All-On-4 Implants Supported Prosthesis with a Modified Approach: A Case Report of Upper Jaw Rehabilitation

Abstract

Young patients tend to prefer quick treatments and fixed restorations compared to older patients. Fixed reconstructions on implants now offer a variety of treatment options for various situations. However, despite the aesthetic and functional benefits, there are currently no clear clinical guidelines regarding the number of implants, loading type, and reconstruction type. Although various recommendations do exist, micro/macroscopic factors significantly influence treatment plans and surgical approaches in nearly every case. In this case report, we describe the rehabilitation of a triangular-shaped upper jaw of a 35-year-old non-edentulous patient using an implant-supported CAD/CAM designed prosthesis. Instead of using the All-on-4 method, five implants were inserted and immediately loaded after a series of extractions. The treatment plan involved placing three implants in the frontal region, with two tilted distally. The plan was designed not only to meet the patient's immediate demands but also to consider any possible future requests in the lower jaw. We also took into account the patient's current dentition and potential risk factors. As a result, we inserted a fifth security implant in the front region between the two front implants. The overall functional, aesthetic, and phonetic outcomes were satisfactory, and the patient expressed excellent satisfaction with the results.