Case 42: All on 4 maxillary arch- Immediate loading- Straumann system

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Case 42: All on 4 maxillary arch- Immediate loading- Straumann system

 All on 4 is an excellent graftless solution for cases where there is no bone in the posterior segments in the maxillary arches. Engaging bicortial stabilisation is important for an excellent stability.

Here is a case of maxillary arch with recently extracted maxillary arch- total extraction. After CBCT analysis, An all on 4 solution was discussed with the patient and planned for an immediate loading prosthesis. However, since the patient did not have much time we could not make a conversion prosthesis. But instead, went ahead with the surgical and provisional acrylic prosthesis immediately.

The entire procedure was done under local anesthesia. The use of an all on 4 guide stent from Straumann was used for the initial drilling. In this case the osteotomy was carried out at sites of 1.2 and 2.1 for axial implants and 2.5 and 1.5 region for the distal angulated implant. Once the placement was done, impression copings were connected with pattern resin and a trayless impression was made using addition silicone. Further steps involved a jig-trial to check the accuracy of the impression, followed by jaw relation and trial. Finally the acrylic provisional fixed prosthesis is fabricated and night gueard is given after completion of the case.












This case was done by me at Parasu Dental Hospital, Chennai.

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