01
Upper Arch: Four Implants and Bone Grafting
Teeth that could not be predictably retained were removed and four upper implants were placed. Bone-graft material was used at localised defects where clinically indicated.
A provisional complete denture was provided on the day of surgery. It was relieved around the implant sites to reduce pressure during the planned healing period.
02
Lower Arch: Four Implants and a Same-Day Provisional Bridge
Non-restorable lower teeth were extracted and four implants were placed during the surgical phase. Immediate loading was planned but remained dependent on implant stability and the clinical findings on the day.
Localised defects were grafted using substitute material combined with the patient's own bone collected from the surgical site where appropriate.
As the required stability was achieved in this case, a provisional fixed lower bridge was connected on the day of surgery. The procedure was completed under local anaesthesia after sedation and other comfort options had been discussed.
03
Definitive Upper Horseshoe Overdenture
After approximately six months of monitored healing, implant integration and tissue health were assessed before the definitive upper overdenture was made.
The metal-reinforced acrylic overdenture used the implants for retention and was designed with reduced palatal coverage where the clinical support permitted. It remained removable for daily cleaning and maintenance.
04
Definitive Lower Metal-Acrylic Implant Bridge
Following the healing and assessment phase, the lower provisional bridge was replaced with a definitive metal-reinforced acrylic bridge.
Using acrylic teeth over metal frameworks in both arches provided compatible opposing materials and a lower-cost restorative option than zirconia. Fit, cleaning access, speech and bite contacts were reviewed at delivery.
05
Periodontal Maintenance and Long-Term Care
Because of the patient's periodontal history, a three-month professional hygiene and clinical review interval was recommended initially, with timing adjusted according to ongoing findings.
Reviews included cleaning around the implants, checking tissue health, bite contacts, attachments and material wear. Daily removal and cleaning of the upper overdenture and cleaning beneath the lower bridge were demonstrated.