Total Rehabilitation Using All-on-4 Hybrid and All-on-4 Standard Concepts

Patients using complete dentures for long periods of time usually exhibit lack of bone and keratinized mucosa in the support area due to bone atrophy. This was the case of this fully edentulous 52-year-old female patient that had been rehabilitated with complete removable dentures in both jaws and was now looking for a fixed solution.

The treatment plan proposed by the MALO CLINIC clinical team, after a meticulous multidisciplinary clinical and radiographic examination - which confirmed an atrophic maxilla - was the placement of a fixed, implant supported full-arch bridges in each jaw.

The surgical procedures were performed in one stage only: 4 NobelSpeedy^TM Groovy RP 4x15mm implants (Nobel Biocare^TM) were used in the lower jaw, following the All-on-4^TM Standard concept; In the maxilla, Branemark Zygoma implants were placed, following the All-on-4^TM Hybrid concept, along with a NobelSpeedy^TM Replace NP 3,5x10mm implant and a NobelSpeedy^TM Groovy RP 4x10mm implant (Nobel Biocare^TM).

On the same day, fixed immediate provisional prostheses (All-Acrylic Bridges) were placed, re-establishing occlusal vertical dimension and function. In a second phase, new provisional bridges were made to improve aesthetics and achieve gingival adaptation. The final rehabilitation was performed 1 year after surgery: a MALO CLINIC Ceramic Bridge and a MALO CLINIC Acrylic Bridge were placed in the maxilla and the mandible respectively.

Case Photos

Initial OPG

Initial situation - Extra-oral, frontal view during smile

Initial situation - Intra-oral, frontal view

Intra-oral, frontal view. Final rehabilitation – MALO CLINIC Ceramic Bridge in the maxilla and MALO CLINIC Acrylic Bridge in the mandible

Extra-oral, frontal view in smile position after conclusion of the definitive rehabilitation

Final OPG