All-on-4

All-on-4™… and More!

Our doctors have changed the lives of so many patients with the revolutionary All-on-4™ treatment option. Designed to last a lifetime, All-on-4™ is a cost-effective, fixed dental implant solution used to replace failing teeth, missing teeth or dentures. The examples presented in this photo gallery provide a glimpse of several of the complex cases that the Center has handled in recent years.

Case Study #1: Rita

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Chief Concern: Rita dealt with an ill-fitting full upper denture and a problematic, lower patient-removable implant bridge.

Treatment Received: We removed her four lower dental implants (minimally-traumatic and Piezosurgery® assisted) and immediate placed four dental implants using the AO4® concept. A fixed screw-retained provisional was placed within 24 hours and went to completion with a screw-retained acrylic hybrid (doctor-removable bridge) three months later. A new full upper denture was simultaneously made that supported Rita’s smile and is extremely retentive against her fixed lower AO4® case. An acrylic night guard appliance is used daily to protect her investment.

 

Before Treatment

After Treatment

Case Study #2: Verlette

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Chief Concern: Verlette was concerned with her unaesthetic asymmetrical smile, broken down lower teeth and inability to wear her full upper denture. She had not seen a dentist in many years.

Treatment Received: In a coordinated visit with her advanced restorative dentist we minimally-traumatically (Piezosurgery® assisted) removed all of her lower teeth and placed 4 dental implants in the lower jaw using the AO4® concept. A fixed-screw-retained provisional (temporary) bridge was placed within 24 hours by her restorative team dentist. Verlette’s case went to completion with a NEW full upper denture and a screw-retained acrylic hybrid (doctor-removable) bridge three months later. An acrylic night guard appliance is used daily to protect her investment.

Before Treatment

Provisional Phase

After Treatment

Case Study #3: Cathy

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Chief Concern: Cathy had chewing concerns due to her poorly fitting, lower removable partial denture attached to three remaining lower teeth. She was also very unhappy with her smile.

Treatment Received: In one surgical visit, Cathy’s remaining lower teeth were removed and four implants were placed using the All-on-4™ concept. A fixed transitional bridge was inserted the next day with completion of a new full upper denture and fixed hybrid restoration in the lower three months later. Cathy is now able to smile and eat everything she desires!

 

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Before Treatment

After Treatment

Case Study #4: Maryjane

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Chief Concern: Maryjane was concerned with her unaesthetic smile, broken down and flared and missing teeth in both jaws and inability to chew as her teeth were uncomfortably loose due to generalized severe periodontitis. She had not seen a dentist in many years.

Treatment Received: In a coordinated visit with her advanced restorative dentist we minimally-traumatically (Piezosurgery® assisted) removed all of her upper and lower teeth and placed 5 dental implants in the upper jaw and 4 in the lower jaw using the AO4® concept. Fixed-screw-retained provisionals (temporary) bridges were placed within 24 hours by her restorative team dentist. Her case went to completion with screw-retained acrylic hybrid (doctor-removable) bridges three months later. An acrylic night guard appliance is used daily by Maryjane to protect her investment.

 

Before Treatment

Provisional Phase

After Treatment

Case Study #5: Tom

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Chief Concern: Tom had not seen a dentist for a number of years and was concerned about loose teeth due to advanced periodontal disease as well as his inability to chew properly, due to the recent loss of two teeth.

Treatment Received: In one surgical visit, Tom’s remaining upper teeth were removed and four implants were placed using the All-on-4™ concept. His lower jaw periodontal disease was treated with laser-assisted new attachment procedure (LANAP). A fixed transitional provisional was placed the next day and the final prosthesis approximately five months later with a night guard appliance to protect Tom’s investment.

 

Before Treatment

Provisional Phase

Case Study #6: Bronni

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Chief Concern: Seventy-year-old Bronni was referred to us by her sister, a patient of ours for many years, who had completed a “SameDay Smile® with us in her upper jaw. Bronni’s teeth were loose as a result of advanced periodontal disease. She had difficulty chewing and was overall very unhappy with her smile. She wanted to obtain a beautiful smile like her sister—a healthy set of teeth that not only looked great but functioned great as well.

Treatment Received: We removed all of Bronni’s remaining teeth in both jaws in one surgical visit. Five implants were placed in her upper jaw and four in her lower jaw using the popular All-on-4™ concept. Her fixed provisional restorations were inserted the next day and her final case was completed in three months. A night guard appliance protects her wonderful new smile.

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Before Treatment

After Treatment

Case Study #7: All-on-4™: Joanne

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Chief Concern: Joanne was concerned by loose teeth and generalized advanced periodontitis, She’d recently lost three teeth and was interested in improving her smile and dental health.

Treatment Received: In one surgical visit, all of Joanne’s remaining upper teeth and lower right posterior teeth were removed with placement of five dental implants in her upper arch using the All-on-4™ concept. An immediate provisional was placed and the final prosthesis was completed as a fixed hybrid in the upper arch with a three-unit fixed crown and bridge in her lower right.

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Before Treatment

After Treatment

Case Study #8: All-on-4™: Kim

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Chief Concern: Kim hadn’t been to a dentist in many years and was unhappy with her smile, had loose teeth, and was unable to chew due to abscessed teeth stemming from generalized, severe periodontitis and generalized dental decay.

Treatment Received: In two surgical visits, starting with the upper arch using the All-on-4™ concept, five implants were placed in her upper arch followed by five implants in her lower arch. The case went to completion six months later.

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Before Treatment

After Treatment

Case Study #9: Tony

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Chief Concern: Tony came in with failed teeth under a lower partial denture due to severe dental decay. He was unable to enjoy eating or being in social situations. Tony desired a permanent dental solution for his problem. He’d been treated three years prior at the Pennsylvania Center for Dental Implants and Periodontics with a fixed dental implant bridge in his upper left arch which replaced a failed crown and bridge— also due to dental decay.

Treatment Received: In one surgical visit, Tony’s remaining lower teeth were removed and six dental implants were placed using the All-on-4™ concept. A fixed transitional prosthesis was placed in 24 hours and Tony’s mouth was completed with his final prosthesis three months later. He had no post-treatment discomfort. See Tony discuss his All-on-Four procedure here.

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Before Treatment

After Treatment

Case Study #10: Diane S.

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Chief Concern: An over sixty-year-old patient presented with an inability to chew properly due to failing lower natural teeth with severe dental decay due to medication-induced xerostomia (dry mouth) and an inability to wear poorly fitting partial denture. Significant bone atrophy had occurred on both lower edentulous ridges where she had been missing teeth for many years. She elected to proceed with the AO4 treatment approach for a permanent tooth solution in her lower jaw and a new, full upper denture.

Treatment Received: In one surgical visit we removed all of her lower teeth with immediate placement of four dental implants using the All-on-4 concept. A permanent lower screw-retained provisional bridge was fabricated by the dental lab team and inserted the next day by her restorative dentist. Her case was completed three months later with a new, full upper denture, a permanent, lower fixed acrylic hybrid bridge and a night guard appliance to protect her investment. By tipping the distal implants using the AO4 concept it enabled the team to fabricate a fixed bridge with an adequate number of teeth to function and digest her food properly.

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Pre-Treatment Smile

Post-Treatment Smile

Case Study #11: Pat

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Chief Concern: Sixty-two-year-old Pat was very unhappy with her smile and inability to chew properly. She had generalized severe periodontitis as well as generalized severe dental caries (cavities).
Treatment Received: In two surgical visits, all of Pat’s upper and lower jaw teeth were removed and four immediately loaded lower implants were placed for SameDay Smile® with bone grafting of the upper extraction sites for ridge preservation. A new full upper denture was placed immediately with a transitional, fixed screw-retained hybrid restoration in her lower jaw. After four months of healing, eight implants were then placed in her upper jaw with site-specific sinus lifts with bone grafting. Pat’s lower final restoration was a wrapped acrylic fixed hybrid with a titanium framework. The upper was restored as a zirconia-reinforced fixed hybrid. Now Pat uses a night guard to protect her beautiful new smile!

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Before Treatment

After Treatment

Case Study #12: Tom

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Chief Concern: Tom was concerned with his unaesthetic smile, broken down teeth in both jaws and inability to wear upper partial denture. He had not seen a dentist in many years.

Treatment Received: In a coordinated visit with his advance restorative dentist we minimally-traumatically (Piezosurgery® assisted) removed all of his upper and lower teeth and placed 5 dental implants in the upper jaw and 4 in the lower jaw using the AO4® concept. Fixed-screw-retained provisional (temporary) bridges were placed within 24 hours by his restorative team dentist. His case went to completion with screw-retained acrylic hybrid (doctor-removable) bridges three months later. An acrylic night guard appliance is used daily by Tom to protect his investment.

Before Treatment

Provisional Phase

After Treatment

Case Study #13: David

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Chief Concern:  With very loose teeth and generalized, advanced periodontal disease, David was interested in permanent tooth replacement.

Treatment Received: In two surgical visits, beginning with his lower arch, all David’s teeth were removed. Immediate implants were placed using the All-on-4™ concept in his lower arch, with ridge preservation (bone grafting) in the upper arch. The upper implants were placed six months later using the All-on-4™ concept.  Fixed provisionals were placed within 24 hours and David’s final case was completed three months later with a night guard appliance to protect his new smile.

Before Treatment

After Treatment

Case Study #14: Yefim

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Chief Concern: Yefim came to us with a failing upper removable partial denture along with generalized severe dental caries (cavities) and loose remaining upper teeth.

Treatment Received: We removed Yefim’s remaining upper teeth and immediately placed four dental implants using the AO4® procedure. A fixed provisional was placed within 24 hours. Yefim’s case was completed three months later with a screw-retained, hybrid (doctor-removable bridge).

Before Treatment

After Treatment

Case Study #15: Candace

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Chief Concern: 65-year-old (non-smoker) female came to our practice to request a third opinion regarding the ideal treatment for her failing dentures, re-incurring cavities (resulting from medically-induced dry mouth, and acute chronic periodontitis). Her main priorities were to achieve a permanent solution which would provide better comfort and a more esthetically pleasing smile.

Treatment Received: In one surgically-coordinated visit with us and prosthodontist Dr. Harry Randel, all remaining teeth were extracted. Significant vertical ridge height reduction was then completed to provide the necessary prosthetic room for a hybrid restoration. Five dental implants were placed in the upper jaw, and four implants were placed in the lower jaw. The following day, a screw-retained metal-reinforced fixed provisional prosthesis was put in place. In three months, after full bone healing was confirmed, permanent screw-retained restorations were put in place.

*Click Here for Full Clinical Case with Treatment Details.

Before Treatment

After Treatment

Case Study #16: Jim

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Chief Concern: Jim was concerned with severely decayed and uncomfortable lower teeth, an inability to wear his full upper denture which all limited his ability to chew comfortably and to be able to smile. He had not seen a dentist in many years.

Treatment Received: In a coordinated visit with his advanced restorative dentist we minimally-traumatically (Piezosurgery® assisted) removed all of her lower teeth and placed 4 dental implants in the lower jaw using the AO4® concept. A fixed-screw-retained provisional (temporary) bridge was placed within 24 hours by his restorative team dentist with using his old full upper denture as the temporary. Jim’s lower case was completed 3 months later as a screw-retained acrylic hybrid (doctor-removable) bridge with a NEW full upper denture. Jim wears a lower acrylic night guard appliance to protect his investment.

Before Treatment

Provisional Phase

After Treatment