Patient Background
A 52-year-old patient came to ORC with severe difficulty chewing and speaking due to multiple missing and loose teeth. The patient had been suffering from advanced periodontal disease for over 10 years, which led to significant bone loss in both jaws.
Initial Assessment
- Condition: Advanced periodontitis with multiple mobile teeth
- Bone Loss: Severe in lower jaw, moderate in upper jaw
- Remaining Teeth: 8 teeth, all with poor prognosis
- Patient Concerns: Unable to eat properly, embarrassed to smile
Treatment Planning
After comprehensive evaluation including 3D CBCT scanning, we determined that the patient was an ideal candidate for the All-on-4 implant technique for the lower jaw and a hybrid implant-supported prosthesis for the upper jaw.
Why All-on-4?
- Minimal bone grafting required — posterior implants placed at 45° angle
- Immediate loading — temporary teeth placed same day as surgery
- Cost-effective — fewer implants needed compared to individual tooth replacement
- Proven success — over 98% success rate at our clinic
Treatment Process
Phase 1: Extraction & Implant Placement (Day 1)
- Extracted remaining hopeless teeth under local anesthesia with IV sedation
- Placed 4 implants in the lower jaw using All-on-4 protocol
- Placed 4 implants in the upper jaw with strategic angulation
- Surgery time: 3.5 hours for both jaws
Phase 2: Immediate Provisional (Day 1)
- Attached screw-retained acrylic provisional prosthesis within 4 hours of surgery
- Patient walked out with a full set of fixed teeth the same day
Phase 3: Osseointegration (Months 1-4)
- Regular follow-ups at 2 weeks, 1 month, 2 months, and 4 months
- Soft diet protocol for initial healing
- Gradual transition to normal diet by month 3
Phase 4: Final Prosthesis (Month 6)
- Fabricated zirconia hybrid prosthesis using CAD/CAM technology
- Delivered final fixed bridges with optimal aesthetics and function
Outcome
The patient reported a complete transformation in quality of life:
- ✅ Chewing efficiency restored to near-natural levels
- ✅ Confident smile — no more embarrassment
- ✅ Clear speech — no loose dentures
- ✅ Facial support — improved facial appearance
“I wish I had done this years ago. I can eat anything, smile without worry, and I look 10 years younger.” — Patient testimonial
Key Takeaways
- Full mouth rehabilitation is possible in a single day with All-on-4
- Even patients with severe bone loss can be treated without grafting
- Digital planning ensures precision and predictability
- Regular maintenance visits are essential for long-term success
