Patient: presented with lower edentulous and upper missing posterior teeth

Patient expectation: Does not want to wear denture

DIAGNOSIS: UPPER MAXILLARY BONE DEFICIENCY IN posterior maxilla

poor lip support , facial profile and masticatory function

lips in repose

Full smile

TREATMENT PLAN: Installation of All on 4 implants (Neobiotech IS II Active) on maxilla

Tooth supported Surgical guide (Varioguide) to facilitate insertion of 15, 25 to avoid sinus cavity

Subsequent extraction of #13, #12,#11,#12 for installation of fixtures on #12, #22,

Bone reduction to make space for fabrication of zirconia screw retained bridges.

Fitting of 4 x angled 30degrees multi unit abutments for screw retained restorations

Zirconia bridges fabricated with Neobiotech Cameleon CS chairside 5 axis milling machine

Patients regains confident smile

Full Smile line. improved facial profile.