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Home ALL-ON-4/6 Your Biggest Risk in Dental Implantation
4Nov

Your Biggest Risk in Dental Implantation

by implantroot

As any other surgical intervention, dental implants come with risks too. In this post I will tell you about the biggest risk you surely want to avoid at any cost. You are now a few minutes away of gaining the skill to identify and avoid this risk for you.

Lately we have entered into many online arguments with quite a few people claiming other clinics (most often we hear Turkey in particular) as being much “cheaper” (thus perceived better) disregarding the risks which this may bring. With this article I want to clear one thing – there can rarely exist a huge bargain in dental implantation unless it compromises your long term health benefits.

Don’t get me wrong – not all clinics in Turkey/ Bulgaria/ Hungary/ Germany/ UK/ …wherever follow bad protocols and not all follow good ones – there are “bad guys” everywhere: in Bulgaria, in Turkey and in the UK, etc. And the opposite – there are “good guys” everywhere. The trick to avoid the risk of being scammed is to learn how to recognize them.

The temptation to say “YES”

Imagine(!) you run a new dental clinic with all its investments and expenses. Today you have an inquiry from a potential patient from the UK, called Ann in this imaginary story, for dental implants. Ann wants a price quote. Of course you want to look professional and you request back Ann’s X-ray (although it means almost nothing in the implantation protocol!) and she sends you one which proves her bad teeth condition. Now, here is the tricky moment for you, your moral dilemma – will you go for honesty and human moral or you’d go for the cash! This is so, sorry I must repeat it, because an X-ray MEANS CLOSE-TO-NOTHING in proving enough jawbone for implantation, and no bone means no implant. At least it should in an ideal world…

Of course you know Ann inquired with at least 5 other clinics and you need to hurry. Let’s imagine you are pressed by your business expenses and you decide to disregard what you learned in the dental university. You need Ann and her potential 5000+ Euro/GBP. You must win Ann – you send her an incredibly low ALL-ON-6 price offer for both jaws, an offer that can rarely be outpriced by others.  In the back of your mind you only hope Ann is good for implants…

And now comes Ann’s risk! She falls for your nice voice and agrees to your offer with free flight, free hotels, free transfers, free food, free tour, free whatever. Ann comes to the clinic with her purely natural trust in doctors being genuine in their Hippocratic Oath. Ann knows nothing about dental implantation protocols (her mistake!). She arrives and meets the nicest version of You, who in the process discovers (by the means of a 3D CBCT scan) that Ann has not enough stable jaw bone (in about 50% of the cases) – so she is no good for implants! Wow, bad luck… what do you decide?

– to tell Ann the truth and greatly disappoint her and pay for her the free flight, free hotel, free whatever and make her very disappointed and possibly angry??

– or to hide the fact and go ahead and take the unjustified risk of placing the implants, likely leading to infections and big future complications??

Remember, you knew well before Ann came to your clinic that she may not be good for implants and still you sent her that “great” ALL-ON-4/6 offer. You knew what you are going into… and now you have to finish what was started and you decide to place these implants. After a few hours Ann is happily implanted and after a day or two Ann sees her new teeth. You smile on the photos and only hope that the complications and problems would not come back soon enough… Believe me you don’t want to be Ann’s shoes.

A real-life case!

Now let’s get back to real life… For the purpose of this article I made a random approach to a few clinics that advertised on Facebook. Nice, ads by the way… some were really CHEAP too. Three out of four said that bloody “YES”! Here is how my conversation went (see screenshot below):

Do you notice the “YES”??!! They offered me an ALL-ON-6 (a fixed structure on 6 implants) for both jaws. No, if’s, warrants or hesitations! Wow, great, my father will finally have fixed teeth again… or maybe not for long… Unless this clinic discovered a real breakthrough in dentistry…

During a phone call, the nice lady on the other side of the line told me that they do not offer zirconium crowns over implants which in fact “should never be done and if other clinics are offering me this are scamming me”. (What?!!) Also, my second stay should be 10 days, which lead me to think that they had no internal laboratory and had to rely on a third-party which is never good.  But all this is secondary. The important thing is they decided to go after the money not caring about my health.Here is another example (click here to see the screenshot). Funny enough this time the same X-ray returned a different “diagnosis” that teeth need to be removed and 8 implants will be placed right after extraction (wow!), which usually is a no-go in the implantation protocol. This only proves what I mentioned previously – the X-ray is not a good base for implantation planning and clinics will likely fall for the cash.

Additionally, quite often clinics tend to talk about the make of implants rather than the make of zirconium (the most common material in dental restorations). Cheap zirconium can be 10X cheaper than quality zirconium (click here to see details). A titanium bar is sometimes required, which adds even more to the price. On the other hand, zirconium, although popular, is not always the best material for All-on-4/6 because it is heavier and not as flexible as G-CAM for example. What I mean is that there is a lot more to consider than just “All-on-4” but many clinics prefer to keep silent about this. Unfortunately, quite often the regular client-patient is unaware of all this and becomes an easy victim.

The business fact is that the clinics working at low profit margins will have bigger difficulty saying “NO” (giving bad news) to patients. Not all do that, do not get me wrong, just the “YES” chance is higher! Such clinics are pressed by lower revenues and every patient in the pipeline is important to keep a steady revenue stream. The medical business requires heavy investment, expensive labour force, big marketing budgets and agile sales teams. Finding a balance between all this is the key to survive in business.

Please do not have any doubt that a careful analysis of a 3D scan the one and only required test to prove your implant case.  A 3D scan is very objective – you either have enough bone or not. Of course in some cases bone grafting can be done, but this rarely comes with any guarantees (Click here to read more). In 2012 the American Academy of Oral and Maxillofacial Radiology (AAOMR) issued an original position statement “that CBCT is the imaging method of choice for gaining the assessment of all dental implant sites” after evaluating all radiology methods used in dental treatment (here is the original reference).

In our case, at Sofia Implant Centre you’d hear our consultant say that we will need a 3D scan before we confirm your case. We are always in the search for a good balance between price and what we offer. We are neither the cheapest, nor want, nor need to be. Price for us is a side effect of our efforts to provide good value. Our message to the patient is always one – your long-term health benefit is leading in all our decisions and actions. Sometimes this creates friction – giving bad news is never easy. We will continue to say “NO” in cases without medical justification. Our promise is that we will never, never, NEVER!, place an implant in case of lack of enough bone. For us this is the right way to go.

Your takeaway
The important thing to remember is that no clinic/doctor can honestly tell you they can place implants until they analyse your 3d CBCT scan. If they do – stay away no matter how cheap their offer is. Going simply for “cheap” will likely cost you a lot more in the future, not only in terms of cold cash but also in time and suffering. Not following the right implantation protocol is the biggest risk you take and you need to know how to recognize it. “Cheap” only raises the risks.

Related article:
What does quality mean in full-arch restoration?

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    Part one done. Some minor complaints, but nothing regarding the medical treatment. Once I complete the process I will write it more detailed. But right now I can only recommend the clinic to anyone looking for implants.
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    Искам да споделя че завурших своята Холивудска усмивка във София Имплант и не само че съм много доволен а просто това е наи добрата инвестиция която съм правил
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    I would like to express my deepest gratitude to the entire team at Sofia Implant Centre for their exceptional care and attitude toward patients. A special and heartfelt thank you goes to Dr. Hussain, an incredible specialist whose expertise is second to none. My case was so complex and challenging that it could literally be featured in a dental medicine textbook! Despite this, Dr. Hussain completely reassured me from day one, encouraging me and giving me full confidence that everything would go smoothly and that I would achieve both a beautiful smile and excellent oral health. I also want to extend my special thanks and appreciation to my patient coordinator, Simeon. Thank you, Simeon, for your utmost professionalism, gentle approach, and warm, friendly attitude throughout the entire process. You made me feel truly supported at every step. I could not be happier with the results and the whole experience. I will whole-heartedly recommend Sofia Implant Centre to all my friends and family!
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    I had full upper and lower all on six implant treatment at the Sofia Implant Centre in February 2026, followed by permanent zirconium bridges in August. The results are exceptional — my smile looks fantastic and I can eat normally again. My thanks to Dr Rafid Hussain, the head surgeon, for the outstanding surgical work, and to Dr Ogur Inal, who fitted my zirconium bridges with real precision and care. I also want to give special thanks to Kris George my Consultant, who managed to secure me an appointment at the last minute when the Centre was fully booked. All the staff were friendly, supportive, and highly professional throughout my treatment. I couldn’t be happier with the experience or the final result. Highly recommended.
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    I recently visited Sofia Implant Centre for a check-up of my All-on-4 implants, which I had completed there 3 years ago, and my experience continues to reward me for choosing their excellent services. My consultant this time, Diyan Shkodrov, was extremely helpful with booking the hotel and arranging my transfer, along with the sweetest clinic guide at the airport, whose name I unfortunately forgot. My meeting during the check-up with dental specialist Dr Kliment Bekiarov, who was also responsible for creating my final smile, was as always very warm, welcoming, and full of positive energy. He was more than willing to answer all my questions, and the check-up showed that everything was flawless. Sofia Implant Centre is one of the most modern and top-quality dental clinics, adhering to the highest European standards with excellent equipment, impeccable cleanliness, and outstanding organised patient care. Everyone on staff—from the drivers and receptionists to the nurses, consultants, and doctors—is dedicated and highly specialised in their role. The system works seamlessly, inspiring trust, organisation, and professionalism. I greatly appreciate the doctors' honesty and ethics, which clearly outweigh short-term profit, as well as their detailed transparency. This was evident in the meeting following the panoramic X-ray to determine the treatment plan. My case was particularly challenging for All-on-4 in the upper jaw due to my very thin bone structure, which carried the risk that the implants might not integrate after the multiple extractions required. The decision was ultimately mine on whether to proceed. My consultant at the time, Lina—a Greek woman raised in Bulgaria—was always willing to explain, advise, and support me on a personal level throughout our communication, from start to finish. So, I decided to take the leap, go ahead with the extractions (which had to be done eventually anyway), and move forward with the implants. The surgery was a success, and everything went perfectly thanks to the surgeon and the nurse assistant. It was a long and thorough procedure that required delicate handling, expertise, and, of course, patience from all of us. My bone was thin but dense and strong. I mention this because while an X-ray may show available bone, it cannot always reveal its actual quality or density. The follow-up process was very satisfying, both for my temporary teeth and especially for the final set, where we used Digital Smile Design simulations. Dr Kliment Bekiarov carefully listened to and discussed all my preferences regarding the shape, size, and colour of my teeth. As a result, I now have a wonderful, natural-looking smile that feels completely my own. They are fully functional, and the total cost was significantly lower than it would have been in Greece. I wholeheartedly recommend Sofia Implant Centre to my friends in Greece and abroad whenever a similar need arises. Thank you to everyone at Sofia Implant Centre. May you all be well and blessed!
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    I was very pleasantly surprised by this dental clinic right from the start. From start to finish, I was treated professionally, yet very warmly and with great care. Special thanks to the doctors, who are outstanding professionals: Dr. Rafid, Dr. Ugur, Dr. Bekyarov, all the dental assistants, and my consultant, Simeon Atanasov, who was always there for me, took a lot of time, and explained everything very clearly whenever I called him with questions—from treatments to prices—and gave me a warm welcome every time I visited the clinic. At every step, I felt well-informed and in safe hands. The entire team is incredibly friendly, attentive, and kind. You can tell right away that they truly put their hearts into their work. The atmosphere at the clinic is very pleasant; it makes you feel comfortable and well taken care of. I will definitely recommend your clinic to as many friends and family members as possible. Thank you so much for the great service! Ivan Smilenov
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    I just want to say a huge thank you to Sofia Implant Centre for all their incredible support and hard work during my first-ever visit and my first-ever dental implant. I am completely blown away!!! I found this clinic after doing a lot of research, and I'm so glad I chose Sofia Implant Centre instead of going to Turkey. Everything is covered under EU regulations and quality standards, the doctors and surgeons are highly experienced, and the service this clinic provides is truly top class. I was seen by different specialists to ensure I receive the best possible treatment for my individual case. Every doctor was absolutely amazing—professional, calm, gentle, highly experienced, and incredibly reassuring. They were also fantastic at easing my pre-surgery worries, and it was a pleasure to be around them during my visits. I had my implant done and didn't even need a single painkiller afterwards. I also had no bruising at all—they really know what they're doing! They give advice based on what's genuinely best for you and focus on saving your natural tooth whenever possible, rather than recommending treatments that would simply make them more money. They don't just suggest removing a tooth—they will do everything they can to save it first. In this day and age, that level of honesty and patient care is very rare. The service is outstanding, and the doctors are truly professional. If you're travelling from abroad, they arrange your transportation and provide you with a well-organised treatment plan. You'll also have some time to explore Sofia during your stay. The reception team were lovely too—friendly, welcoming, and always helpful. I felt completely looked after from start to finish, big thanks to sales agent - Kris Aleksander. I would 100% recommend Sofia Implant Centre to anyone looking for exceptional and top class dental care and surgery. The entire process was handled seamlessly, and the care I received was truly outstanding. Thank you all so much for taking such great care of me once again!
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    Regarding my fears of flying and going to the dentist, it was a surprisingly pleasant stay. The treatments, and especially the implant placement, were carried out quickly and professionally, without significant pain or swelling. The doctors and the team there are very professional and friendly, even during longer procedures!
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    I am very satisfied with the treatment I have received at Sofia Implant Centre. From the friendly and professional behaviour at the registration desk to the guiding consultat, high professional processing of installing 4 dental implants by the doctors and nurses and all supporting personel. I would definitely be very glad to suggest your services to all friends of mine.
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    March 6, 2026
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    From early stages inquiry Kris talked me through the process booked my flights and Sofia implant centre did the rest got to choose my hotel which this you pay yourself but get a discount via the clinic. All the transfers to and from the clinic was taken care of. All the staff were professional and welcoming went over my plan after 3d cray everything was explained and the costs were broken down. All medication was provided pain, antibiotics and vitamin c all to help with the healing process. At the end of a week of treatment I was fitted with my temporary teeth after agreeing color and size for 6 months then back for my permanent. Thank you to all the team from the drivers to the surgeons and everyone else like receptionists and nurses. The centre is kept immaculately clean and got shown round the centre even the lab in house that make the teeth. Definitely recommended it.
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    The doctors and the whole team of Sofia Dental gave me an amazing experience during my stay there. They made me feel heard, respected and cared. The team is highly professional and flexible, they made my whole stay and treatment stressless and smooth. I liked the eye for detail that the staff has and the way they manage to tackle my treatment and fulfill my idea of healthy glamorous smile. I highly recommend the clinic. Everyone should give themselves a professional, stressful and satisfying dental treatment and I am sure Sofia Dental Centre is the right place for everyone.
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    Ivelina Succaria
    February 20, 2026
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    The whole team of Sofia Denta, dear all, thank you so much for the professionalism and the whole amazing experience you gave me. You change lives and I dare say you are the best European dent clinic.
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    February 19, 2026
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    I had an excellent experience with Implant Sofia. From the very first contact, the entire process was highly professional and well organized. I received a dental cleaning, X-rays, and finally the implant, and they truly exceeded my expectations. The procedure was completely painless, and my recovery has been very smooth; I haven’t even needed to take any painkillers. The medical team demonstrated great expertise, precision, and a very careful approach at every stage. I would especially like to thank Deyan, who stayed in contact with me throughout the entire process. He was always attentive, clear with the information, and very professional. His support made everything much easier and gave me great confidence. I highly recommend Implant Sofia to anyone considering dental treatment. Excellent care, high quality, and very satisfying results.
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    Alejandro Diaz Robledo
    February 19, 2026
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    I had an excellent experience with Implant Sofia. From the very first contact, the entire process was highly professional and well organized. I received a dental cleaning, X-rays, and finally the implant, and they truly exceeded my expectations. The procedure was completely painless, and my recovery has been very smooth; I haven’t even needed to take any painkillers. The medical team demonstrated great expertise, precision, and a very careful approach at every stage. I would especially like to thank Deyan, who stayed in contact with me throughout the entire process. He was always attentive, clear with the information, and very professional. His support made everything much easier and gave me great confidence. I highly recommend Implant Sofia to anyone considering dental treatment. Excellent care, high quality, and very satisfying results.
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    Arron Tatlow
    February 11, 2026
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    my journey at Sofia implant started in 2024 , I had a negligent dentist in the UK and ended up with severe gum disease . I contacted various dentists abroad Sofia implant center was the only one who was interested in saving as many of my own teeth as possible .I spoke to Kris who co ordinated everything from start to Finnish including booking hotels arranging for me to be picked up from the airport and he was always there if I needed anything .Dr Hussain extracted the bad teeth also he is a maxillofacial surgeon who repaired a scar on my lip for which I am eternally grateful for . I decided to have the guided implants ,Dr Patchev put them in for me , this wasn't pain free but was bearable and everything was explained to me .For the next part I was under Dr Jana who fitted the teeth onto the implants all on 5 top 4 implants on bottom and 6 crowns .All was finished in Dec 25 I am extremely happy with the outcome so a massive big thanks to everyone who treated me the front desk staff and the drivers bobby and angel .Since returning to the UK I have visited their Stockport branch for a little correction , to anyone who is considering implants ,Sophia implant center is second to none. An extra thank you to Kris who went above and beyond . Sofia implant center is a very professional state of the art center ,I would highly recommend them thank you again for my new smile 😁
    
    

    In the following posts we will give you some useful tips on:

    What quality to expect from Sofia Implant Centre. Materials used, services & work standards.

    Your Biggest Risk in Dental Implantation

    What is a dental implant?

    Are dental implants right for me?

    How to choose the best implants on the market?

    CBCT (3D) Scan – Why Is It Important?

    Extraction of teeth and placement of implants

    Implants and lack of jawbone

    What is All-on-4 and All-on-6 complete dental restoration?

    The three most important things for successful treatment by the ALL-ON-4/6 protocol?

    ZIRCONIUM and … zirconium.

    Why the modern dental laboratory is so important?

    Surgical guides for dental implants – why is it so important?

    Why getting an implant passport is a must?

    Classic or basal implants

    Bite registration for complete dental restorations.

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    DENTAL IMPLANTS: HOW TO AVOID MAKING A MISTAKE WHEN CHOOSING A CLINIC? 28 Mar, 2022
    Missing a tooth? Why You Shouldn’t Delay Dental Implant Placement 11 Apr, 2025
    Key Differences: All-on-4 vs Single Implant 18 Oct, 2024
    Tilted Implants – the Right ALL-ON-4 Protocol 18 Oct, 2024

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