All-on-6 dental implants for $15,000 per arch — the same all-inclusive price as All-on-4, because the protocol you receive should be a clinical decision, not a price-tier upsell. Performed by a board-certified oral surgeon in Bonney Lake, Washington.
Surgery, IV sedation, same-day provisional, prototype try-in, final zirconia — all included regardless of whether the protocol is All-on-4 or All-on-6.
Schedule ConsultationA full-arch fixed prosthesis supported by six dental implants instead of four — typically chosen when bone density, bite mechanics, or anatomical factors make six implants the right clinical answer.
Six titanium implants distributed across the arch. One fixed zirconia prosthesis. Two additional anchor points for biomechanical redundancy and force distribution.
All-on-6 isn't a premium tier of full-arch implants. It's a different protocol matched to specific clinical situations. Here are the factors that guide protocol selection at consultation.
When clinical factors favor six implants and the patient has adequate bone, All-on-6 is the right protocol.
All-on-4 has more long-term outcome data and is the appropriate choice for most full-arch patients. The protocol was specifically designed to use existing bone density without requiring grafting in the posterior regions.
The honest framing matters here. Six implants are not categorically better than four. The published clinical literature shows comparable long-term implant survival between the two protocols when both are properly planned and executed. What changes is which protocol is biomechanically appropriate for which patient.
At Elite Oral Surgery, the protocol recommendation comes from 3D Cone Beam CT imaging, evaluation of bite mechanics, and review of patient-specific factors at consultation. The recommendation is in writing, with the clinical reasoning explained, before any surgical date is scheduled. Patients who want a different protocol than what is recommended are heard out — but the clinical recommendation is based on what your specific case requires, not on what generates more revenue.
The pricing structure reinforces this. All-on-4 and All-on-6 are priced identically at $15,000 per arch all-inclusive at Elite. There is no financial incentive for the practice to recommend one over the other. The recommendation reflects clinical fit. Period.
No marketing, no winner. The honest comparison between two clinically validated protocols, each appropriate for different patient situations.
The published clinical comparison is unambiguous on one key point: when both protocols are properly planned and executed in healthy patients, long-term implant survival rates are comparable — both above 95% in most studies. The choice between them is not "more is better" but rather "which is right for this patient."
Some patients ask whether the additional cost of All-on-6 is "worth it." At many practices, this is a meaningful decision because the protocols are priced differently — $20,000-$25,000 for All-on-4 versus $30,000-$50,000 for All-on-6 is common in the corporate and chain models. At Elite, both protocols are $15,000. The cost question is removed from the decision, leaving only the clinical question: which is right for your specific anatomy and bite mechanics?
The All-on-6 workflow follows the same three-visit clinical sequence as All-on-4. Slightly longer surgical time on day one. Same restorative timeline. Same final zirconia at week 10-12.
Six implants placed under in-house IV sedation. Surgical time approximately 3 hours per arch. Printed PMMA provisional bridge seated the same day, allowing immediate function on a soft food diet. Home that afternoon with someone to drive you.
Printed prototype of the final prosthesis evaluated for bite, esthetics, and phonetics. Refinements made based on how you've lived with the provisional. Final design approved with your input before zirconia is fabricated.
Permanent zirconia bridge with titanium framework seated. Designed for decades of service. Hygiene instruction specific to six-implant prostheses. Follow-up scheduling at 3, 6, and 12 months — all included.
The clinical depth on the workflow — what to expect, recovery timeline, dietary restrictions, post-operative behaviors — is covered comprehensively on the Full-Arch pillar page. The All-on-6 procedure follows the same recovery and integration sequence as All-on-4, with surgical time being the principal difference on day one.
All-on-6 has been studied extensively, though the published literature on six-implant full-arch protocols has fewer long-term datasets than All-on-4 — primarily because the All-on-4 concept was published first and has more years of accumulated follow-up.
The most relevant comparative literature for All-on-6 versus All-on-4 includes randomized clinical trials and multi-center reviews evaluating the two protocols head-to-head. The overall finding across this literature is that both protocols achieve high implant survival rates in healthy patients with adequate bone, and that no major difference in long-term implant survival has been demonstrated when both are properly planned and executed.
One short-term randomized study of edentulous maxilla cases showed somewhat higher survival in the All-on-6 group versus All-on-4 over 12 months, but the sample size was small (10 patients total) and the follow-up window was short — meaningful long-term conclusions cannot be drawn from such a study alone. Larger reviews and longer-term datasets continue to support comparable outcomes.
Where All-on-6 demonstrates a clinical advantage is in mechanical redundancy and force distribution. If one implant fails to integrate or develops late-stage problems, the prosthesis continues to be supported by five remaining implants — versus three with All-on-4. For patients with strong bite forces or bruxism, the additional implants reduce per-implant load, which biomechanical research suggests can lower the risk of mechanical complications over time.
Where All-on-4 demonstrates an advantage is in the depth of available longitudinal data. The Maló Clinic studies of All-on-4 mandibular cases now extend to 18 years of follow-up — the longest published full-arch implant outcome data available. All-on-6 outcome studies typically extend to 5-10 years. For patients who place high value on the longest available track record, this matters.
The honest synthesis: both protocols work. The right one for you is the one matched to your specific clinical situation.
References: ¹ Maló P, et al. JADA, 2011 (All-on-4, n=980). ² Maló P, et al. Clin Implant Dent Relat Res, 2019 (All-on-4, 10-18 year follow-up). ³ Multiple comparative reviews and clinical studies of All-on-6 protocols, including randomized trials of All-on-4 vs All-on-6 in maxillary cases. Survival rates above 95% are consistently reported in healthy patients across these datasets.
Pricing data drawn from competitor public marketing, third-party industry reports, and patient-reported outcomes. Updated April 2026.
Comparison reflects published price ranges and operating models as of April 2026. Most providers price All-on-6 higher than All-on-4 by $5,000-$15,000 per arch, treating six implants as a premium tier. Elite does not — protocol selection is a clinical decision and the all-inclusive price reflects that. Pricing for ClearChoice based on published $14K-$36K range and third-party patient-reported data; Nuvia based on third-party industry reports.
Candidacy, materials, the full risks and complications discussion, alternatives to full-arch implants, and detailed comparison of All-on-4, All-on-6, and zygomatic protocols — the comprehensive guide is on the Full-Arch pillar page.
Neither is categorically better. They are different protocols matched to different clinical situations. The published comparative literature shows comparable long-term implant survival rates between the two when both are properly planned and executed in healthy patients — typically 95%+ in well-selected cases.
All-on-4 has the deepest published longitudinal data — over 18 years of follow-up in the Maló Clinic studies. All-on-6 has somewhat less long-term data but offers biomechanical redundancy (a five-of-six failure leaves the prosthesis still supported) and may distribute forces more evenly across the arch.
The right protocol depends on your specific bone density, bite mechanics, and anatomy. That recommendation is made at consultation, not as a default.
Two reasons. First, the protocol you receive should be a clinical decision made on what's right for your case — not a financial decision driven by what costs less. Pricing the protocols differently creates an incentive for the practice to recommend one over the other for revenue reasons. Pricing them the same removes that incentive entirely. The recommendation reflects clinical fit.
Second, the all-inclusive structure absorbs the cost difference operationally. Two additional implants add some material cost and surgical time, but our practice is built around predictable full-arch workflows that absorb this without requiring separate pricing tiers. The patient gets the right protocol; the practice gets a clean operating model.
You can ask, and we'll discuss the clinical reasoning either way at consultation. The recommendation we make will be based on your 3D imaging, bite analysis, and case-specific factors — not on what you ask for.
Patients who specifically want All-on-6 are heard out, and we explain whether their case actually warrants it. If your anatomy is better suited to All-on-4, we'll explain why — and then the choice is yours. We don't charge more for All-on-6, so there's no financial reason to push you in either direction. The recommendation reflects what we believe will produce the best outcome for your specific situation.
Sometimes. All-on-6 generally requires more bone availability across the arch than All-on-4 — particularly in the posterior regions, where the additional implants are placed. Patients with reduced posterior bone may need grafting to support six implants, while the All-on-4 angled posterior placement avoids the need for posterior augmentation.
This is one of the factors that informs protocol selection. If grafting would be required to enable All-on-6 but All-on-4 can be performed without it, the All-on-4 approach is often the right choice — both for clinical predictability and to avoid the additional surgical complexity, healing time, and cost of grafting procedures.
Two key differences. Pricing structure: ClearChoice typically prices six-implant cases at the higher end of their $14,000-$36,000 range, often $25,000-$40,000 per arch with their zirconia upcharge. Elite prices All-on-6 at $15,000 per arch, same as All-on-4, with zirconia included.
Surgeon model: ClearChoice partners with surgeons at each location. The surgeon you meet at consultation may not be the surgeon who performs your procedure, and follow-ups may be handled by different providers. At Elite, Dr. Volland personally performs every case and sees every patient at every visit.
The comparison applies to other corporate chains as well — most price six-implant protocols significantly above four-implant protocols.
The available evidence does not support a meaningful longevity difference between the two protocols when both are properly planned and executed in healthy patients. Long-term implant survival rates for both protocols sit above 95% in the comparative literature, with All-on-4 showing 93-95% survival in the longest-running studies (10-18 years).
What can affect long-term outcomes more than the implant count is patient-specific factors: oral hygiene compliance, smoking, controlled vs uncontrolled diabetes, bite forces, and adherence to six-month professional maintenance. These behaviors and conditions affect implant longevity far more than whether four or six implants were placed initially.
The recovery is comparable to All-on-4 with marginal differences. Surgical time is approximately 30 minutes longer for six implants versus four. Post-operative swelling, bruising, and discomfort are similar. The same soft food restriction during the 6-8 week osseointegration period applies to both protocols.
The only meaningful difference patients tend to notice is slightly more soreness on day one due to the additional surgical sites. By day 3-5 post-op, the difference is no longer perceptible.
If your initial All-on-4 case develops complications — implant failure, mechanical issues, late bone loss — additional implants can be placed to convert the support to a six-implant configuration. This is a real surgical option that we evaluate case-by-case when patients with previous All-on-4 work present with issues.
That said, this is a salvage scenario, not a planned upgrade path. If All-on-6 is the clinically appropriate protocol for your initial case, we recommend it from the start rather than starting with All-on-4 and converting later.
The protocol distribution varies by patient population, but consistent with the published clinical literature, the majority of full-arch patients are appropriate candidates for All-on-4. The All-on-4 protocol was specifically designed to use existing bone density without requiring grafting, which makes it the appropriate choice for most patients with significant tooth loss and the bone resorption that comes with it.
Patients with adequate bone, strong bite forces, severe bruxism, or specific anatomical considerations may benefit from All-on-6. The recommendation is made on a case-by-case basis at consultation.
Dental insurance typically provides limited coverage for both All-on-4 and All-on-6 — usually a small portion attributed to extractions or the prosthesis component. Coverage caps for implant procedures in most plans range from $1,000-$3,000 lifetime, which doesn't substantially offset the cost of either protocol.
For practical purposes, most patients use HSA/FSA funds (eligible for both), financing through one of our five partners (Cherry, Proceed, Sunbit, LendingClub, CareCredit), or a combination of both. The financing options work the same regardless of whether the protocol is All-on-4 or All-on-6.
3D Cone Beam imaging. A written treatment plan with the protocol recommendation and clinical reasoning explained. A direct conversation with Dr. Volland about whether All-on-6 is the right approach for your specific case.
Schedule Your ConsultationSurvival rate citations on this page reflect published longitudinal studies in the implant dentistry literature. Patient outcomes vary by individual circumstance, anatomy, behavior, and adherence to maintenance protocols. Comparative survival data between four-implant and six-implant protocols is most reliable when drawn from well-controlled studies in healthy patient populations.