In my years of practicing dental implantology, I’ve encountered many challenging cases, but one in particular stands out due to its complexity and the remarkable transformation it brought about — a full mouth All on 4 and zygomatic implants case.
I’ll take you through a detailed look at a patient’s journey from removable teeth to a fixed, natural-looking smile, utilizing full mouth implants with an emphasis on the All on 4 or 6 technique and zygomatic implants.
The Patient’s Struggle: A Dire Dental Situation
My patient arrived with a dental condition that significantly impacted her quality of life. She was dealing with advanced gum problems and was left with only three real teeth on her upper jaw.
Her lower front teeth, although present, were loose and noticeably shifted forward, creating an unnatural appearance to her smile. The discomfort and insecurity she felt about having to remove her teeth were palpable.
Addressing Bone Loss and the Role of Zygomatic Implants
The biggest hurdle in her case was the significant bone loss in her upper jaw, a result of long-term denture use leading to disuse atrophy. She was told this could not be done and she would need a snap in denture.
This is where the specialized approach of using zygomatic implants came into play. These implants are designed for such scenarios where traditional implants aren’t viable due to insufficient bone density.
Tailoring the Treatment: All on 4 Implants and Facial Analysis
Our treatment plan was comprehensive. After an in-depth discussion about lifestyle changes, including the necessity to stop smoking/vaping, we conducted a thorough facial analysis. This revealed the need to open up her vertical dimension of occlusion, as her face had become shrunken in from the loss of teeth over time.
The surgical procedure was meticulously planned and executed in a single session under IV sedation. We removed the remaining teeth and placed implants, including zygomatic ones in the upper jaw due to the lack of bone. The All on 4 technique was instrumental in providing a stable base for the new teeth.
From Prototypes to Permanent Teeth by Crafting the Perfect Smile
The journey from healing teeth prototypes to final full mouth implants was critical. These prototypes were carefully designed to closely resemble the final zirconia bridges, ensuring that the end result was both aesthetically pleasing and functionally effective.
The Transformation with All on 4: A New Smile and Renewed Confidence
The outcome was a complete transformation. Not only did my patient get a stable bite and a radiant smile, but the ease of cleaning the bridges and the comfort they brought significantly improved her life.
Reflecting on the All on 4 Case: Expertise in Complex Dental Procedures
This case, with its intricate use of All on 4 and zygomatic implants, highlights the importance of expertise in handling complex dental procedures. It’s a testament to the trust patients place in us and the responsibility we bear in transforming lives. Complications are common with these procedures!
Conclusion: The Gratification of Making a Real Difference
Seeing my patient’s journey from a state of discomfort and self-consciousness to one of joy and confidence was immensely gratifying. It’s cases like these that underscore the transformative power of full mouth implants and advanced techniques like All on 4 and zygomatic implants.
Your Thoughts and Questions are Valued
As we close this detailed journey of dental transformation, I invite you to share your thoughts and questions. Whether you’re curious about the specifics of the All on 4 technique, zygomatic implants, or have inquiries about your own dental concerns, I’m here to engage and provide answers.
Your comments and questions not only enrich our blog community, but also help others who might be facing similar dental challenges. I personally read and respond to your comments, as your insights and experiences are invaluable to me.
So, please, feel free to leave a comment below or ask any questions you might have. I look forward to our discussions and to assisting you in any way I can on your journey to a healthier, happier smile.
Hello Dr. Amin:
Thank you so much for your time.
I am a 65 year old female who has watched and enjoyed many of your videos with extreme interest. I have been through ‘hell’ the past five years trying to figure out where I went wrong. I had started with a dentist who promised painless implants done with laser. He mapped out a color coordinated plan with zygomatic and pterodactyl implants wherever necessary but ended up literally ramming in 8 implants, 1 of them which pierced the naval cavity–he did it all in 35 minutes, according to my daughter because i had been sedated. He used outdated one piece screws, all of which were subsequently removed. He also hadn’t prepared a restoration, so the ‘crowning glory’ consisted of some material which he shaped around the teeth leaving me in extreme pain in the gum and a midline slanting to the left. I won’t bore you with the rest, as I experienced the vagaries of 2 more dentists before i was finally referred to a dentist specializing in zygoma implants who did amazing work.
The dentist doing the restoration had initially referred me to the zygoma specialist so I opted to continue with him. He uses 3D temporaries and is very pleasant and willing to work with me. However, his work is causing me anxiety. Prior to my implants he had done extensive facial scanning. However, the initial temporary on the first day post surgery looked very ‘generic’ like straight dentures with short little teeth and minimal support for my lips, giving me the impression of a ‘cadaver’. I mentioned it to him. He countered with, we’ll work on it, don’t worry. Some months later he generated a second set without seeing me, although I had requested much longer teeth, both for looks and ability to speak properly. I was very disappointed with the second set as there was no significant change.
At that point, I consulted with a dentist whom I had seen previously, a specialist in reconstruction, whom i had been unable to use because he worked with an implant surgeon who wanted to do bone grafts for two years to prepare me for work. I explained that I needed validation that I wasn’t being difficult. He used temporary material and wax in the front illustrating how my dentist had ‘closed’ my mouth instead of opening it. When he was done I looked years younger, because he had eliminated most of the lines and relieved the sunken look I had on both sides of my mouth.
He took numerous pictures, suggesting I share them with my dentist and wished me good luck.
My dentist was very insulted that I had gone for a second opinion. I explained how unhappy I was with the teeth, especially when the second set looked like the first. I shared phrases from the consultation: supporting the lips, much longer teeth, higher bite, etc. and I felt much more confident that I knew what I should be asking for. Did I do something so wrong?
Thank you.
Adele
I do not think you did anything wrong! The quality of the lab work and that communication with the lab technician even via tremendous technology has to be ideal. Understanding what you want versus what you are getting as interpretation I think is the problem. And the reality is there are fewer lab technicians and dentist that really designed smiles to be customized. This for me is a really big part of what I do because I hate the generic smile. Many of these all on 4 clinics offer 1 of 5 or 6 smiles that the use on all patients! The dental designer and dentist need to be in sync. Some faces and skeletal bite patterns are much more challenging to customize than others. It sounds like your vertical dimension of occlusion is over closed. That can make a tremendous difference in your face and lip support.
Hello, I am a 51 yr old F. I have had a full upper denture for approximately 15 yrs. I have 11 original bottom teeth. Missing molars except 2. I recently went to an all on 4 facility and was told, I was not a candidate due to little to no bone density. Would zygomatic implants be an option? Also, is it a possibility that another Dental surgeon would feel differently on my scans and do the reg implants? Any information would be greatly appreciated.
Hi Tracy-it sounds like you have a difficult case. I would suggest seeing somebody who is very skilled and experienced at zygomatic implants. There are a lot of people who say they do these but they do not do them frequently enough. Honestly there is not an upper jaw that I cannot treat so if it comes to that you are welcome to travel here to Burbank California. I have many patients who do so!
Hello, I’m a 61 year old female. I was prepped for a crown on tooth #18. After the procedure the tooth became very sensitive and my dentist recommended a root canal and referred me to a endodontis. After the cat scan the endodontis said he wouldn’t do the root canal because the root of the tooth is intertwined with the nerve and could cause permanent facial numbness if the nerve is touched. He has recommended I see an oral surgeon to have the tooth extracted. My question is doesn’t extraction still have the same risk of permanent facial numbness and is there anything that can be done before or during the extraction process to prevent this from happening? Would getting an implant be ideal for this situation? If so should it be immediate or after some time.
I’m interested in this doctor ! My name is Michelle and I have a few questions ? Pls ! Thank you !
Hi Michelle. Best to call the office and come in as a patient if you can! 😊
Hello, in reading your All on 4 and Zygomatic Implants article, I’m curious about the space between the jaw and the implant in the last 2 pictures. The space seems like a lot visually, so wouldn’t food get lodged in there very easily. Does the implant eventually graft to the jaw?
Great question. The design of the underside of the bridge prevents it and makes it very easy to clean. Other designs are prone to problems.
Great question. The bridge is shaped in a special way to prevent food from going in and making it very cleansible. This is a SUPER IMPORTANT aspect of treatment.