FULL-ARCH IMPLANT REHABILITATION USING THE ALL-ON-4® AND ALL-ON-6® CONCEPTS WITH DIGITAL WORKFLOW: A CLINICAL CASE SERIES

Background: The All-on-4® and All-on-6® concepts, combined with digital workflows, have significantly transformed full-arch rehabilitation by enabling immediate function, improved prosthetic precision, and reduced surgical morbidity. While the All-on-4® approach is widely documented, the All-on-6® concept offers additional biomechanical stability in selected cases, particularly in patients with higher functional demands or compromised bone quality. 

Objective: To evaluate clinical outcomes, complications, and patient satisfaction in patients treated with full-arch implant rehabilitation using fully digital All-on-4® and All-on-6® protocols. 

Materials and Methods: Twenty-four edentulous or terminal dentition patients underwent treatment using CBCTguided planning, intraoral scanning, and CAD/CAM prosthesis fabrication. Treatment allocation included All-on-4® or All-on-6® configurations based on bone availability, occlusal load considerations, and anatomical limitations. Outcomes assessed included implant survival, marginal bone loss, prosthetic complications, and patient-reported satisfaction over a 12-month follow-up period. 

Results: A total of 120 implants were placed (96 in All-on-4® cases and 24 in All-on-6® cases). The overall implant survival rate was 98.3%. Mean marginal bone loss at 12 months was 0.78 ± 0.23 mm. Immediate loading was successful in 23 patients. Minor prosthetic complications occurred in 16.7% of cases. The All-on-6® group demonstrated slightly improved load distribution and reduced prosthetic stress. Patient satisfaction significantly improved across all domains. 

Conclusion: Both digital All-on-4® and All-on-6® workflows demonstrate high success rates, predictable outcomes, and excellent patient satisfaction. The All-on-6® concept may provide additional biomechanical advantages in selected cases, supporting its use as a complementary treatment modality.