The path to innovation rarely begins in ideal circumstances. After graduating from NYU’s College of Dentistry in 2011, Dr. Randy Roberts moved to Utah to start a practice with his brother, John. The two youngest of eight children, they prioritized staying close to family, even if it meant starting a dental business in one of the country’s most competitive regions for dentistry.
They purchased a bank-owned dental office in Taylorsville and launched what would eventually become Utah Smile Clinic. Like most general dentists, Dr. Roberts offered the usual array of services: fillings, crowns, veneers, and orthodontic aligners. But it wasn’t long before his curiosity pushed him to explore the world of implants. After a series of advanced implant courses and hundreds of successful surgeries, he discovered a passion — and a particular aptitude — for dental implant restoration. In short order, he became one of Utah’s top dental implant providers.
In 2013, Dr. Roberts faced a crossroads that would redefine his career and influence the future of full-mouth rehabilitation. His cousin, worn down by years of dental neglect and substance abuse, turned to him with a mouth full of failing teeth and a treatment plan he couldn’t afford. The only widely accepted solution was an All-on-4, but Dr. Roberts knew the procedure came with compromises: aggressive bone reduction, removable dentures that trapped food, and an unnatural-feeling prosthetic. Furthermore, the splinted design minimized physiological bone stimulation, potentially accelerating resorption over time.
All-on-4 changed the game when it was introduced, offering edentulous patients a fixed solution supported by just four implants. But like most things, it came with trade-offs. When faced with restoring the teeth of a close family member, Dr. Roberts didn’t like the idea of removing his healthy bone. He wondered, “If I can replace three or four teeth with a natural-looking bridge without bone removal or artificial gums, why can’t I restore an entire arch of teeth using the same methods?”
His cousin’s case was the catalyst, and he began developing a protocol that would solve some of the common pain points of All-on-4 while staying in a similar price range. Drawing on his extensive implant experience and a deep understanding of restorative biomechanics, Dr. Roberts envisioned a new kind of permanent smile solution. Instead of relying on a monolithic prosthesis, he imagined three individual zirconia bridges, each supported by two implants, preserving native bone, improving hygiene and phonetics, and creating a more natural-feeling result.
Over the course of several months, he began engineering what would become a defining advancement in FP1 restoration — the 3 on 6™. On January 28, 2014 — his birthday — he performed the first 3 on 6™ procedure. The outcome was transformative, and not just for his cousin. What started as an act of family service quickly evolved into a paradigm shift in implant dentistry.
The concept behind the 3 on 6™ is elegantly simple and biomechanically sound: six dental implants are placed to support one solid arch of teeth, providing cross-arch stabilization. After allowing time for osseointegration, the single arch is replaced with three segmented zirconia bridges — one on the anterior and one on each posterior quadrant. No bone removal necessary. No artificial gum material. No bulky prosthetics. Just permanent, implant-supported teeth that feel and function more like the real thing.
This segmentation turned out to be a game-changer. Unlike a monolithic denture-like restoration, segmented bridges allowed for healthier force distribution, improved hygiene, and superior phonetics. Patients retained their natural bone architecture, which allowed for better esthetics and long-term oral health. Because the bridges sat directly over the ridge rather than floating over pink acrylic, food impaction was minimized — and when it did occur, cleaning was far more manageable. There were also nearly no cases of prosthetic fractures with the final segmented zirconia bridges, and in cases where there were needs for replacement, it was much cheaper and easier to replace a 4-unit bridge than an entire full-arch fixed prosthetic.
Most importantly, patients loved the feel. The 3 on 6™ doesn’t rely on the palate for stability, doesn’t need to be removed for cleaning, and doesn’t simulate tissue — it replaces only the teeth. For patients who had struggled with dentures or the “false” feeling of All-on-4, this was a restoration that felt like they had their real teeth back.
Unlike All-on-4 hybrids, which often require complex removal and maintenance protocols, the 3 on 6 system shouldn’t need to be removed. In fact, the ultra-polished tissue surface of the bridges can actually adhere to the gums making it significantly more difficult for food and bacteria to get under the bridges or around the implants. This reduces long-term prosthetic complications that may otherwise result in surgical re-intervention.
As the number of successful 3 on 6™ cases grew, so did demand for this revolutionary approach to full-arch restoration. Dr. Roberts began seeing patients from across the country and even internationally. The demand from patients and popularity of the treatment approach led to inquiries from colleagues who wanted to learn how they could offer 3 on 6™ in their own practices. In response, Smile Systems was founded in 2019 to serve as the official training, support, and innovation platform for the 3 on 6™ procedure.
The success of the 3 on 6™ procedure is due in large part to its adaptability to modern digital workflows. Technologies such as CBCT imaging, intraoral scanning, 3D facial scanning, 3D printing, and photogrammetry allow for extreme precision in surgical planning and prosthetic fabrication. The use of zirconia — a durable and esthetically superior material — ensures long-term stability without sacrificing appearance.
Smile Systems continues to push boundaries by integrating emerging tools and techniques into the 3 on 6™ process. Same-day design and delivery of screw-retained temporaries is now common practice, allowing patients to leave surgery with a beautiful, fixed smile. The result is a process that feels like the future of restorative dentistry — minimally invasive, highly esthetic, and customized to each patient’s anatomy.
For decades, FP1 restorations — those replacing only the crowns of the teeth, without artificial gums — have been considered ideal but often impractical for full-arch cases. They required precise implant placement, excellent patient anatomy, and meticulous restorative planning. Many dentists would use the term “unicorns” when describing how rare they felt it was for a patient to qualify for FP1 treatment. Over 10 years of 3 on 6™ treatment has proven that is not the case. Today, Dr Roberts believes the vast majority of patients in need of full arch teeth restoration qualify for FP1 or FP2 treatment. Many patients have even converted from All-on-4 prosthetics that they hated to more natural feeling 3 on 6™ bridges that they love.
If there is one thing the 3 on 6 has accomplished, it has shown that there isn’t a one-size- fits-all solution to full arch restoration. The 3 on 6™ makes FP1 predictable and accessible for a wide range of patients. It provides dentists with a repeatable, trainable process that can be integrated into their practice with the right training and tools. It doesn’t just offer an alternative to All-on-4 — it redefines what full-mouth implant dentistry can look like when guided by sound prosthodontic principles and modern digital dentistry.
While the 3 on 6 was providing incredible results, Dr. Roberts faced an uphill battle to find an implant system designed for FP1 treatment. Most implant manufacturers cater to the needs of dentists providing single implants or the All-on-4 treatment, neglecting the unique treatment protocols and needs of dentists performing FP1 restorations. Dr. Roberts felt that he had two unresolved pain points with his 3 on 6™ treatment protocol: weak abutments and prosthetic screws coming loose.
A full-arch splinted prosthetic reduces the forces on implants and abutments. But with segmented bridges, they receive significantly higher forces. While the increase in forces was an important part of 3 on 6™ treatment in increasing bone stimulation modeling, it also meant increased stresses on weaker abutments and screws. After trying dozens of implant designs from a multitude of manufacturers, he thought his only option might be to create his own implants. That was when he discovered the implant he had been looking for, TRI®.
The TRI implant was revolutionary in that it doesn’t require an abutment. The direct-to-connection design meant one less weak point to worry about. In addition, the prosthetic screws of TRI are nearly 10x larger than traditional screws, designed to withstand the full forces of oral function and reducing the likelihood of the screw loosening over time. Most prosthetic screws recommended torque value is 15-20ncm. TRI’s, however, is about double at 35ncm.
Dr. Roberts began testing the implants with 3 on 6 treatment and fell in love with the results. Unlike traditional implant systems that rely on intermediary abutments, TRI implants allow for direct-to-implant screw-retained restorations — eliminating the need for an abutment altogether. For FP1 treatments, where prosthetics sit directly on the ridge, and precision is key, this simplification reduces potential points of failure while improving esthetics and stability. By removing the abutment layer, there’s less micromovement, fewer opportunities for bacterial infiltration, and a more passive fit between the implant and the final zirconia bridge. These benefits are extremely valuable in full-arch cases, where long-term peri-implantitis can compromise the entire restoration.
Another standout feature Dr. Roberts gravitated to was TRI’s proprietary connection system, which utilizes a robust screw and deep conical interface. The design is significantly more resistant to mechanical fatigue, making it ideal for full-arch load scenarios. In high-function cases like the 3 on 6™, where patients expect their teeth to perform like natural ones, the strength of this connection helps avoid loosening or screw fracture over time. The result is a restorative system that’s not only strong and hygienic, but also beautifully compatible with modern FP1 philosophy — prioritizing tissue preservation, esthetics, and patient comfort.
Today, the 3 on 6 is being performed in clinics across the U.S. and Canada by trained and licensed providers. Thousands of patients each year are receiving permanent smile restorations that are more affordable, more hygienic, and more natural-feeling than traditional options. Patients love that their teeth never have to be removed. They love that there is no transition line beneath their gums, and they love how it feels inside their mouth. In a street survey where patients were shown side-by-side retracted photos of All-on-4 and 3 on 6 smiles, 98% of respondents said they felt the 3 on 6 looked better and more natural.
Dr. Roberts and his team at Smile Systems continue to accelerate the adoption of FP1 treatment protocols by implant dentists across the country. Through their rigorous training program, they are expanding access to treatment while preserving the values that inspired the original innovation: compassion, practicality, and a commitment to long-term oral health.
For dentists, the 3 on 6 represents more than just a new treatment option — it’s a chance to offer something better. Imagine being one of the first dentists to offer All-on-4 to the market 25 years ago. 3 on 6 clinicians are at the tip of the spear when it comes to smile rehabilitation. The future of dentistry is more hygienic, more esthetic, and more natural feeling.
If you are interested in becoming a 3 on 6 Provider, you can visit SmileSystems.com for more information or to register for an upcoming course.
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