SHOULD I HAVE 4 IMPLANTS OR 6?

This is the question most patients are sold on, and the honest answer is not what you will read elsewhere: for most arches, four well-placed implants perform as well as six.

The ITI — the largest academic implant organisation in the world — reviewed 93 studies with a median follow-up of eight years and found no statistically significant difference in implant survival between fewer than five, five, or more than five implants. Their recommendation for a one-piece full-arch restoration is "a minimum of four appropriately distributed implants."

A 2026 meta-analysis of 55 studies put survival beyond five years at 98.14% for All-on-4 and 97.50% for All-on-6 — no meaningful difference. A separate cohort of 943 patients and 5,989 implants found 98.8% against 98.7% at five years.

Where six implants do help is long-term bone stability: at five years, bone loss around the implants averaged 0.94 mm with six implants against 1.28 mm with four.

So the decision is not "more is better". It depends on your bone volume, your bite, whether you grind your teeth, and which jaw we are treating. We will tell you which we recommend and why — and if four is enough for your case, we will say so rather than sell you two more.

WILL I REALLY LEAVE WITH TEETH ON THE SAME DAY?

Yes — and it is important you understand exactly what those teeth are.

On the day of surgery you are fitted with a fixed temporary bridge. It is screwed onto the implants, it does not come out, and you will leave the hospital able to smile and eat soft food. It is not your final set of teeth.

Your permanent bridge is made after the bone has integrated with the implants, and fitted on your second visit. This is not a delay we have invented; it is how the concept was designed and how it is documented internationally. Bone remodelling around an implant is still underway at eight weeks.

Some clinics advertise "teeth in a day" without explaining that they mean temporary teeth. We would rather tell you now.

AM I A CANDIDATE IF I HAVE BEEN TOLD I DON'T HAVE ENOUGH BONE?

Very often, yes. This is precisely the problem All-on-4 was designed around.

The two back implants are placed at an angle, which allows them to use the bone you still have and avoid the sinus in the upper jaw and the nerve in the lower jaw. For a large number of patients, this removes the need for bone grafting altogether.

Where the upper jaw has lost more bone than even angled implants can work with, zygomatic implants anchor into the cheekbone instead. Published cumulative survival is around 96% at twelve years. We place these ourselves — most clinics refer these cases elsewhere or simply decline them.

A CBCT scan answers this question properly. "You don't have enough bone" is an answer that depends entirely on who is looking at the scan.

CAN I HAVE THIS TREATMENT IF I HAVE A MEDICAL CONDITION?

This is where being inside a hospital stops being a detail.

Full-arch surgery is longer and more demanding than a single implant. If you have a heart condition, high blood pressure, diabetes, a respiratory illness or a history of cancer, or if you take blood thinners, your case is reviewed by the relevant hospital specialist before we schedule anything. Cardiology, internal medicine, anaesthesiology, intensive care and a 24-hour emergency department are in the same building.

Well-controlled diabetes is not a barrier. Published data shows no statistical difference in implant failure between diabetic and non-diabetic patients when control is good. What matters is your HbA1c, not the diagnosis on your record.

Blood thinners usually do not need to be stopped. Current UK guidance is explicit that anticoagulant therapy should not be interrupted for dental surgery where the INR is below 4; bleeding is managed locally. We follow the guidance of your own country.

Heavy smoking is the one risk we will ask you to change. Smoking roughly doubles the odds of implant failure. We ask patients to stop around the surgery, and we will tell you plainly if we think your case is being put at risk.

CAN I BE ASLEEP DURING THE SURGERY?

Yes. Sedation and general anaesthesia are administered by hospital anaesthetists in an operating theatre, with the monitoring and recovery facilities of a general hospital behind them.

Many of our full-arch patients are here because they have been avoiding the dentist for years. If that describes you, you are not a difficult patient. You are the patient this treatment exists for.

WHAT WILL MY NEW TEETH BE MADE OF?

For almost every patient, the bridge is zirconium-based. Zirconia is strong, it carries no dark metal line at the gum, and it is what we use as standard.

A minority of patients need more than that. If you bite with unusual force, or you grind your teeth, we build the bridge on a metal substructure underneath the zirconium. The metal is not visible. It sits beneath and carries the load, and in the right case it is the difference between a bridge that lasts and one that keeps coming back for repair.

We do not do this for everyone, and that is deliberate. A metal substructure adds significantly to the cost of the treatment, and most patients do not need it. We assess how your bite loads the bridge and tell you which group you are in. If you don't need it, we won't sell it to you.

We also work with monolithic zirconia, milled from a single block, for the smaller number of cases that call for it.

Across long-term reviews, the most common technical problems with full-arch bridges are screw loosening, at 5–15%, and chipping of the ceramic surface. Both have more to do with how your bite loads the bridge than with the brand name on the material — which is why the bite assessment comes before the shade.

If you grind your teeth, you also leave with a hard night guard, included with your permanent bridge rather than charged as an extra. A hard guard reduces wear on the prosthesis by a factor of around 1.8. A soft one does not.

HOW LONG WILL ALL ON FOUR LAST?

The honest answer has two parts, and it affects what you should budget for.

The implants last a long time. Long-term follow-up of All-on-4 cases at ten to eighteen years reports cumulative implant survival in the region of 93–95%.

The bridge on top does not last as long. It is a working part, under load every day. Published long-term data reports roughly 80% prosthesis survival at five years and 60% at ten. In one study following patients for up to ten years, every prosthesis had experienced at least one minor complication by year six — most often a loose screw.

That is not a reason to avoid the treatment. It is a reason to know what you are buying: a permanent foundation, with teeth on top that will need servicing and, eventually, remaking.

Any clinic that tells you this is a one-off, lifetime purchase is not describing the evidence.

HOW DO I LOOK AFTER THEM?

Fixed teeth are not maintenance-free teeth. They are easier to live with than dentures and harder to clean than you might expect.

You will brush twice a day and clean underneath the bridge daily, with the interdental brushes and water flosser we give you and show you how to use. The bridge is not removed at home, and the professional guidance is against removing it routinely — only where a patient cannot maintain adequate hygiene.

Professional review follows the schedule used in the UK: every three to four months during the first year, then every three to six months for life, adjusted to your own risk. Peri-implant disease is the main long-term threat to implants, and it is largely preventable.

HOW MANY TRIPS AND HOW MANY DAYS?

Two trips.

First trip: 4 days. Consultation, CBCT scan, extractions if needed, implant placement, and your fixed temporary teeth.

Three to six months at home, while the bone integrates with the implants.

Second trip: 5 to 7 days. Impressions, try-in, adjustments, and the fitting of your permanent bridge.

You approve the look of your new smile at the try-in stage, while you are still with us in Istanbul — not after you have flown home.

WHAT YOU LEAVE ISTANBUL WITH?

Your written five-year guarantee. A signed, dated contract in your name. If a complication arises from treatment we performed, the revision treatment is carried out here free of charge for five years.

Your implant record. The make, model, reference and batch number of every implant placed. UK and Irish patients ask for this, and most clinics abroad do not provide it. Without it, a dentist at home is working blind.

Your treatment record, X-rays and aftercare instructions.

ABOUT THE THINGS YOU WILL HAVE READ

If you have researched this treatment in the UK or Ireland, you will have come across dental practices warning against having it done in Turkey. Some of those warnings are fair. Here is where we stand on each of them.

"You won't know what was put in your mouth." You will. You leave with the make, model and serial number of every implant.

"There's no recourse if something goes wrong." Turkish law requires every licensed health tourism provider to carry complication insurance, and we carry it. On top of that, you hold a signed five-year guarantee from us.

"You'll have to fly back for every follow-up, so the real cost is higher." Routine reviews can be carried out by a dentist at home, which is why your records matter. Where a revision is needed and it is covered by your guarantee, the treatment here is free of charge.

"Language barriers cause mistakes." An English-speaking patient coordinator is with you at the chairside, not just at the airport. Your treatment plan and consent documents are in English.

"Cheap implants are used to cut costs." We use Straumann and NucleOSS. Both are named in your record. You choose.

"You'll be treated in a shopfront clinic." We are a registered medical unit of a general hospital.

We would rather you brought these questions to us than decided without asking them.

WHAT DOES ALL ON 4 COST IN TURKEY COMPARED TO UK?

All-on-4 is not available on the NHS. NHS guidance states that implants are "usually only available privately and are expensive", with limited exceptions such as treatment after mouth cancer or an accident.

UK price guides report full-arch treatment at roughly £8,000 to £14,000 per arch outside London, and £12,000 to £18,000 in London.

Our prices are published in full, in pounds, including what the treatment does and does not cover. The figure you are given before you travel is the figure you pay — it is written into your treatment plan before you book a flight.

[ See our full price list → ]

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ALL ON 4, ALL 6 AND DENTURES COMPARED

                         Full dentures  -  All on 4 / All on 6  -  Individual implants for every tooth

Fixed in place:  No  -  Yes  -  Yes

Number of implants:  None  -  4–6 per arch  -  8–12 per arch

Removed at night:  Yes  -  No  -  No

Bone grafting usually needed:  N/A  -  Often avoided  -  Frequently

Treatment time:  Weeks  -  Two visits over 3–6 months  -  6–12 months

Cost:  Lowest  -  Middle  -  Highest

Long-term maintenance:  Relines, remakes  -  Professional review 3–6 monthly  -  Professional review 3–6 monthly

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FREQUENTLY ASKED QUESTIONS

How soon will I have teeth after the implants are placed?

On the same day. A fixed temporary bridge is screwed onto the implants during your first visit. Your permanent bridge is fitted on the second visit, three to six months later.

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Are the teeth fitted on the day permanent?

No. They are fixed, but temporary. Anyone telling you otherwise is not describing how this treatment works.

 

What are my new teeth made of?

Zirconium, for almost everyone. If your bite is unusually heavy or you grind, we reinforce the bridge with a metal substructure underneath — but only where it is needed, because it adds to the cost.

 

Can I eat normally?

With your temporary bridge, you will be on a soft diet for the first weeks while the implants integrate. With your permanent bridge, most patients eat normally. It is not identical to natural teeth, and we will be specific with you about what changes.

 

Will my speech change?

There is usually a short adjustment period of days to a few weeks, particularly with certain sounds. This settles. If a specific sound remains a problem, the bridge can be adjusted.

 

How do I clean them?

Brush twice daily and clean underneath the bridge every day with interdental brushes and a water flosser. We show you how before you leave, and you have professional cleaning every three to four months in the first year.

 

How long will my new teeth last?

The implants: around 93–95% are still in place at ten to eighteen years. The bridge: roughly 80% at five years and 60% at ten. It is a working part and will need maintenance.

 

Is the procedure painful?

The surgery is carried out under local anaesthetic, sedation or general anaesthesia, so you feel nothing during it. Swelling and discomfort for several days afterwards is normal and managed with medication.

 

Are All-on-6 implants better than All-on-4?

Not in terms of survival. Large reviews find no significant difference. Six implants show slightly better bone stability at five years; four implants show slightly fewer mechanical and biological complications. The right number depends on your bone and your bite, not on price.

 

What are the drawbacks of All-on-4?

The bridge will need maintenance and eventually replacement. Cleaning underneath it takes more care than cleaning natural teeth. If you grind your teeth, complication rates are higher and you will need a night guard. And it is surgery, with the risks surgery carries.

 

Will I need a bone graft? What if I've been told I don't have enough bone?

Often not — the angled implants are designed to avoid grafting. Where bone loss is severe in the upper jaw, zygomatic implants are the solution, and we place them here.

 

Am I too old for this treatment?

Age alone is not a barrier. General health matters more than the number, which is one reason we work inside a hospital.

 

Can I have All-on-4 if I have diabetes or take blood thinners?

In most cases yes. Well-controlled diabetes does not reduce implant survival, and current UK guidance says anticoagulants should not be stopped for dental surgery. Your case is reviewed by a hospital physician first.

 

How is this different from dentures?

The bridge is fixed to implants and does not come out. There is no adhesive, no movement while eating or speaking, and no palate coverage in the upper jaw.

 

What happens if my implants fail after I return home?

You contact us with photographs and an X-ray. Where the complication is covered by your five-year guarantee, the revision treatment is carried out here at no charge for the dental work.

 

What records do I leave Istanbul with, and will a dentist at home see me?

You leave with your implant record — make, model, reference and batch number — along with your X-rays, treatment record and guarantee. Many dentists at home will see you for routine reviews, and having that record is what makes it straightforward.

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