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An All-on-4® treatment concept on a patient who had a stroke.

Medical history

Patient had stroke also known as cerebrovascular accident (CVA), cerebrovascular insult (CVI), or brain attack , a couple of years ago and presented with debilitated in motor function . Controlled hypertension, and  diabetes. Patient was suffering from depression, anxiety, frustration, and anger after  her stroke.

Patient profile;  Female 59 years of age .

Relevant Dental History

No experience of  wearing dentures . Severe periodontal disease leading to progressive tooth loss.

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Patient came in with this severe periodontal condition.

Treatment Plan

As the result of the patient’s progressive tooth loss, we suggested the All-on-4® treatment concept on both upper and lower jaws. Nevertheless due to patient’s physical condition, we scheduled a short, stress-free early morning appointment. We also decided to start with the lower dentition with the All-on-4® treatment concept and to let patient use a full upper complete denture after all her existing teeth were extracted.

Surgical and Prosthodontic treatment within a day .

The extractions of all the compromised teeth in both upper and lower and the surgery using the All-on-4® treatment concept surgery was carried out by Dr. Kamsiah in the lower arch with a fixed provisional acrylic prosthesis and provided the patient with Immediate Function on the day of the surgery at our clinic .

Extractions of all the compromised teeth.
Extractions of all the compromised teeth.
A 3D CT view of the case. It allows a three-dimensional and cross sectional views of the implant placements, bone, nerves, and tissue.
A 3D CT view of the case. It allows a three-dimensional and cross sectional views of the implant placements, bone, nerves, and tissue.

The upper arch was provided with an immediate full denture since patient can’t afford an extended treatment within a day. A few minor adjustments periodically on her provisional prosthesis and her upper denture. Patient was advised to be on soft food for the next two weeks.

With product support from Nobel Biocare, you too can place teeth on the same day as surgery, in a simple, safe and fast procedure.
With product support from Nobel Biocare, you too can place teeth on the same day as surgery, in a simple, safe and fast procedure.

Conclusion:

This patient told us it was the first time in years she felt confident about her smile and was happier. Her depression, anxiety, frustration, and anger after a her stroke have also decreased significantly. This patient entered my clinic with severely compromised teeth due to her periodontal problems, neglect and emotional turmoil  and left the same day with a fixed implant-based provisional restoration that looks and feels like a full set of natural teeth.

The final prostheses were delivered to patient after 3 months.

The use of four implants also makes it easier to achieve passive fit, which is of critical importance whenever a cantilever is called for. The use of four implants reduces treatment complexity, which has many benefits. Costs for both the doctor and the patient are reduced because less surgical time and product are used.

Your team including our lab technicians and equipment are all in one patient-centered facility. That’s one of the advantages that we have. The technicians work in our clinic so that we could do our recordings and try-ins to achieve the smile that patient always wanted.

Dr Kamsiah G Haider BDS, MDSc

A dentist , a continuous education junkie and inspiring other dentists to be a real dentist ! Who do you want to help you improve your smile if you are looking for a dentist? Dr. Kamsiah also known as Dr. Kam is cosmetic dentist with over 30 years experience . As a Master and Instructor of the Digital Smile Design , together with dental implantology , prosthodontics and orthodontics I have the experience and knowledge to handle the most complex cases in cosmetic dentistry. Oral reconstruction, rehabilitation with or without dental implants and conscious sedation dentistry all in one place. She earns her membership of the International Association for Orthodontist (iAOi) in 2014. She has been a Diplomate of the American Board of Prosthodontics and Implantology (ICOI) since 1997. She's into guided surgery and full mouth rehabilitation on failed dentition also known as teeth in a day with the help with digital dentistry. Something she's passionate about since embarking into private practice 23 years ago. Dr. Kamsiah was a full time lecturer at the University of Malaya and an Associate Professor at the International Islamic University and lectures on prosthetics , the All-on-Four concept and recently on the Digital Smile Design. Specialties: Prosthetic Dentistry, Dental Implants, Cosmetic Dentistry, Orthodontics, Invisalign, Bone-Screw Orthodontics, AO4, Teeth in one day.

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