From no bone to a full arch of dental implants

This patient attended our clinic suuffering with almost complete tooth loss in his upper arch. The few remaining teeth were of poor health and prognosis. He was waring a removable denture to continue with life, so that he could have a ‘smile’. His removable denture made eating, speaking and smiling very dfficult. Each day would be full of challenges – will he be able to eat certain foods in front of other people without it being embarassing for him? Will his denture move when he speaks to a client at work? Does he have the confidence to smile with his teeth on show when faced with a photo opportunity? These were the concerns raised to me by this patient. As is often the case, he presented to me with a similar set of problems that so many other patients have faced when attending my clinic for the first time.

He wanted to have permanent teeth. He didn’t want to live the rest of his life with a removable plastic denture.

We planned to provide him with 6 Straumann dental implants in the upper arch to support a permanent implant fixed bridge. We planned for something that we call an FP1 design. This is the term given to a type of implant supported prostheses that is ‘fixed’ in place and also one that has no ‘artificial gums’. In other words, the teeth fit directly into the gums and I would recreate a natural gum line for the patient, to provide him with the closes thing to natural teeth as is possible.

Bone loss due to missing teeth and abscesses.

The patient was excited at the prospect of having fixed teeth on dental implants. After assessment with a CBCT scan however, we found that he had almost no bone at all in many of the areas around his upper jaw. The presence of long standing abscesses coupled with areas that had teeth missing for many years had left his upper arch with very little to no bone. We couldn’t just simply place 6 implants in his upper arch with their beign such a lack of bone.

Instead we planned to provide a significant bone graft which enabled us to build the foundations required to support the future dental implants.

The stages of treatment were broken down in 3 sections or phases. The first was the bone grafting process, the most important process. Growing this much bone, from virtually no bone at all, take time. The body can only produce bone within the graft material at a given pace. There is no shortcut to this and patience really does pay off. We provided the bone graft and then waited 9 months for the graft to ‘harden’ and turn into ‘real’ bone.

At this stage we were able to place the 6 implants and then soon after (3 months later) the final implant supported bridge was provided.

By taking the patient approach, planning thoroughly and respecting biological principles – we were able to provide this patient with a permanent set of teeth in his upper arch. As close to nature as possible.

Is this life changing for our patient?

I’ll let you answer that…

Thank you for reading,

Mohsin Patel