All-on-4® Case Study

Review this patients case with us to better understand how All-on-4® treatment works and what the patient goes through during treatment.

This patient presented to NC Prosthodontic Specialists very unhappy with his smile and was ready to undergo treatment to achieve the smile of his dreams!  The patient was ready to get rid of the active infection present in his mouth and improve his oral health; as well as improve his smile to allow full confidence in his life. Following the initial consult, it was decided that unfortunately the remaining teeth were not usable and a full mouth tooth replacement therapy was necessary to achieve his goals. 


The treatment decided on by both Dr. Bill Scruggs and our patient was an immediate solution on both arches to remove the bad teeth, place implants and provide non-removable teeth in the same day so that the patient could avoid wearing a denture all together.  The plan was to use an All-on-4® treatment concept in the lower arch which is described below.

The 3D CT scan (Cat Scan) made in office revealed that the patient was a candidate for the All-on-4® treatment concept to provide a bridge supported on 4 implants for the patient. The advantage of this treatment for the patient (as described more in detail here) is that an entire row of teeth can be supported by 4 implants while still avoiding vital anatomic structures that could have prohibited this type of treatment in the past.  Here is a before and after picture of the x-ray showing the 4 implants.


The patient presents on the day of the procedure ready to begin his journey to achieve his dream smile.  In about 4 hours of total time in the office, the lower teeth were removed, the implants placed, and immediate teeth were delivered that are secured by the implants and the patient was able to leave that day avoiding a lower denture.  The patient underwent the procedure with ease under local anesthesia. If he chose to do so, Deeper sedation such as IV sedation is available if necessary.  Below are how the patient presented the day of the procedure and how the patient went home.


Throughout the healing process, our patient was able to wear permanent fixed teeth that were not removable which has several advantages.  

  1. The patient is able to avoid a denture 

  2. The wound is protected and the post operative discomfort is greatly reduced

  3. The patient is confident even the day after the procedure in public because the teeth are secure and rigid

After the implants were fully healed, final permanent fixed bridges were fabricated in house by our in-house laboratory technicians and customized through try-in procedures to the patient’s liking.  Our patient was able to choose the size, shape, and color of his teeth during this process.  The patient was very pleased with the final esthetic result and the patient’s oral health was greatly improved by removing infection.  Below are photographs of the patient at the end of treatment.


Before and after