After many years of postponing, the time had come for this patient to fix his teeth. He elected to start on the upper and move to the lower one year later.

Pre-operative, lips retracted.

Pre-operative, panoramic x-ray.

Panoramic x-ray after surgery on upper jaw.

Fixed temporary on the day of surgery. This can be accomplished if the bone density is good.

Wax try-in of upper final prosthesis. Nothing is left to chance, we try this in for evaluation of aesthetics, bite, smile and patient approval.

Wax try-in (mock-up) is tried in patients mouth for approval.

Matching of the gum tissue color is one more step we take in the “customization” process. Most offices have only two choices for the gum color.

We can blend colors if the patient’s shade is between shade tabs.

Occlusal (mirror) view of the upper implants. This patient had good bone in these five areas. If the bone was better we would have added a sixth implant.

Master cast of implants and abutments (occlusal view).

Frontal view of the final implant bridge.

Occlusal view of final implant bridge.

Tissue-view of the final implant bridge. Note the convex (cleansable) contours. This is a wide departure from “All-on-4” treatment which is virtually uncleansable.

Final fixed implant bridge, occlusal view.

Final fixed implant bridge, occlusal view (intra-oral).

Frontal view of upper implant bridge (intra-oral). Just because the patient is delaying treatment on the lower doesn’t mean we can’t improve it for the year he is waiting. See next picture.

The lower teeth were bonded with composite resin to improve aesthetics and function during the year he is waiting to do his lower.

Smile of upper permanent and lower bonded teeth. The patient is starting to learn how to smile, again!

Panoramic x-ray of lower surgery. A fixed temporary was made that day.

Final upper zirconium implant bridge. Final lower titanium/acrylic bridge. For patients with grinding habits, I recommend different materials in the opposing jaws to decrease the chances of breakage. Here, the lower acrylic teeth are softer than the upper zirconium which allows for tooth wear (attrition) instead of breakage.

Final panoramic x-ray. Note: parallel implants, no angled abutments, easily cleaned contours.

Final portrait picture of patient smiling. The patient’s smile is improving daily. Patient’s report that it can take up to a whole year to smile freely after so many years of guarding/ hiding their smile.

Full Mouth Implant Restoration

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