1. This picture illustrates uneven gums, gappy margins of the upper bridge with underlying tooth decay, and three relatively healthy teeth on the right side. The lower left bridge is visibly caved down destabilizing the bite.
2. Treatment involved removal of all upper teeth (except one very back tooth which was not visible), leveling of the gumline with an alveolectomy and an immediate All-on-4 dental implants restoration incorporating aesthetic gum replacement. The lower right bridge was replaced to the correct height for an optimal plane of occlusion (bite).
3. The upper replacement teeth were removed 15 months after implant surgery to reveal complete healing and healthy gums.
4. The upper fixed replacement teeth were re-fitted over the dental implants for another 24 months before next review.
5. An X-ray taken at 15 months shows angulated fixtures in the back, and straight fixtures in the front, placed using a conventional All On 4 protocol.