All-on-X (5–6 Implant) Full-Arch

When 4 implants aren't ideal — bone density, bite forces, or arch shape — we go to 5 or 6.

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All-on-X is the natural extension of All-on-4. Some patients — usually those with stronger bite forces, larger jaw arches, or specific bone-density patterns — benefit from 5 or 6 implants per arch instead of 4. The extra implants distribute chewing forces more evenly, deliver a slight long-term success-rate edge, and provide redundancy if one implant ever fails.

Whether your case calls for All-on-4 or All-on-X is determined by your CBCT scan and Dr. Sunny's clinical judgment. We don't push you toward more implants for the sake of revenue — and we don't undersell on implants for the sake of price. Some cases are textbook All-on-4. Others genuinely need 6. We tell you which one applies and why.

What's included

The All-on-X difference.

Slightly higher long-term success rate

More anchor points = more redundancy. The functional difference is small but measurable in 10+ year studies.

Better for heavy chewers

Patients who grind teeth, have strong bite forces, or want maximum chewing efficiency benefit from 5–6 implant designs.

Same surgical day, similar timeline

Like All-on-4, you walk out with permanent-feeling temporary teeth on day 1 and the final bridge 3–6 months later.

Honest assessment, no upsell

We don't recommend All-on-X unless your case actually calls for it. About 70% of arches we treat are All-on-4.

How it works

From first photo to final crown.

01

Virtual consult + photo upload

Same 60-second form as All-on-4. Dr. Sunny will recommend All-on-4 or All-on-X based on your photo and concerns.

02

In-office 3D CT scan

CBCT imaging is what determines whether your case is All-on-4 or All-on-X. Free at our offices.

03

Custom surgical plan

Implant positions designed around your bone density, arch shape, and bite force pattern. Custom surgical guide manufactured.

04

Surgery day

5 or 6 implants placed, temporary fixed bridge installed same day.

05

Healing (3–6 months)

Osseointegration. You wear the temporary bridge throughout.

06

Final bridge delivery

Custom permanent bridge installed at follow-up visit.

What patients say

Hear from patients across all three locations.

★★★★★
"$1,999 was unbeatable. Other places quoted me $4,000+. Dr. Sunny was upfront about everything from the first photo I sent. No surprise charges, no hidden fees, exactly what they said."
Sarah M.
Sacramento · $1,999 Single-Tooth Implant
★★★★★
"I'd been hiding my smile for years. Dr. Sunny did my full upper arch and I walked out with permanent teeth that day. Best decision I've made in a decade."
Robert J.
Modesto · All-on-4
★★★★★
"I was nervous because the price seemed too good. But the team explained every step, the 3D scan was free, and the final crown looks better than my real teeth. Five stars all the way."
Maria G.
Fair Oaks · Single-Tooth Implant
Common questions

Common questions about this procedure

Where we are

Three California offices. One trusted team.

Dr. Sunny and the surgical team rotate across all three locations. Same protocols, same implants, same $1,999 price.

Elk Grove

9340 W Stockton Blvd, Suite 120

Elk Grove, CA 95758

(916) 886-1806

Mon–Fri 8am–5pm

See location details →

Fair Oaks

11121 Fair Oaks Blvd

Fair Oaks, CA 95628

(916) 918-5960

Mon–Fri 8am–5pm

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Riverbank

2754 Topeka St

Riverbank, CA 95367

(209) 569-3502

Mon–Fri 8am–5pm

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All-on-X (5 or 6 implants per arch): when more anchor points actually matter

Why approximately 30% of full-arch patients benefit from All-on-6 over All-on-4 — and how CBCT bone density data determines the right protocol.

All-on-X vs All-on-4: when biomechanics call for more implants

All-on-4 was specifically engineered to work with the minimum number of implants required for full-arch support: four. The protocol is elegant, well-evidenced (10-year survival in the 94–96% range across multiple cohort studies), and works for the majority of full-mouth implant candidates. All-on-X — typically All-on-5 or All-on-6 — adds one or two additional implants when biomechanical or bone-density factors warrant it. Common indications: heavy parafunctional activity (bruxism with documented attrition or fractured natural teeth), wider-than-average arch dimensions where the four-implant anteroposterior spread leaves longer cantilever segments, mandibular cases with high Class I bite force where the four-implant configuration is closer to its design limits, and patients with type-IV (low-density) posterior maxillary bone where additional implants improve load distribution.

How CBCT bone-density mapping determines All-on-4 versus All-on-X

The protocol decision is not driven by patient preference or upsell incentive — it is driven by the 3D bone anatomy revealed in the CBCT scan. CBCT imaging provides Hounsfield-equivalent density measurements at the planned implant sites, lets the surgeon assess cortical bone thickness, measure the maxillary sinus floor position, and identify the inferior alveolar nerve trajectory. Bone density is classified using the Lekholm-Zarb system (D1 dense cortical through D4 fine trabecular). All-on-4 with immediate loading typically requires D1–D3 bone at the four planned positions to achieve the 35+ Ncm initial torque needed for primary stability. If the posterior tilted-implant sites present D4 bone, adding a fifth or sixth implant distributes load to additional anchor points and reduces the failure risk associated with marginal primary stability. Approximately 30% of our full-arch cases fall into this category.

All-on-X cost considerations and what every full-arch patient should verify

All-on-X (5 or 6 implants per arch) costs more than All-on-4 — the additional implants themselves carry a unit cost, the additional multi-unit abutments and surgical guide complexity add modestly to case time, and the post-operative monitoring is unchanged. At our practice, All-on-X cases are priced based on the specific surgical plan rather than as a single fixed number; written quotes are provided after the CBCT review at consult. For any full-arch implant patient considering All-on-X anywhere, four items to verify in writing: (1) Is the recommendation driven by your CBCT bone-density data, or by a generic 'more implants is better' upsell pattern? (2) Are the additional implants billed at the same per-implant rate as the base four? (3) Is the surgical time additional, and does that change sedation cost? (4) Is the final permanent bridge fabrication included regardless of implant count, or priced per-implant?

Send a photo. Hear from Dr. Sunny in 24 hours.

No pressure, no high-pressure sales call. Just a written treatment plan and a short video from the surgeon — so you can decide if implants are right for you on your own time.

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