Complete Denture with All‑on‑4 Technology – Case Study
Introduction
Full mouth rehabilitation with All‑on‑4 technology offers an effective solution for patients with severely damaged dentition, bone loss, and functional limitations. This complete denture with all-on-4 case study presents the story of a woman who avoided dental treatment for more than a decade. During this time, progressive periodontal disease and bone resorption made chewing, speaking, and social interaction increasingly difficult. The case demonstrates how accurate diagnostics and modern implantology can restore a complete denture even in severely compromised conditions.
Patient Information (Anonymized)
The patient is a 58‑year‑old woman who previously led an active lifestyle but gradually withdrew from social activities due to the condition of her teeth. Advanced periodontal disease, multiple missing teeth, and the near‑complete loss of chewing function forced her to consume only soft foods. She is a non‑smoker, has no chronic illnesses, but avoided dental care for more than ten years due to dental anxiety. Her family history includes periodontal disease and early tooth loss.
Diagnosis
Clinical examination revealed only a few remaining teeth in the upper arch, all severely mobile and no longer functional. The gums were inflamed and prone to bleeding, and the bone structure had significantly receded. The patient’s facial profile had collapsed, further affecting her self‑confidence.
Diagnostic imaging findings:
— The panoramic X‑ray showed extensive bone loss in the posterior maxilla.
— The CBCT scan revealed enlarged maxillary sinuses and insufficient bone height for conventional implants.
— Adequate anterior bone width allowed the All‑on‑4 protocol to be applied.
Final diagnosis:
— Advanced periodontal disease.
— Severe bone resorption.
— Functional and aesthetic insufficiency.
— Psychological distress.
Treatment Plan
The implantologist recommended full mouth rehabilitation using the All‑on‑4 protocol, which best matched the patient’s anatomical conditions and expectations.
Reasons for choosing All‑on‑4:
— The anterior bone provided sufficient stability for implant placement.
— The angled posterior implants avoided the sinus area, eliminating the need for bone grafting.
— The patient could receive an immediately loaded, fixed final denture.
— The method is predictable and minimally invasive.
The patient’s goal was to regain a stable, natural‑looking full denture that restored chewing function and confidence. She accepted the treatment plan.
A traditional two‑stage implant procedure with sinus lift and lateral bone augmentation was considered, but the degree of bone loss would have required multiple surgeries over 9–12 months. The patient did not wish to undergo such a lengthy process.
Compared to this, the All‑on‑4 solution:
— Required only one surgical procedure.
— Provided an immediately loaded, fixed temporary denture.
— Avoided bone grafting. — Offered rapid psychological relief.
Before surgery, a digital wax‑up was created to show the expected aesthetic outcome, reducing the patient’s anxiety
Surgical Procedure
The procedure was performed under local anesthesia. The patient remained calm throughout, having been thoroughly informed about each step.
Full Denture with All‑on‑4 Technology – Three‑Step, 20‑Day Protocol
This implant‑based full‑arch complete denture with all-on-4 was completed in three steps over a 20‑day period.
1. Appointment – Preparation and Implant Placement
— Consultation with the oral surgeon.
— Extraction of teeth unsuitable for restoration.
— Preparation for implant placement.
— Implant placement according to the All‑on‑4 protocol.
2. Appointment – Check‑Up and Impression Taking (After 7 Days)
— Evaluation of implant stability.
— Suture removal.
— Impression taking for the temporary denture.
3. Appointment – Fixation of the temporary denture (after 10–12 Days)
— Bonding and fixation of the final zirconia full‑arch denture.
— The denture is fixed and cannot be removed by the patient.
Results and Follow‑Up
In the days following surgery, the patient experienced mild swelling and sensitivity, which is a natural reaction. Soft tissues healed well during the first 1–2 weeks, and inflammation subsided.
On postoperative day 7, the mandatory follow‑up took place. The implantologist:
— checked implant stability,
— removed the sutures,
— took impressions for the temporary denture.
Healing continued over the next 10–12 days, with the gums stabilizing and the oral cavity showing a healthy condition.
The long term temporary denture was delivered on day 20. A zirconia full‑arch restoration was fabricated and securely fixed. Chewing function was restored, the facial profile became more harmonious, and lip support improved. The patient described the experience as: “It feels like I got myself back.”
Osseointegration progressed steadily over the following 4-5 months. Follow‑up examinations confirmed healthy tissues and stable implants. The patient returned to normal eating habits and regained confidence in social situations.
This All‑on‑4 case study demonstrates that full‑arch rehabilitation with All‑on‑4 technology is effective even when bone volume is insufficient for traditional two‑stage implants. The method is fast, predictable, and avoids bone grafting.
Alternative options considered: — Sinus lift with multiple implants. — Removable denture.
The chosen solution provided the best functional, aesthetic, and psychological outcome. Long‑neglected dental problems can cause significant physical and emotional burden, but the All‑on‑4 treatment restored both chewing function and quality of life.
Summary
Full‑arch rehabilitation with All‑on‑4 technology provided a fast and effective solution for restoring a severely compromised upper arch. By week three, the patient received a stable, fixed denture, and osseointegration progressed without complications. The method is a reliable long‑term alternative without the need for bone grafting.
In our Articles section, there are many writings on the following topics: dentures with implants, dental implantation with one-phase and two-phase implants, and All-On-4 & All-On-6 technology.
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