Case Study Lower immediate rehabilitation with Computer-Guided Keyhole Surgery and an All-on-4 Fixed Implant Bridge and upper staged rehabilitation with Bone Grafting and Fixed Implant Bridge on 6 implants    BEFORE   AFTER 1. The dentures fit loosely over the bare gums 2. Implants were placed using computer-guided surgery (Nobel-Guide) 3. The gums were closed with dissolvable sutures and comfort caps were placed whilst the teeth are fabricated. 4. An impression of the implants was taken. 5. Lower replacement teeth are fabricated using highly aesthetic high-impact acrylic 6. The lower replacement teeth are screwed to the implants. 7. Alveolectomy and bone grafting were performed in the upper jaw and left for 6 months to heal. The patient continued to wear her upper denture during the healing process. 8. After healing of the grafts, six dental implants were placed using Nobel-Guide computer guided keyhole surgery. Comfort caps were placed whilst the teeth were being fabricated. Note that there are no stitches with this keyhole surgical method. 9. In the next day, teeth were set in wax in and tried in over the implants to assess function, aesthetics, comfort and speech. Once all parameters are met, the case is sent for fabrication. 10. The upper replacement teeth are fabricated using highly aesthetic high-impact acrylic.

Case Study2 Upper rehabilitation with an immediate All-on-4 Fixed Implant Bridge before after 1. The patient presented with gum disease and failing bridges with recurrent tooth decay. Whilst 3 teeth were sound (left), they were sacrificed in order to avoid bone grafting and achieve and optimal result with alveolectomy aesthetic gum replacement. The lower bridge (right) was caved down destabilizing the bite. 2. Treatment involved removal of all upper teeth (except one back tooth), alveolectomy and an immediate all-on-4 restoration incorporating aesthetic gum replacement. The lower bridge (right) was replaced to the correct height for an optimal occlusion (bite). 3. The upper replacement teeth were removed 15 months after implant surgery to reveal complete healing and healthy gums. 4. The upper fixed replacement teeth were re-fitted over the implants for another 15-24 months before next review. 5. An x-ray was taken at 15 months showing angulated implants in the back, and straight implants in the front, placed using a conventional all-on-4 protocol. Before After

Case Study3 Simultaneous upper & lower rehabilitation with an immediate All-on-4 Fixed Implant Bridges before after 1. The patient presented with numerous missing teeth and dysfunction. He could not tolerate partial dentures. The remaining teeth were decayed and had gum disease. 2. All teeth were removed and immediate implant bridges were placed in the upper and lower jaws using conventional all-on-4 technique. The gums were closed with dissolvable stitches visible here above the top teeth. 3. A baseline x-ray was taken after surgery showing angulated implants in the back, and straight implants in the front, placed using a conventional all-on-4 technique. Note that this technique allows bypassing of nerve bundle in the lower jaw, and bypassing of deficient bone and sinuses in the upper jaw. Before After