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All-on-4 rehabilitation with Neodent implants for periodontitis and occlusal dysfunction

All-on-4 rehabilitation with Neodent implants for periodontitis and occlusal dysfunction

Complaints:

Tooth mobility, bad breath, and an esthetic defect.

Diagnosis:

Stage II–III periodontitis, impaired occlusal stability, and dysfunctional changes of the stomatognathic system.

Treatment:

During the diagnostic stage, a computed tomography (CT) scan was performed. Based on the diagnostic findings, the patient was offered full-arch implant rehabilitation using the All-on-4 concept. A 3D design of the future smile was created. An intraoral digital scan of the jaws was performed using a 3Shape scanner, and surgical navigation guides were fabricated. In addition, a gnathological analysis was carried out to assess the biomechanics of the masticatory system, establish the proper mandibular position, and create stable interarch contacts for the future prosthetic restoration. Under general anesthesia (medically induced sleep), Brazilian Neodent implants were placed according to the All-on-4 protocol. Immediate loading was performed with a temporary prosthesis reinforced with a titanium bar during the healing period, allowing the patient to immediately regain esthetics and function. After 6 months, the implants were evaluated for successful osseointegration, and the stability of the surrounding soft tissues was assessed. Permanent zirconia prostheses reinforced with a custom titanium bar were fixed using screw-retained fixation and supported by four implants.

In this case, the patient was concerned about tooth mobility, persistent bad breath, and significant smile aesthetic issues caused by severe periodontitis.

Due to the substantial loss of supporting tissues, preserving the remaining teeth and restoring function with localized treatment was no longer possible.

Following CT imaging, 3Shape digital scanning, 3D treatment planning, and gnathological analysis, a full-arch implant rehabilitation using the All-on-4 concept was selected.

Special attention was paid to restoring proper jaw relationships and ensuring stable function of the entire stomatognathic system.

Under general anesthesia, Neodent implants were placed, and a temporary fixed prosthesis on a titanium bar was delivered immediately, allowing restoration of smile aesthetics and chewing function on the day of surgery.

Six months after successful osseointegration, the temporary restoration was replaced with a permanent zirconia prosthesis on a custom titanium bar with screw-retained fixation.

Result:

The consequences of severe periodontitis were eliminated, chewing function, smile aesthetics, and stability of the stomatognathic system were restored.

The patient received a reliable fixed restoration and regained comfort in everyday life.

In cases of tooth mobility and advanced periodontitis, modern implant treatment makes it possible to restore teeth even after extraction of hopeless teeth.

Learn more about All-on-4 treatment and implant rehabilitation for periodontitis.

Treatment performed by:

The surgical stage was performed by oral and implant surgeon
Vitalii Hnyp