An examination showed significant gum disease and bone loss around the remaining teeth. There was also decay starting around the exposed root surfaces.

This patient came to our office dissatisfied with his smile. His teeth had been declining for the last 20 years and he was getting ashamed of his smile.

An examination showed significant gum disease and bone loss around the remaining teeth. There was also rampant decay around the exposed root surfaces.

At the first surgical appointment, we picked a few strategic teeth and prepared them to receive fixed provisional bridges. Some implants were also placed in the neighboring extraction sites at this time.

Our prosthodontists then make full arch provisionals here in the office. These are tooth-supported so there is no pressure on the underlying implants while they integrate.

Provisionals help provide esthetics and function throughout the entire treatment process. At the end of this first surgical appointment, there is already a significant improvement in his smile.

The patient is then left to heal for 2 months while the implants integrate. We typically take a staged approach if the implants do not go in with enough torque at the time of surgery. However, through careful planning and preparation, we are able to ensure that patients do not leave the office without teeth.

Two weeks after surgery, tissues have healed well and the patient is able to keep his provisionals nice and clean.

Two months after the initial surgery, the remaining lower teeth are extracted and additional implants are placed.

A new lower provisional is made on implants this time. Tissue contours are still kept nice and convex to allow for optimal healing.

When we deliver the provisional, a specific suturing technique is used to help the tissues adapt well to the prosthesis. We aim for a thick band of tissue around implants to help maximize long term health and hygiene.

A two week follow up shows healthy tissues which are beginning to take the shape of the planned final restoration.

At the third surgical appointment, the remaining upper teeth are removed and the final implants placed.

A new provisional is made for the upper jaw. We are able to contour it nicely to preserve the tissue architecture for maximum health and esthetics.

A two week follow up shows healthy tissues which are beginning to take the shape of the planned final restoration.

Another 2 months after surgery, the patient is ready to begin the process of finalizing the restorations. Impressions are made and records are sent to the lab so they can fabricate wax prototypes for a try-in.

Using the information provided, the lab fabricates wax prototypes to simulate the design of the final restorations.

Prototypes are tested in the mouth to check for fit and esthetics. Any final changes can be made at this stage before the definitive restorations are made.

The wax prototypes are then used to fabricate definitive restorations in zirconia and acrylic-titanium. They are checked on articulated models to ensure they fit perfectly.

The lab hand finishes and builds character into the definitive restorations. The result is a realistic, natural result that is customized for each individual patient.

Special care is taken when finishing the tissue-contacting surfaces to ensure they are smooth, convex, and easily cleansable for long term success.

On the day of delivery tissues are healthy. A well-made provisional ensures they are shaped perfectly to receive the definitive restorations.

The definitive bridges are screwed in place and the screws are torqued down firmly. The final result is strong, functional, and esthetic restorations that will serve the patient well for years to come.

The patient is very happy with his new smile. His years of progressive dental breakdown are over and he can enjoy his new restorations with confidence.

A final post operative radiograph shows well-placed implants with good bone support. With proper care and maintenance, this restoration should serve the patient well for many years to come. Contact us for a complimentary consultation and see if this is the right treatment for you!

Full Mouth Implant Restoration

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