When a 35-year-old man walked into my office, I could see the toll that years of severe tooth decay and grinding had taken on his smile. He wanted to fix his worn teeth. His teeth were worn down to the gums, altering his facial structure and aging his appearance.
This case was a testament to the transformative power of full mouth dental implants, often referred to as All-on-4 or All-on-6 dental implant procedures.
It’s a perfect example of how a thorough diagnosis and meticulous treatment planning can lead to life-changing results. If you’re curious about the intricacies of dental implants, check out another full arch implant case.
Fixing worn teeth: The initial steps
Our journey began with a comprehensive examination, including x-rays, face scans and surface scans to understand both the dental issues and the person behind them.
Interestingly, this wasn’t a case of neglect due to substance abuse, but rather a lack of dental education. He drank a lot of soda from when he was a child and it basically destroyed his teeth, then eventually collapsing the bite as the soft teeth scissored by one and another.
I planned to restore his vertical dimension of occlusion, essentially rebuilding his bite to its natural height. This was achieved using advanced scanning technology and a lot of time spent understanding his unique needs. The process involved digitally reconstructing his mouth to determine the optimal placement for implants, a crucial step for long-term success.
You can learn more about the importance of digital planning in our post about zygomatic and pterygoid implants.
Next phase: The All-on-4/6 implant surgery phase
The surgery itself was completed in a single visit, under IV sedation, when I extracted all thirty teeth and placed twelve dental implants.
The next day, he received his healing teeth, which he wore for three to four months. He had little to no pain from the Exparel shot. These temporary healing teeth allowed us to fine-tune the fit and function before transitioning to the final prosthesis.
For anyone considering similar procedures, my guide on 15 important things to know about dental implants is a must-read.
A complete transformation!
Ultimately, I fitted him with monolithic zirconia teeth with titanium base inserts, offering the best in both aesthetics and durability. To protect these new teeth, we provided a nightguard and administered Botox to reduce grinding forces. The entire reconstruction took about six months, but the impact on his life was immediate and profound.
For more stories of transformation and to see how patients fix worn teeth, see our deep dive into complex dental cases.Witnessing the joy and gratitude from him and his family was incredibly rewarding. It’s moments like these that remind me why I chose this profession. Listen to his own words!
Dr Amin,
This is a wonderful success story!
Beautiful restoration for this guy! So very happy for him, I had the all on 4 procedure 2 years ago unfortunately it wasn’t successful. Thank you for sharing your perfect skill with us.😊
Oh no! What happened??!!
After 2 years and many attempts to make a temporary fixed screw retained all on 4 denture, it seems impossible to align my arches and get the occlusion dialed in. When i chew my lower jaw moves forward and it is an edge to edge bite. Very painful after a few days. The new temp prosthesis I received last week, upper back arch the teeth extend to far past the implant causing flexing when I chew food or bite. The left side upper and lower canine and incisor hit when I chew makes the tissue around the implants sore. Unfortunately my dentist thinks we need to remove the abutments and go with conventional dentures, removable when they become too painful. 😣 I don’t want to do this because my implants are very strong and solid according to scans, but after 10 sets of temps that just don’t fit the lab is exhausted, i have no other choice I can’t deal with the pain any longer. Expensive downgrade. Thank you for all the information you so graciously provide for everyone. I will continue to read everyone’s comments and your answers. Makes me happy when I see your beautiful work and your patients glowing with their new smiles. 😊
Thank you for your kind words. It just seems excessive with how many attempts you have had. **Very respectfully**… Do you feel that your expectations are realistic?
Also, do you feel that the office and lab have the capabilities to meet that expectation?
Hi Dr Amin, I have the all on 4 upper and lower dentures. After several attempts to fit prosthesis to my arches. The back left implant abutment came off, it was reinstalled and was very painful. The bite force caused bone pressure. The surgeon did an exploratory surgery removed the abutment and covered the implant post. He found nothing wrong just a small amount of inflammation around the abutment. He then moved and repositioned gum tissue over the implant and stitched it into place. He made a conventional denture with a soft liner to wear over the three remaining abutments. I really don’t understand what his plan is in doing this. The denture is very painful on the surgical site and it makes the tissue around the other implants sensitive and sore. The lower arch is the fixed screw temporary denture and the top is a conventional denture. It is 20 days post op since the exploratory surgery. The tissue and bone along the incision is still very sore and sensitive! Is this normal? I am trying to wear the denture but it is very painful rubbing on the incision tissue. What do you think the surgeon has in mind in this procedure? After my mouth heals from this surgery, should I remove the other three abutments and have a conventional denture on the upper. I had the original all on 4 procedure done in October 2022. Never got past the temporary teeth to the final stage.The lab could never align the arches of teeth, to fit my bite when chewing food, left canine and incisor upper and lower do not fit properly together when closing jaws. Any suggestions you might have is appreciated. Thank you 😊