This case presents full mouth teeth replacement with All-on-4 concept treatment.
Patient information
Healthy Australian female patient, 59 years old, came to BFCdental (Bangkok, Thailand) for making new full mouth teeth replacement.
She choose all remaining teeth extraction and All-on-4 concept treatment for her treatment option because of her affordable budget, and she need to complete full mouth treatment within 1 trip, 14 days.
Introduction
This case presents full mouth teeth replacement with All-on-4 concept treatment. We use 4 dental implants and 5 dental implants to support lower & upper fixed hybrid denture. 4 tilted distal implants in all of quadrants had been placed for avoiding anatomical structures. We had used 3D-surgical guide with NEO-NAVIGUIDE kit drilling in upper jaw which is compromised bone width in most of area. After upper implants placement, we use buccal graft with sticky bone & CGF (concentrated growth factor) for guided bone regeneration.
Preoperative Photographs
1st appointment : All remaining teeth extraction & 4 Lower implants placement
2 diameter sizes in 1 Parallel pin
17º Tilted distal implant Q4
2 diameter sizes in 1 Parallel pin
2 diameter sizes in 1 Parallel pin
Multiunit Angled Abutment : Different point of engagement = Different prosthesiss screw hole axis
Closed tray impression technic with Transfer impression coping
GBR with Sticky bone + CGF
After operatio
After 1 day
2nd appointment : Upper implants placement
In Skeletal Class 2 patient, one of concern is…
“Upper front screw access holes on Screw-retained implant restoration”.
Surgical guide + NEO NAVIGUIDE Kit drilling
Surgical guide for upper jaw
Surgical guide for upper jaw
Main concern: Surgical Guide stability during drilling
After 5 dental implants placement with NEO NAVI GUIDE (Surgical guide usage for Proper position of implant placement)
Compromised bone width can be augmented with bone graft materials after placement
3 front dental implants:Multi unit straight abutment
2 distal dental implants:Multi units angled abutment
GBR & Socket grafting with Sticky bone (AFG + particulate bone) & CGF
Open tray impression technic with pick-up impression coping
3rd appointment : Try-in framework & bite registration
Upper jaw: After operation 1 day
Lower jaw: After operation 2 days
After operation 1 day
After operation 2 days
Try-in U&L metal framework
Fit checking of U&L metal framework by Panoramic X-ray + Bite registration
4th appointment : Upper & Lower Teeth Try-in
RE-BITE for mid-line correction
5th appointment : Upper & Lower Teeth insertion
Upper: After 10 days
Lower: After 11 days
Smile line observation
Observe Soft tissue profile & Maxillomandibular angle
6th appointment : Recheck (after insertion 1 day)
After treatment
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