Both All-on-4 and All-on-6 replace a full arch of teeth on implant anchors. The number of anchors changes the biomechanical load distribution, the surgical complexity, and the price. The right choice depends on your bone profile, bite force characteristics, and jaw anatomy — it is a clinical decision, not a patient preference. This guide explains the clinical difference, clarifies when six anchors are actually indicated, and gives current AUD pricing across the three main Vietnamese cities for full-arch treatment.
The clinical difference
All-on-4 places four implants per arch. Two are positioned vertically at the front of the jaw, anchoring into the dense anterior bone. The two rear implants are angled — typically 30–45 degrees — to engage the available anterior bone while avoiding the maxillary sinuses (upper jaw) or the inferior alveolar nerve (lower jaw). This angled placement is what makes All-on-4 viable in cases of posterior bone loss: the angle reaches bone that a vertical posterior implant could not safely access. The technique was originally developed and commercialised by Nobel Biocare and is now implemented across multiple implant systems.
All-on-6 places six implants per arch. The distribution is more even across the arch, with less extreme angling required at the rear positions. Because each implant bears a proportionally smaller fraction of the total bite load, the per-implant stress is lower — which reduces long-term bone stress at each implant neck and can decrease marginal bone loss risk over time. All-on-6 also provides greater redundancy: if one implant fails to integrate, five remain to support the arch; with All-on-4, a single integration failure is more architecturally significant.
Neither procedure is inherently superior. All-on-4 was designed precisely for the bone resorption scenarios where six-implant placement is not feasible — and in appropriate cases it performs excellently. All-on-6 offers greater load distribution in cases where bone volume permits it. The CBCT scan determines which category your jaw falls into.
When is All-on-6 recommended?
The treating implantologist will assess four primary factors from the CBCT and clinical examination:
- Bone density and volume: Lower bone density benefits from more anchor points — each implant carrying less load reduces the risk of peri-implant bone stress. Patients with significant bone resorption who still have sufficient volume for six implants may be better candidates for All-on-6 than for All-on-4 with maximum posterior angulation.
- Bite force profile: Patients with a history of bruxism, or male patients with high masseter muscle activity, generate substantially higher bite forces than average. Greater anchor point distribution manages this force more conservatively over the long term. If you have been told you grind, or you have a history of fracturing natural teeth or previous restorations, this factor applies to you.
- Jaw length and arch anatomy: Longer arch measurements can accommodate six implants with adequate inter-implant spacing. Spacing matters — implants placed too close together create a zone of reduced vascularisation between them. The CBCT measurement confirms whether the available arch length supports six placements without compromising spacing.
- Opposing arch: If both arches are being restored simultaneously (dual arch treatment), the total bite load is distributed across 6+6 or 4+4 anchors. Dual arch cases with strong bite force are a conservative indication for All-on-6 on both arches — the total anchor count and load distribution become more significant when both sides of the bite are implant-supported simultaneously.
All-on-6 cannot be determined by patient request — it requires CBCT-based assessment by the treating surgeon. Clinics that offer All-on-6 as a straightforward upgrade option without CBCT assessment are not following evidence-based protocols.
Price comparison — AUD 2026
All prices are per arch unless stated. Dual arch pricing is indicated separately. Australian domestic estimates are included for savings context.
| Treatment | HCMC (AUD) | Da Nang (AUD) | Hanoi (AUD) | AU home est. |
|---|---|---|---|---|
| All-on-4, Osstem/Dentium, per arch | A$10,251 | A$9,945 | A$10,098 | A$28,000–40,000 |
| All-on-6, Osstem/Dentium, per arch | A$12,164 | A$11,791 | A$11,972 | A$35,000–50,000 |
| All-on-4, Straumann/Nobel, per arch | A$12,240 | A$11,861 | A$12,286 | A$38,000–55,000 |
| All-on-6, Straumann/Nobel, per arch | A$14,554 | A$14,108 | A$14,765 | A$48,000–65,000 |
| Dual arch All-on-4, Osstem/Dentium | A$20,502 | A$19,890 | A$20,196 | A$56,000–80,000 |
Osstem and Dentium are South Korean manufacturers with a 10-year manufacturer warranty. Straumann and Nobel Biocare are Swiss and global manufacturers respectively, with lifetime manufacturer warranties on the implant fixture. Warranty applies to the implant component itself, not to the prosthetic arch or abutment hardware, which is subject to normal wear and the individual clinic\'s restorative guarantee.
City availability — where can you get All-on-6 in Vietnam?
All-on-6 requires larger implant surgical teams, CBCT-guided surgical templates, and the case volume to maintain clinical proficiency. Not all cities in the SmileJet network offer All-on-6:
Ho Chi Minh City: Available at multiple SmileJet-verified partner clinics. HCMC has the highest full-arch implant case volume in Vietnam, with the largest pool of experienced full-arch implantologists. The widest choice of implant brands (including full Straumann and Nobel Biocare availability) is in HCMC.
Da Nang: Available at the largest SmileJet partner clinics in the city. Da Nang has grown significantly as a full-arch implant destination; case volumes at the flagship partner clinics support All-on-6 proficiency.
Hanoi: Available at flagship partner clinics. Hanoi\'s implant infrastructure is strong but the verified All-on-6 offering is concentrated at a smaller number of clinics than HCMC.
Hoi An: All-on-6 is not available. Hoi An partner clinics are verified for crown, veneer, and single implant work; full-arch complex implant cases are referred to Da Nang (approximately 30 km, 45-minute drive).
Phu Quoc: All-on-6 is not available. Full-arch complex cases are referred to HCMC partner clinics. Phu Quoc is well-positioned for cosmetic treatments and single implant cases, and functions as an accessible entry point given the island visa exemption.
CBCT is mandatory before either procedure
No responsible implant surgeon should commit to All-on-4 or All-on-6 without a cone-beam CT scan. The CBCT provides the three-dimensional data set that makes the procedure planning possible: bone volume and density at each planned implant site, sinus floor position (critical for upper jaw angled placement), inferior alveolar nerve position (critical for lower jaw placement), and any existing root remnants or pathology that require management before implant placement.
Some patients who believe they are straightforward All-on-4 candidates are found on CBCT to require sinus lifts or ridge augmentation before implant placement — procedures that add cost and extend the treatment timeline by 4–6 months (graft healing). This is not a failure of the consultation process; it is the consultation process working correctly. Proceeding without CBCT and discovering these issues at surgery is the failure mode to avoid.
CBCT at SmileJet partner clinics in HCMC starts from A$184. For patients who have had a CBCT within the previous 6 months (from their home dentist or a referral clinic), the CBCT data can sometimes be sent in advance and reviewed by the Vietnamese surgeon before your trip — reducing the on-site assessment time. Confirm this option at the quote stage.
Frequently asked questions
Is All-on-6 always better than All-on-4?
No. All-on-4 was specifically designed for cases where bone loss has already occurred in the posterior jaw and six-implant placement across the full arch is not feasible without sinus lifts or extensive grafting. In these cases — which represent a significant proportion of full-arch patients — All-on-4 is not a compromise; it is the indicated protocol. The question is not which procedure is generically superior, but which is appropriate for the specific bone architecture in your jaw. That question is answered by CBCT data, not by the procedure name.
Can I ask for All-on-6 if the surgeon recommends All-on-4?
You can ask, and the surgeon may agree if your bone volume supports six-implant placement without crowding or compromised spacing. But requesting All-on-6 as a perceived premium option — without clinical indication for six anchors — adds cost without demonstrable benefit in cases where All-on-4 is the indicated treatment. A surgeon who offers All-on-6 on request without CBCT-based justification is not following evidence-based protocol. A surgeon who explains the CBCT findings and recommends All-on-4 is giving you accurate clinical information.
How long does All-on-4 or All-on-6 treatment take in Vietnam?
The treatment is structured across two trips, both required. Trip 1 (surgery plus immediate-loading acrylic temporary arch): 10–12 days. Trip 2 (final milled zirconia arch fitting and occlusal refinement): 5–6 days, scheduled 3–6 months after Trip 1. Total Vietnam time across both trips: 15–18 days. Allow for the osseointegration window between trips — three weeks or six weeks in Vietnam is not an alternative to the two-trip structure.
Which implant brand is used for All-on-4 and All-on-6 in Vietnam?
Osstem and Dentium (South Korean, 10-year manufacturer warranty on the implant fixture) are the most widely used at SmileJet partner clinics across all five Vietnamese cities. Straumann and Nobel Biocare (Swiss and global respectively, lifetime manufacturer warranty) are available at flagship partner clinics in HCMC, Da Nang, and Hanoi. The angled posterior placement in All-on-4 does not affect implant brand suitability — all major brands (Straumann, Nobel, Osstem, Dentium) have validated angled placement protocols and matching angled abutment systems. Brand selection should be discussed at the CBCT review stage, with pricing implications confirmed in the written quote.
