Transforming Oral Health and Confidence

Full-Arch Rehabilitation

Patient: 36-year-old male
Chief Complaint: “Pain in my teeth, I don’t smile anymore.”

Background:

This young patient presented with a history of dental neglect, multiple missing and decayed teeth, and a profound impact on his emotional well-being. During the consultation, he shared his struggle with depression and social isolation, stemming largely from his deteriorating oral condition. He had consulted multiple providers but felt disconnected from their proposed treatment paths.

His goals were clear: eliminate pain, regain confidence, and reclaim his ability to socialize, smile, and eat without shame.

Clinical Examination & Findings

  • Multiple missing maxillary teeth
  • Remaining maxillary teeth showed severe caries, mobility, and periapical pathology
  • IO scan and CBCT confirmed:
  • Teeth 11 and 21: Grade 2 mobility
  • Teeth 16 and 26: Large periapical lesions, cervical decay
  • Tooth 15: Grade 2 mobility
  • Teeth 13 and 23: Mostly intact, required only conservative restorations

Treatment Plan

After an in-depth review of all possible restorative options, including segmental prosthetics and removable appliances, the patient elected to proceed with a full-arch, implant-supported fixed prosthesis. He was fully informed that additional procedures might be needed over time, but he expressed a strong desire for a definitive and aesthetic solution.

Surgical and Prosthetic Protocol

  • Anesthesia:
    Local anesthesia with IV sedation

  • Surgical Phase:
    Extraction of all remaining maxillary teeth
    Placement of 4 dental implants in areas with viable bone
    PRF and bone grafts used to augment defects and enhance healing
    Immediate Load: A provisional prosthesis was delivered immediately post-surgery.

Prosthetic Staging:

10 weeks:
Bulky initial prosthesis replaced with a milled PMMA provisional for improved fit and esthetics
16 weeks:
Final monolithic zirconia prosthesis delivered

Outcome

The transformation was not merely functional or aesthetic, it was deeply personal. The patient reported a significant reduction in depressive symptoms, lower reliance on antidepressants, and an overall brighter outlook on life.

He now smiles freely, engages socially, and has rediscovered the joy of sharing a meal with others.

Reflections
This case is a powerful reminder that dentistry is human work. Beyond restoring teeth, we have the privilege of helping patients rediscover themselves, restoring dignity, health, and hope.