All-On-4 Zirconia Porcelain Teeth




Doctor’s Comments

As a 51 year old business woman this patient lost her teeth and her self esteem when she was fitted with a full upper denture (see below left).  Apart from the functional problems, she was always worried that her denture would dislodge and avoided social interactions.

She came to our clinic seeking a more permanent alternative with dental implants. The problem was that her bone quality was not ideal. Also the sinus spaces were in the way and did not allow an adequate spread of the implants towards the back for a full arch.

She was eager to get rid of her denture so we proceeded with placement of four dental implants but could only fit 10 teeth at the time (instead of the typical 12), as seen in the after picture below.  Planning for the future, we also performed some bone grafting in the back at the same time as the original implant surgery so as to allow the future placement of additional implants and extension of her bridge more towards the back.

With 10 teeth this lady was happy with her function and got her confidence back. After over 2 years in function, she decided to get the additional implants and extend her bridge further back. She also wanted to upgrade to Zirconia at the same time because it was a more durable long term solution compared to the High Impact Acrylic teeth that were fitted at the time of the original surgery.

The x-ray on the left shows the four fixtures in position as well as the bone grafts in the sinus areas, and on the right it shows the additional fixtures in the grafted sinuses and the zirconia bridge, which appears white due to its high density.

This treatment is known as All-On-4 Plus.

The denture in position BEFORE treatment. The appearance was not as much of a problem as the looseness of the denture.

The denture has large flanges and full plastic palate to provide a suction effect for retention.

The edentulous arch is seen before treatment.

After the All-On-4 treatment in the upper, the bridge is permanently attached to the implants that support it. There are no flanges or plastic covering the palate.  The stitches that are visible are dissolvable and fall out within 10 days.

Immediately after the initial treatment with a shortened arch of 11 teeth.  We originally planned for 10 teeth because the sinuses were in the way, but in the end managed to fit an extra tooth towards the back on the one side.