All on four

Patient visited the Nungambakkam clinic with a chief complaint of missing upper and lower teeth and wanted to get it replaced.Patient expectation was to have fixed replacement. Medical history revealed as known diabetic which was under control. Dental history, underwent total extraction under sedation elsewhere. Blood investigations report such as HbA1C. OPG, CBCT to know the quality of the alveolar bone.Treatment planned – All on four implant with hybrid denture.

Why All on Four ?

 

Increased alveolar bone resorption in the maxillary posterior region and knife edged ridge.Quality of the alveolar bone was D3.Stability even in minimum bone volume.By tilting the two posterior implants, longer implants can be used. This increases bone-to-implant contact and avoids vertical bone augmentation.The tilted implants can be anchored in better quality anterior bone and help avoid important anatomical structures.

Surgical technique

 

Under full mouth local anaesthesia , flapless implant procedure was done. Second stage procedure, the prosthetic phase was started about three months after the placement of the implants. We had decided to give hybrid denture for the upper and lower arch with Multi unit abutments placed over all the 8 implants. Open tray impression transfers were placed over the multi unit abutments and the impression transfers were connected using pattern wax.The impressions were made and sent to the lab.A jig trial was done to make sure the impression transfers fit the laboratory analogs as well as the implants without any discrepancy.Jaw relations was registered in the same appointment.Castable abutments were used to fabricate the metal framework.A metal trial along with the acrylic teeth setting was done, the dentures were processed and delivered in the next appointment.

 

 

Doctors
Dr. Murali, Oral & Maxillo Facial Surgeon
Dr. Janardanan, Prosthodontist

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Dentys Dental Care

Inwinex Towers, 2nd Floor, 2A

Plot No 130, D.No 8-2-277/B,

Road No 2, Banjara Hills,

Hyderabad – 500 034

Phone : 040-46478888