Toronto Bridge + All on 4 = Total rehabilitation of the edentulous patient

Patient history

Mr. Lucio contacted us at the beginning of 2016 on the recommendation of another satisfied patient. All I had was a panoramic x-ray showing a large atrophy of the bone on both jaws.

On radiography, a severe atrophy of the bone of both jaws is observed.

At that time, in such cases, most dentists in Chisinau proposed 2 alternatives: mobile prostheses or so-called semi-fixed prostheses. Semi-fixed prostheses are supported by several dental implants, but must be removed daily to be cleaned. We proposed the same solutions.

Fortunately for the patient, the treatment was postponed for almost 2 years. During this time we introduced new techniques in our practice and we managed to convince ourselves that they “work”.

Implant-prosthetic rehabilitation techniques and the temporary solution

In 2018, Mr. Lucio decided to start dental treatment in Moldova. I did a three-dimensional tomography so I could plan the treatment correctly. After a thorough analysis of 3D tomography, our surgeons proposed a solution that changed the patient’s life: FIXED TREATMENT.

The upper jaw was rehabilitated with the help Toronto Bridge techniques, which involves the insertion of 4-6 dental implants, “parallel” to each other.

For the mandible (lower jaw) the only possible solution was to insert 4 implants through All-on-4 technique. All 4 dental implants are in the frontal area, of which 2 are inclined to “bypass” the lower alveolar nerve. At the same time, due to the inclination of these implants, the pressure is distributed between the implants more evenly.

After insertion, the implants were checked with Mega ISQ – a special device used to check the stability of the implants. The values indicated by it allowed us to fix the temporary teeth on the newly inserted implants. Thus, Mr. Lucio began to enjoy new FIXED teeth, although temporary, even from the first days after the intervention.

On radiography temporary (plastic) teeth are practically not observed. Only a shadow and fillings can be seen that close the access holes (white spots above the implants). However, they are strong enough to mix with them.

The final result

Both final bridges (upper and lower teeth) were made of metal ceramic. For fixing them on dental implants, special accessories were used – MUA (multi unit abutment). MUAs allow the tensionless screwing of long bridges on implants that have axis divergences (which are not parallel to each other). In the All-On-Four technique they are mandatory, but for better results MUAs are recommended at any bridge on implants.

The end result is a very aesthetic and natural one, and Mr. Lucio is a very responsible patient and returns periodically to Moldova for controls and professional care of the new tooth.

Before and After replacing all teeth with dental implants. The final radiograph shows that the bridges are quite massive. However, in the photo the teeth are of normal size, and the result is very aesthetic. We obtained this result due to the use of pink ceramics to imitate the gum.