Oral Rehabilitation for Periodontal Disease – All-on-4® with a Twist, still 100% Success!

The Dental Problem

Periodontal disease starts in the gums and, if untreated, can damage the tissues and bones supporting the teeth, leading to tooth loss. This common condition affects many adults worldwide, and, unfortunatley patients often seek treatment too late.

We recently treated a 64-year-old patient with severe gum disease. His teeth were unsalvageable and needed extraction, requiring full-mouth rehabilitation. We presented treatment options, and the patient chose the All-on-4® implant procedure, a proven method for over 25 years. This technique uses only four implants per jaw and avoids bone grafting. While it usually allows fixed, non-removable temporary teeth during healing, this case was different, as we’ll discuss.

Solution

IIn one procedure, we removed the unsalvageable teeth and placed four Nobel Biocare implants in the lower jaw. Due to severe inflammation, we couldn’t immediately place implants in the upper jaw. A few days later, the patient received a fixed temporary bridge on the lower implants. For the upper jaw, we could only provide a removable prosthesis.
The patient returned to our clinic four months later. By that time, the lower implants had integrated perfectly, allowing us to install the final bridge without complications. We also placed four Nobel Biocare implants in the upper jaw, but due to the soft bone resulting from the inflammation, we couldn’t achieve adequate primary stability. Therefore, we decided against loading the implants with a fixed temporary bridge and opted for the patient to continue using a removable temporary prosthesis, which we adjusted for a better fit and comfort.
Within a few months, the upper implants had integrated perfectly, achieving the necessary stability. This allowed us to fit the permanent All-on-4® bridge, completing the full-mouth rehabilitation.

Result

Thanks to the All-on-4® treatment, the patient can now live a full life. The functional and natural-looking restoration enables him to enjoy his favourite foods, smile freely, and engage confidently in social situations. With proper oral hygiene, he will likely only need to visit the dentist for check-ups and dental hygiene appointments in the future.