[Health Column] 15 Steps to Restoring a Full-Arm Case with Poor Prognosis of Remaining Teeth Using Temporary Dentures and Implant Prosthetics

 

Hello, I am Hong-yeol Moon, Chief Director of Seoul Barun Implant Dental Clinic. 🦷

 

This patient visited the clinic with severely loose teeth and a poor prognosis for the remaining teeth, making eating very difficult. Upon initial examination, a combination of periodontal disease, cavities, and tooth fractures was confirmed, and it was a situation where it would be difficult to stably restore overall function by treating only a few teeth.

 

I first evaluated the preservation potential of the remaining teeth one by one, identified those requiring extraction, and used temporary dentures to maintain basic function and appearance during the treatment period. Subsequently, I established a full-mouth reconstruction plan that proceeds in stages, from implant placement and alveolar bone grafting to final prosthetics.

 

Since full-mouth cases do not end with a single surgery but go through several stages, I will summarize what was checked and what decisions were made at each stage, along with photos.

 

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🦷 Treatment process in photos

 

📸 Photo 1 — Initial Panoramic

Checked the condition of the entire upper and lower jaws, teeth, and alveolar bone at the time of visit

I examined the condition of the teeth throughout the upper and lower jaws using the initial panoramic X-ray. Several teeth were severely damaged, and the remaining alveolar bone and tooth support were also poor. Upon reviewing the image, I determined that comprehensive reconstruction was necessary rather than partial treatment.

 

📸 Photo 2 — Oral photo before treatment

Accompanied by tooth misalignment, fracture, and gum inflammation

This is a photograph of the oral cavity taken before treatment. Inside the actual mouth, we could confirm that the tooth alignment had collapsed and that fractures and gum inflammation were progressing in combination. Since full-mouth cases affect the patient's eating, pronunciation, and appearance, overall daily discomfort must be taken into account when establishing a treatment plan.

 

📸 Photo 3 — Extracted tooth

Teeth that were difficult to maintain for a long time

These are the extracted teeth. As you can see in the photo, several teeth were already in a condition where long-term preservation would be difficult. I determined that rather than simply leaving as many teeth as possible, it was more important to remove the teeth causing inflammation and create an environment where the prosthetics could function stably.

 

📸 Photo 4 — Panoramic view after tooth extraction

Reconfirmation of remaining bone and oral structure after trimming problematic teeth

This is a panoramic X-ray taken after tooth extraction. It is a process of re-examining the remaining bone and oral structure after removing the problematic tooth. At this stage, the general direction regarding the placement of future implants and the application of temporary dentures has been determined.

 

📸 Photo 5 — Oral photo after tooth extraction

Missing Tooth Space · Timing of Temporary Denture Application

This is an oral photograph taken after tooth extraction. Immediately after treatment, the patient may feel psychologically burdened due to the large gap left by the missing tooth. Therefore, I utilized a temporary denture during this period to help maintain basic appearance and function throughout the treatment.

 

📸 Photo 6 — Temporary dentures applied

Improves eating, pronunciation, and aesthetics during the gum recovery period

This is a photo showing the application of a temporary denture. A temporary denture is not merely a device to improve appearance during treatment; it is an important step that temporarily compensates for eating, pronunciation, and aesthetics during the gum recovery period. It also serves as a reference when planning the final form of the implant prosthesis later on.

 

📸 Photo 7 — Implant Placement and Alveolar Bone Graft

Surgery that considers both implant placement and bone reinforcement

This is a scene showing the implant placement and alveolar bone grafting. In full-mouth cases, the relationship between each implant is crucial. I performed the surgery by considering both the placement and bone reinforcement to ensure the final prosthesis could withstand loads stably.

 

📸 Photo 8 — Panoramic view after implant placement

Confirmation of the entire maxillary implant location

This is a panoramic X-ray taken after implant placement. It allows for a comprehensive view of the implant positions in the maxilla. This intermediate verification process is crucial for adjusting the next stage of surgery or the prosthetic design.

 

📸 Photo 9 — Additional implant placement and alveolar bone graft

Proceed in stages while monitoring recovery status

This scene shows the placement of additional implants and alveolar bone grafting. Full-mouth reconstruction is often performed in stages, monitoring the patient's recovery progress, rather than being completed in a single surgery. I proceeded with each stage carefully, ensuring stability without overexerting myself.

 

📸 Photo 10 — Panoramic view after additional mandibular implantation

Arrangement of maxillary and mandibular implant placement · Completion of the basic structure of the final prosthesis

This is a panoramic X-ray taken after additional implants were placed in the lower jaw. With the placement of the upper and lower implants finalized, the basic structure for the final prosthesis has been established. From this stage onwards, the occlusal relationship between the temporary and final prostheses is planned in more detail.

 

📸 Photo 11 — Panoramic view of implant placement completion

Verification of the stability and supporting structure of each implant

This is a panoramic X-ray taken after the implant placement was completed. We verified that each implant is stably positioned and that the structure is capable of supporting the final prosthesis. In full-arch cases, this verification is directly linked to the success of the final prosthesis.

 

📸 Photo 12 — Reapplication of temporary teeth during treatment

Temporary prosthetic adjustment considering pronunciation, eating, and appearance

This is a picture showing the temporary teeth reapplied during the treatment period. In long-term treatment, it is important to adjust the temporary prosthetics in stages to minimize discomfort for the patient in daily life. During this period, I managed the temporary prosthetics while considering pronunciation, eating, and appearance.

 

📸 Photo 13 — Panoramic view after treatment completion

Structure for connecting the entire upper and lower jaw prosthetics and restoring masticatory function

This is the panoramic X-ray after the completion of treatment. The entire upper and lower jaw prosthetics are connected, creating a structure capable of restoring chewing function. This is a case where the restoration was completed not merely by increasing the number of teeth, but by considering the overall occlusion and masticatory balance.

 

📸 Photo 14 — Oral photo after treatment

Arrangement of tooth alignment and prosthetic shape

This is an oral photograph taken after treatment. Compared to before treatment, the alignment of the teeth and the shape of the prosthetics have been refined, restoring both the patient's appearance and function. For full-mouth prosthetics, regular occlusal checkups and hygiene management are very important even after treatment.

 

📸 Photo 15 — Before and After Treatment Comparison

Comparison of prosthetic structures before and after treatment

These are before and after comparison photos. Initially, the patient experienced discomfort with both eating and appearance due to tooth damage and gum issues, but after treatment, you can see that the prosthetic structure has been restored to a more stable state. Through such before-and-after comparisons, I explain to the patient the significance of the treatment and the necessary future care.

 

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🪥 About post-treatment care

Although implants do not develop cavities like natural teeth, the accumulation of plaque and food particles around the prosthesis can lead to gum inflammation or peri-implantitis. Therefore, after treatment, it is essential to carefully manage the boundary between the prosthesis and the gum using auxiliary devices.

 

 

 

 

🗣️ Frequently Asked Questions (FAQ)

Q1. How long does full-mouth implant treatment take?

A. In cases like this, where both tooth extraction and alveolar bone grafting are required, the procedure is divided into several stages to allow time for the gums and bone to recover. Since the duration may vary depending on the remaining bone volume, the extent of inflammation, and the patient's overall health, a plan is established following a precise diagnosis.

 

Q2. Do I have to live without teeth while receiving treatment?

A. No. In this case as well, we applied temporary dentures immediately after extraction and temporary teeth after implantation in stages. We plan for temporary prosthetics to maintain eating, pronunciation, and appearance throughout the treatment period.

 

Q3. Isn't it better to save the remaining teeth as much as possible?

A. The principle is to first assess the possibility of preservation. However, if teeth that cause inflammation and are difficult to maintain in the long term are left in place, the prosthesis may also become unstable later on. The judgment is based on the stability of the overall structure rather than the number of teeth.

 

Q4. Does the follow-up care end once the treatment is finished?

A. Post-treatment care is more important for full-mouth prosthetics. Since peri-implantitis and occlusal changes progress gradually, they can be maintained without major problems if detected in advance during regular checkups.

 

To summarize this case

This treatment goes beyond simply filling the empty space; it is a step-by-step process conducted after assessing the condition of the remaining teeth and gum bone to ensure stable prosthetics in the long term.

 

Even for implants in the same area, treatment methods and duration may vary depending on residual bone volume, the extent of inflammation, occlusal status, and overall health; therefore, a precise diagnosis and sufficient consultation are required before treatment.