This young lady came to our clinic shortly before her sister's wedding and was hoping to have treatment so she can smile again. Her teeth were compromised to the point that they were irreparable for the long term but there was enough bone in the lower jaw for immediate dental implants. In the upper jaw, the situation was quite different. The numerous infections from her teeth destroyed the jawbone and limited her options. She needed reconstruction of her jawbone with bone grafting and other reconstructive procedures but this meant a delay in the timing of when dental implants could be placed. As an alternative to giving her the needed improvement for the short term for her sister's wedding when we performed the lower All On 4 surgery, we also removed most of the upper teeth leaving only four that were less severely compromised and used some of the bone from the lower jaw to reconstruct the upper jaw. The teeth that we kept we then used to support a fixed bridge which served for 2 years until she decided to proceed with dental implants in the upper jaw. By that time the grafts have fully consolidated and it was possible to place the implants and fit the fixed replacement teeth within 3 days from her surgery.
1. The remaining teeth were heavily filled with tooth-coloured composite filling material. They had recurrent decay and many had associated infections in the jawbone.
2. The lower teeth were removed and replaced with immediate All on 4 dental implants. In the upper, all but the 4 most stable teeth were removed the bony defects left by the infection (not visible here) were reconstructed at the same time as the lower surgery and the four teeth that were kept were used as stumps to support a fixed bridge temporarily.
3. A temporary bridge was fitted to the four teeth that were retained. This was done as an immediate bridge","with all the preparation taking place in advance of the removal of the other teeth.
4. The aesthetic improvement at this stage was adequate for the patient to regain some confidence to smile at her sisters wedding.
5. The x-ray shows the lower All On 4 dental implants and the upper bridge supported by the 4 temporarily retained natural teeth.
6. This picture was taken before any treatment.
7. This was the end result after the grafts have consolidated which allowed us to treat the upper with immediate dental implants similar to the way the lower was treated in the prior stage.
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