinus lifts are done at all six of our clinics. Beyond that, zygomatic and pterygoid implants anchor into bone further back and higher up, and can be an option where a conventional implant has nowhere to go.

It is worth a second opinion and a scan before accepting that nothing can be done.

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What It Costs

A full arch is a significant piece of treatment and the fee reflects the number of implants, whether the bone needs building up first, and what the final teeth are made from. As a guide, most single-arch cases run between $22,000 and $32,000, and both arches between $44,000 and $64,000, with more complex cases above that. A hybrid prosthesis sits around $26,000 to $28,000 per arch.

Those figures do not cover extractions, specialised diagnostics or bone grafting, none of which can be settled before a consultation and a scan, and the anaesthetist is billed separately if you have IV sedation or a general anaesthetic. We give you a written quote after the consultation, so your own figure is in your hands before anything is booked.

Interest-free payment plans are available, and health fund rebates are claimed through HICAPS where your policy allows. There is more on our payment options page.