All-on-8 adds more implants; All-on-X uses smarter placement.
Total edentulism—the complete loss of natural teeth—is something that goes beyond affecting the chewing function only. It is known to cause resorption of the alveolar bone, which leads to alteration of the bony and facial structures.
Therefore, those who come to Lema Dental Clinic in Turkey for consultation often raise a question, “Is it that the All-on-8 protocol is better than All-on-X, or is it that a smaller number of implants can bring results all the same?”
In fact, from a clinical perspective, the number of implants is not representative of the overall quality. It simply corresponds to the choice among other things of using the patient’s bone density, available alveolar volume, and biomechanical load distribution.
Imagine the jawbone as a construction site. Osseointegration here means that the titanium implant and bone have formed a bond that will remain intact, conceived as a permanent structural bond. If bone density is pretty good, the structure does not falter. On the contrary, if the bone volume is not enough, the surgical tactics have to be modified so as to safeguard the success of the prosthetics over time.
The All-on-8 Approach: Time-Tested Implant Protocol
The All-on-8 proposition has been the standard of restorative dentistry for years. Through the placement of 8 implants, dentists are capable of evenly spreading the occlusal forces along the whole dental arch. As a result, this setup yields the highest level of safety for the implant-supported fixed prosthesis.
According to Professor Doctor Coşkun Yıldız, for patients who have excellent alveolar bone density, the All-on-8 method is a great choice, as it highly stabilizes the primary condition and distributes the bite force,e which minimizes the wear of any single implant.
On the downside, this operation needs a lot of bone. For this reason, if you have undergone severe bone resorption, the All-on-8 option will require you to first have a bone graft, among other surgeries. These grafts, however, extend not only the treatment time but also the biological recovery time.
The All-on-X Approach: Targeted Biomechanics
The All-on-X prosthetic restoration is a device supported by implants with a number changing according to the requirements – four or six – placed with the help of angulation.
So, what we do in our clinical work is: We’ve found that by changing the posterior implant’s direction towards tilting the basis, is that the supporting prosthetic of these implants focuses on the areas where the with denser cortical bone. Consequently, the obstacles such as the maxillary sinus or the mandibular nerve canal are largely avoided by these anatomical limits.
With the help of this surgical method, a fixed prosthetic solution was also obtained that was immediate-load. Triangulation stability is achieved here via the geometrical consideration rather than the implant count.
Comparative Table on Clinical Elements
It would be best if you knew your oral anatomy well to choose between these two.
| Feature | All-on-8 | All-on-X |
| Alveolar Bone | More Bone | Less Bone |
| Grafting | Often Needed | Seldom |
| Surgery Time | Long | Short |
| Prosthetic Stability | Evenly Distributed | Based on Triangulation |
| Cost | Higher | Lower |
Lema Dental Way
Dr. Polen Akkılıç, along with the team, thinks that implant placement is more of a treatment development that should be adapted to the patient’s condition, in all ways. Turning human biology into mass production is definitely off the table for us.
There are a few patients in Turkey who are set on All-on-8, but the 3D CBCT scan produces a result indicating that an All-on-X protocol may be advantageous biomechanically for their bone.
To come up with an implant-supported base, stable for the entire duration of a person’s life, is our main clinical target. We help our patients handle anxiety about medical tourism by offering them a detailed, evidence-backed surgical plan at the stage of their appointment scheduling.
Top Questions and Answers
No. Stability is a function of osseointegration and the most favorable implant positions. Both methods have high success rates when done by an experienced oral surgeon utilizing appropriate biomechanical angles.
Generally speaking, when the dental implants are in the design bone, and the patient carries out regular maintenance and good oral hygiene, they can be thought of as practically lifelong. Also, regular visits to the dentist guarantee that the prosthetic will have an even longer life.
In fact, we make sure the patient will have both function and appearance during the period of osseointegration. Immediately after the implant operations, a temporary fixed bridge is generally offered so that normal speech and nourishment are possible.
We can ensure a surgical process free of pain by using advancements in local anesthesia and sedation. Pain in the days post-surgery is to be expected, but can be handled very well with the help of painkillers.
The answer to that is a huge 3D CBCT scan. Cross-sectional examination of your jawbone bears the key to the safest and most stable anatomical sites for implantation, according to Professor Doctor Coşkun Yıldız.
- Babbush, C. A., Kutcipal, E. A., & Brokloff, J. (2013). The all-on-four immediate function treatment concept: A clinical report on the medium-term outcomes. Journal of Oral Implantology, 39(S1), 325-333.
- Maló, P., de Araújo Nobre, M., & Lopes, A. (2019). The use of tilted implants for the rehabilitation of completely edentulous arches: A systematic review. International Journal of Implant Dentistry, 5(1), 1-12.
- Patel, H., & Al-Amleh, B. (2020). Biomechanical considerations in All-on-8 versus All-on-4 implant-supported prostheses. Journal of Prosthetic Dentistry, 124(3), 345-352.
- Tarnow, D. P., & Elian, N. (2017). Immediate loading of dental implants: The evolution of the All-on-X concept. Clinical Oral Implants Research, 28(S14), 112-119.
- Zarb, G. A., & Albrektsson, T. (2015). The role of bone quality and implant distribution in full-mouth rehabilitation. Journal of Clinical Periodontology, 42(S16), S214-S220.
