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Full-mouth All-on-4 rehabilitation with Neo Biotech implants and bone grafting

Full-mouth All-on-4 rehabilitation with Neo Biotech implants and bone grafting

Complaints:

The patient complained of tooth mobility in the upper and lower jaws, pain, inability to chew food properly, and bad breath.

Diagnosis:

Missing teeth in the left lateral area of the upper jaw, as well as mobile teeth affected by tooth decay and periodontitis. Secondary edentulism in segment 2, generalized periodontitis, stage II.

Treatment:

Treatment was carried out as a complex clinical case in several stages. At the first stage, full diagnostics and planning were performed: computed tomography (CT), digital jaw scanning with 3Shape, and a photo protocol for accurate treatment planning and fabrication of a surgical navigation guide. Next, non-viable teeth were removed in one procedure. In the area of teeth 2.4, 2.5, and 2.6, pronounced atrophy and deformation of the jaw were detected, which worsened the prognosis for implantation. For this reason, an individual titanium membrane was used to restore the 3D volume of the alveolar ridge with Straumann Xenograft bone substitute material combined with autologous bone — the patient’s own bone. Soft tissue augmentation / gum grafting was also performed. After tissue preparation, implants were placed according to the All-on-4 protocol on the upper and lower jaws as a solution for this complex clinical case. A Neo Biotech implant measuring 4.5 × 13 mm was used. Immediately after the surgery, impressions were taken to fabricate a temporary restoration with immediate loading. This allowed the patient to restore aesthetics and partial chewing function during the implant healing period. The surgery was performed under medication-induced sedation / medication-induced sleep, which ensured maximum comfort. After 4 months, implant integration was checked, and a permanent zirconia restoration was fabricated and fixed.

Here, the problem was related not only to tooth mobility, but also to significant bone loss caused by periodontitis.

Therefore, additional preparation was required before implantation: bone grafting, restoration of the alveolar ridge volume, and gum grafting.

In the area of atrophy in the upper jaw, an individual titanium membrane, Straumann Xenograft bone substitute material, and the patient’s own bone were used.

This bone grafting created more stable conditions for the subsequent placement of implants.

After surgical preparation, All-on-4 implantation was performed on the upper and lower jaws using Neobiotech implants.

The surgery was performed under medication-induced sleep, and the temporary restoration with immediate loading allowed the patient to receive teeth immediately during the implant healing period.

Result:

After implant integration, a permanent zirconia restoration was fixed. The patient can chew, smile, and speak normally again without mobile teeth, pain, or discomfort.

If teeth have become mobile due to periodontitis and there is not enough bone for implantation, this is not always a dead end.

Learn more about full dental implantation on 4 implants, bone grafting, and dental restoration in cases of periodontitis.

Who performed the treatment:

The surgical stage was performed by oral surgeon and implantologist
Polozhyi Ruslan.