All-on-6 Dental Implants
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Dr. Yuriy May – Leading All-on-6 Dental Implants Expert in the USA
Most full mouth reconstruction cases in the USA involve metal dental implants. At Natural Dentistry, Dr. Yuriy May is one of the very few specialists in the country offering full mouth reconstruction with zirconia dental implants, which are 100% metal-free.
Dr. May has trained with Dr. Volz of Switzerland and adopted the All-In-One technique that allows him to complete full mouth metal-free implant cases and full arch implants using no metal. This is a highly specialized skill that few oral surgeons or dentists possess.
Dr. May continued developing techniques until he was able to perform full-mouth zirconia implant treatment for patients who were intolerant to titanium implants and other alloys.
Understanding All-on-6 Dental Implants
Often, the term “Full Mouth Reconstruction” in the context of implants is referred to as “All-on-X,” with X being the number of dental implants placed into a single arch. All-on-X refers to the number of dental implants placed in the jaw after the removal of all teeth.
In most cases, all-on-X implant surgeries are some of the most complex dental surgeries, mostly performed with metal implants. It is likely that 99% of the cases undertaken by dentists and surgeons in the USA and internationally are performed with titanium (metal alloy) dental implants. For those patients who need full-mouth dental metal-free implants, there were few options in the USA until Dr. May started performing full-mouth zirconia implant cases after opening his practice, Natural Dentistry.
As of 2024, Dr. May has placed different combinations of full-mouth zirconia implants ranging from All-on-5 Implants to All-on-10 Implants – all cases being 100% metal-free and only using ceramic dental implants.
All-on-6 Dental Implants: Challenges & Benefits
The challenge of full mouth reconstruction, regardless of implant material risk, is always present in clinical terms, surgical complications, and of course, the financial burdens taken on by the patient. However, titanium dental implants used for All-on-4 Implant cases also carry the risk of hypersensitivity, allergic reactions, and peri-implantitis, known as “material risk” as an additional challenge.
Is Full Mouth Reconstruction Possible with All-on-6 Dental Implants?
Can All-on-6 dental implants, as well as All-on-4 and All-on-8, be done with metal-free zirconia implants? YES!
Can full mouth reconstruction with All-on-6 zirconia implants be performed on both arches? YES!
Can patients with autoimmune disorders, metal sensitivities, or chronic illnesses safely get All-on-6 dental implants? YES!
Once a patient has determined that full mouth reconstruction with All-on-X Dental Implants is a viable and necessary procedure, what choice does a patient have in terms of dental materials? What if the patient has autoimmune disorders? Or if the patient is sensitive to metals? What if the patient is highly reactive to chemicals and foreign materials? What if the patient has a history of Oncology, CIRS, Lyme, Hashimoto’s, Mold sensitivity, or PEFM sensitivity?
Why Choose Dr. Yuriy May for Your All-on-6 Dental Implants?
In choosing a dentist for such a large undertaking, what dentist have you met that will give you DENTAL MATERIAL CHOICE? Virtually none. But now you’ve found Dr. Yuriy May in the USA – who has done full mouth double and single arch All-on-6 on titanium and All-on-4, All-on-6, All-on-8 Dental Implants in zirconia dental implants, which are 100% metal-free. In the last few years, he has become an internationally renowned expert in offering this same solution with metal-free zirconia implants. That means, at Natural Dentistry Center, located right outside of New York City and close to Boston, we perform 100% of our full mouth reconstruction All-on-X surgeries METAL-FREE with zirconia implants.
All-on-6 Dental Implants: Titanium vs. Zirconia – Which Is Best?
Patients all over the globe don’t have many choices when it comes to full-mouth implants, unlike single-tooth implants, which allow a broader range of zirconia dental implants to be chosen over titanium alloy implants. Over 3 new fully ceramic dental implant brands were introduced by the FDA in the USA between 2018 and 2020. With this being said, Dr. May can now place SDS, Zeramax, Z-Systems, Ceraroot, Zibone, Straumann Pure, and Nobel Pearl Zirconia metal-free implants. The increase in popularity of biocompatible dental implants across the USA and Europe, allows experts like Dr. May to take on more challenging cases and provides more options and accessibility for ceramic implant patients.
Finding the Right Dentist for All-on-6 Zirconia Dental Implants
Dr. May is one of the few dentists in the United States offering Full Arch Zirconia Implant Restorations, ranging from 4 to 12 zirconia implants on a single arch. Technically, one would call that “Ceramic All-on-4 Implants” and can substitute any number of zirconia implants up to “Zirconia All-on-10 Metal-Free Full-Arch Implants.” The entire surgery, including every single implant component, and the final prosthetic is 100% METAL FREE! Dr. Yuriy May is one of the only USA-based biological dentists who performs the All-In-One Biological Surgery Concept.
What Is the All-In-One Biological Surgery Concept?
The All-in-One Biological Surgery Concept means that the entire surgery (extractions, sinus lifts, PRF grafting, ozone, valvuloplasty, zirconia implant placement, and a full temporary prosthetic) is done in a single day. Temporary restorative work is done in a single surgery which takes between 4-6 hours. Many patients fly to Natural Dentistry Center for this life-changing surgery and full-mouth ceramic rehabilitation. Dr. May is considered the best for his protocols, surgical experience, and aesthetic results. The cases performed in our USA office range from highly predictable to extraordinarily challenging, often involving all teeth being removed and replaced with zirconia dental implants. In some cases, based on patient desire and clinical specifics, mixed dentition (saving some of the natural teeth) is used,
What Is the All-on-6 All-In-One Dental Concept?
The All-In-One Dental Concept involves performing only ONE single surgery for a patient to complete all extractions, infection removal, tissue and bone grafting, jaw bone contouring, and immediate implant placement with temporary teeth. Almost ALL of Natural Dentistry’s patients choose this approach to biological dental surgery for several reasons. These reasons include minimizing risks and complications, reducing time to restoration, and achieving more predictable results. Many of our traveling patients from California, Texas, Michigan, Florida, North Carolina, Arizona, and other states appreciate and seek out Dr. May for the Zirconia Dental Implants Surgery All-In-One Dental Approach as it is naturally optimized for the logistics of traveling from out of state. While not always the case, many times the All-In-One Ceramic Implant Surgeries avoid sinus lifts, as these procedures typically add risk levels and a higher degree of post-surgical complications. Dr. May has exclusively developed ceramic implant surgical techniques and immediate zirconia implant placement techniques to avoid sinus lifts.
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All-on-6 Zirconia Implants: USA vs. Switzerland – Where to Go?
The choices for seeing the top experts in the industry are either Dr. Yuriy May in Connecticut, USA or Dr. Ulrich Volz at SDS Dental Clinic in Switzerland. The main differences, apart from choosing the USA vs. Switzerland, are that, unlike the SDS clinic, all of Natural Dentistry’s surgeries and restorations are performed by Dr. May himself. At the Switzerland clinic, they have a team of restorative dentists, surgeons, and lab technicians who will be working on the patient during their stay. While we can coordinate with Dr. Volz and the SDS clinic on cases since all of our cases are done in a single day, we often only coordinate with them to complete unfinished cases for zirconia implant restorations. This is for patients who didn’t have crowns/full prosthetics completed at SDS. On occasion, we remake crowns and prosthetics for purely aesthetic reasons if the patient desires a more USA-oriented smile design.
Since both Natural Dentistry Center and SDS follow the “all in one” protocol, which condenses the surgeries into one single surgery or procedure, there are not many patients with unfinished surgical work (as opposed to restorative work) that either need additional surgery at our USA office or the SDS Switzerland office. We very much respect SDS Switzerland’s clinical work and recommend it as the only other safe and predictable option besides Natural Dentistry Center in the USA for your full mouth metal-free reconstruction with zirconia dental implants.
If you are a traveling patient, we see patients from all over the USA and abroad. You can find travel information for your trip here.
Call/text the patient concierge to learn more (860)554-1130 (Responses available only AFTER the new patient form request is filled out, click here).
Titanium vs. Zirconia: Key Differences in All-on-6 Implants
Titanium All-on-6: Surgery, Placement & Benefits
Titanium implants have been used by surgeons and skilled dentists for full mouth reconstruction and implant-supported prosthetics for decades. Over 50 implant manufacturers make them and they come in various shapes, sizes, and connections. They have “custom abutments” that allow titanium implants to be more forgiving in the hands of a surgeon or skilled full-mouth reconstruction dentist.
Titanium dental implants are 99.9% placed as 2-piece implants, meaning a small and tolerable mistake in location and angle of Titanium Implant placement can easily be corrected with a custom titanium abutment. This will compensate for a missed angle or slightly skewed placement. Additionally, surgeons and implant dentists are primarily trained to place titanium implants, making it the most mainstream and accessible solution for full mouth reconstruction and all-on-X implants for most individuals requiring this treatment.
Advantages of titanium implants include:
- Mass production by over 50 manufacturers with unlimited variations in their technical lineups and product selection.
- The ability to have custom abutments made to simplify case restoration or correct less-than-perfect implant placement.
- Use as angled implants (not parallel in the mouth) since custom abutments can be angled in the reverse direction to achieve the appropriate angulation for attaching a prosthetic.
Zirconia All-on-6: Surgery, Placement & Restorative Challenges
Zirconia implants are placed by only the highest-skilled dental implant experts and a few oral surgeons trained specifically for this purpose. While zirconia implants have been FDA-approved in the USA since 2007 and have over 20 years of research, there are still limited manufacturers and brands distributing these implants.
Dr. Yuriy May at Natural Dentistry Center utilizes all FDA-available brands in the USA, which is uncommon among ceramic implant-knowledgeable dentists. The zirconia implant brands available in the USA and used at Natural Dentistry include SDS, Z-Systems, Ceraroot, Zeramax, Straumann Pure, Nobel Pearl, TAV Dental, and Zibone.
It’s important to understand that while zirconia dental implants are very strong, they have less flexural give than metal alloy implants. This limits ceramic implants to being manufactured with very little angulation, and 95% of zirconia dental implants are made completely straight.
This means zirconia implants in a full arch must be placed perfectly “parallel,” otherwise the restorative aspects will be extremely difficult and increase the likelihood of failure and zirconia bridge breakage (in addition to long-term implant failure). This is why titanium implant oral surgeons, periodontists, and dentists who may find a way to do an “easy” All-On-4 Dental Implant case with titanium CANNOT do the same with ceramic implants.
A full arch with zirconia dental implants requires extensive skill in placing ceramic dental implants daily AND experience with All-on-4/All-on-6 cases from both surgical and restorative perspectives. Combining these factors, Natural Dentistry Center has become the USA’s authoritative expert, leader, and biological surgery center.
Full Mouth Reconstruction with Zirconia Implants: 5 Case Studies of Metal-Free Implant Success
Case 1: All-on-6 Metal-Free Upper Arch with Zirconia Dental Implants
This is a classic, beautiful All-on-6 Ceramic Dental Implant Upper Arch case completed with Z-Systems one-piece zirconia dental implants. All dental implants placed were one-piece ceramic dental implants after the patient chose to remove all infected root canals and non-restorable teeth affected by years of periodontal disease and bone loss.
Case Dynamics: With missing teeth in the posterior regions for years, the sinuses had dropped, requiring sinus lifts in the back maxillary molar regions if the patient wanted 8-10 zirconia implants placed. However, most Natural Dentistry patients choose to minimize risks and complications, reduce time to restoration, and opt for the All-In-One-Dental Approach due to the logistics of traveling from out of state.
The All-In-One-Dental Concept involves one surgery for all extractions, tissue and bone grafting, jaw bone re-contouring, and immediate implant placement with immediate temporary teeth. Following both the recommendation and the patient’s choice, the decision was made in this full mouth All-on-6 zirconia implant case to avoid sinus lifts and expedite healing time. This required PERFECT parallel placement and exact positioning to avoid the sinuses and achieve the perfect AP spread. As you can see, the results are flawless, and there were no complications.
Upper All-on-6 Ceramic Implant Case Conclusion: The patient’s surgery to final restoration was completed in 6 months. This patient flew in from North Carolina for surgery and is happily four years post-op with no complications and living life to the fullest. The patient works as a holistic oncology patient advisor, helping patients find alternative medical treatments to conventional oncology treatments. They have done significant research about root canal alternatives, root canal infections, periodontal disease, autoimmune implications, and the connection between oral and overall health.
Case 2: Full Mouth Reconstruction with All-on-6 Zirconia Implants – Double Arch, Single Surgery
This case involves a full mouth double jaw reconstruction with 100% metal-free zirconia implants, completed entirely by Dr. May. It was a full mouth, double arch All-In-One-Surgery Concept performed in the USA using SDS Dental Implants at Natural Dentistry.
Case Details: The single surgery lasted just under 5 hours, with an additional hour of restorative time for temporary teeth on all upper and lower ceramic implants. Dr. Yuriy May planned, placed, and immediately loaded the implants. During the morning surgery, 17 extractions were completed, PRF 100% natural bone grafting was done, and 15 SDS zirconia implants were immediately placed and temporarily restored with esthetic temporary teeth. All-On-7 Ceramic Dental Implants were placed on the upper arch without the need for any sinus lifts. A total of 8 SDS zirconia implants were placed on the lower arch in parallel placement style, of which 7 were 1-piece ceramic implants, and 1 molar implant was a 2-piece ceramic implant.
The patient had numerous consultations before choosing Natural Dentistry for her surgery. She specifically wanted to avoid titanium metal implants and have as few surgeries as possible. The goal was to extract all infected root canals and non-restorable teeth affected by years of decay and neglect.
Case Dynamics: The patient had missing teeth in one of the lower posterior regions for years and bilaterally on the upper teeth. The sinuses had dropped during this time, requiring sinus lifts in the back maxillary molar regions. Like most Natural Dentistry patients, this patient opted for the All-In-One-Dental Approach to minimize risks and complications and reduce time to restoration. No sinus lifts were required, and the patient was walking and talking during the surgery as only mild conscious sedation was used. The patient had minimal swelling and was talking beautifully and smiling normally within 6 days of surgery.
Case Conclusion: The patient’s surgery to final restoration is expected to be delivered within 6 months of the surgery. The patient is “local,” located only 3 hours away, and drove in from the Boston area for surgery. She is extremely happy with her immediate post-op results, experiencing no complications and living life to the fullest while still in her temporaries. The patient is expected to be fully restored with beautiful metal-free full-arch implant-supported bridges for both upper and lower teeth in 2021.
Case 3: All-on-8 Zirconia Implants Upper & 3 Zirconia Implants Lower
Case Details: This All-on-8 Zirconia Implant Upper Arch case involved surgery to remove all decayed and hypermobile teeth that were periodontally involved. The surgery took an “All in One” approach, removing all infections, metals, and non-viable teeth and placing implants immediately where possible. Under light sedation, the surgery lasted just under 5 hours. Some upper arch zirconia implants were immediately placed after extractions, while others were placed into PRF-grafted areas that had been missing teeth for several years.
Within the morning surgery, 9 extractions were completed, autologous PRF bone grafting was done, and 10 SDS zirconia implants were immediately placed along with 1 lower Ceraroot ceramic implant. On the upper jaw, 8 SDS zirconia implants were placed in parallel placement style, of which 6 were 1-piece zirconia implants, and 2 were 2-piece implants. On the lower arch, 1 Ceraroot implant and 2 SDS implants were placed.
Case Dynamics: The patient had missing posterior teeth and hypermobility around anterior teeth with periodontal involvement. Like most Natural Dentistry patients, this patient opted for the All-In-One-Dental Approach. The patient was responsive during surgery and experienced minimal swelling, talking beautifully and smiling normally within 4 days of surgery.
Case Conclusion: The patient’s surgery for final restoration was delivered 5 months after the initial zirconia implant surgery. The traveling patient drove 8 hours for surgery and was elated with her immediate post-op results, experiencing no complications. The patient has been fully restored since 2021.
Case 4: All-on-6 Zirconia Implants – Full Mouth Lower Arch Reconstruction
Summary: This All-On-6 Zirconia Implant Full Arch patient flew in from out-of-state for a lower arch full mouth reconstruction with ceramic metal-free implants. The case was completed using six one-piece SDS Zirconia Implants with an immediately loaded prosthetic. Our traveling patient initially had one remaining lower broken tooth and several infected root tips underneath a failing removable partial. The patient specifically wanted a metal-free lower zirconia implant-supported prosthetic that would not move around when eating and speaking, as she was tired of the failing, painful, unstable prosthetic that had been repaired continuously over the last 7 years.
Case Details: The patient had 5 remaining non-restorable teeth: one hypermobile tooth used as an anchor for the failing removable prosthetic and four decayed root tips. The patient had little posterior bone and also wore an upper denture that she was comfortable with. The surgery was completed in under 3 hours, including 5 extractions, debridement, periodontal ligament removal, ozone treatment, PRF grafting, and immediate ceramic implant placement as far back as the patient had bone.
At the end of the surgery, six SDS one-piece zirconia dental implants were placed, and an immediate prosthetic was loaded onto the newly placed implants to serve as a splint and provide esthetic function. The immediate prosthetic was barely visible due to the patient’s normal overbite. The patient recovered well and returned for a 1-month post-op check, where the tissue was healing quickly and implants were integrating. The patient had no issues with speech and maintained a soft/pureed diet. At the 4-month mark, the patient returned for zirconia implant preparation and full-color 3D intraoral scans to begin the final prosthetic design.
Case Conclusion: The patient had a final prosthetic inserted and bonded at the 5-month mark after surgery. The prosthetic was shorter than the upper denture due to the lack of bone in the posterior ridges, but the patient had much-improved masticatory (chewing) function and speech pattern compared to before the start of the case. The patient experienced significantly improved esthetics and was extremely happy with the comfort and appearance of the life-like lower teeth and entirely metal-free permanent ceramic implant-supported treatment. The lower prosthetic material was entirely milled zirconia with minimal porcelain overlay at the incisal edges of the teeth for light translucency to maximize esthetics. In the future, the patient plans to return to Natural Dentistry to have the upper arch reconstructed with zirconia dental implants by Dr. May.
Case 5: Full Mouth Reconstruction with 10 Zirconia Implants – Mixed Dentition Approach
Summary: This case discusses a full mouth reconstruction where 10 Zirconia dental implants were placed, and the patient strongly desired to save any remaining teeth with an acceptable prognosis. Based on discussions with the patient and Dr. May’s assessment, the case was treatment planned as a full mouth metal-free reconstruction with mixed dentition (retaining natural teeth & replacing non-restorable/infected root canals with ceramic zirconia metal-free dental implants). This case involved placing 10 zirconia implants, including seven Z-Systems one-piece ceramic implants and three Zeramax 2-piece zirconia dental implants.
This case is unique in that it’s a full mouth reconstruction that retained several natural teeth with an acceptable near-term prognosis, which is highly unusual. Keeping a few natural teeth in an overall compromised oral environment tends to reduce the long-term predictability of the case and successful outcomes. However, when patient objectives are made clear Dr. May’s assessment of the overall prognosis is explicitly communicated and risk is accepted by the patient, a mixed dentition case is possible for full mouth reconstruction.
Case Dynamics: Surgical treatment was performed in a single 4-hour surgery and included 12 extractions. Ten implants were immediately placed with an immediate load temporary for the ceramic upper implants splinted (attached) to the natural remaining teeth. Three Zeramax 2-piece ceramic implants were placed in the left molar regions, and the rest were placed into areas of extractions, avoiding close contact with the natural remaining teeth. The patient also had several cavitation sites next to root canals that were debrided in the same surgery, allowing the patient to experience a rebound in health, as described in a video testimonial by the patient using her own words.
Because the case was not a full arch All-on-6 or 8 case and instead involved individual ceramic implants placed between natural teeth, most of the restorations were individual implant-supported biocompatible crowns in combination with biocompatible crowns on natural teeth. The patient’s esthetic goal was to look age-appropriate in harmony with her existing style and appearance. In line with the patient’s objective, the crowns and bridges were designed to look as natural as possible while reflecting shades and contours that complement the patient’s face and smile esthetically.
Conclusion: The patient is enjoying hiking, walking on the beach, working, and resuming a normal life with regained health. She is confident and happy with her smile and travels for regular cleanings and check-ups with Dr. May.
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About Dr. Yuriy May
Widely sought after for his precision and leadership in biological oral surgery and zirconia implantology, Dr. Yuriy May is recognized as an accomplished leader in metal-free, biologically driven dentistry. With over 12 years of clinical experience, his work is defined by uncompromising standards, refined surgical execution, and outcomes that support both oral and systemic health.
Dr. May holds advanced certifications and training in zirconia implantology from programs ranging from IAOCI and Tufts University, is Board Certified as a Naturopathic Dentist by the ANMCB, and is a distinguished Ceramic Implant Ambassador for SDS—an honor reserved for clinicians shaping the future of ceramic implant science.
A respected educator and international lecturer, Dr. May has presented extraordinary ceramic implant cases to dentists worldwide, including the JCCI in Switzerland, and has served as an instructor in the Ceramic Implant Program at ACIMD. He lectures nationally, publishes complex metal-free surgical cases, and serves as a Board Member of the IAOCI (International Academy of Oral Ceramic Implantology). Dr. May has recently become an Associate Fellow of the AAID (American Academy of Implant Dentistry), one of the few focusing solely on zirconia dental implants, and has been and an Accredited S.M.A.R.T. Certified member of the IAOMT for many years. He is also a Certified Biological Dentist with the IABDM, reflecting his commitment to removing root canal infections and to mercury-safe, evidence-based biological protocols.
Dr. May’s reputation, results, and excellence in ceramic implant dentistry have made him a destination provider for patients and referring clinicians seeking the highest level of ceramic implant surgery and biological dental care.
DMD, IBDM, AIAOMT, CIABDM
Associate Fellow, American Academy of Implant Dentistry
ANMCB Board Certified Naturopathic Dentist