Rehabilitation of a patient with severe dental phobia using the All-on-4 protocol

1. The patient came to the clinic with severe dental phobia and a request for full functional and aesthetic rehabilitation of the dentition. Due to the long-term avoidance of dental treatment, there was a generalized carious process with the destruction of all the remaining teeth to a degree that could not be restored.

1. In addition, several teeth were already missing from the oral cavity, previously removed.

1. After a thorough diagnosis, a protocol for full rehabilitation using the “All-on-4” concept was proposed for both jaws. The treatment plan included: • removal of all remaining teeth in the oral cavity; • one-stage installation of 4 implants on each jaw with optimal angulation of the distal implants; • early loading in the form of metal-composite structures supported by titanium beams.

1. During one surgical visit, total teeth extractions were performed with minimal trauma and eight implants were installed (4 for the upper and 4 for the lower jaw).

1. A few days after the surgery, after the healing stages were completed and the stability of the implants was checked, temporary metal-composite prostheses with screw fixation were fixed.

1. The patient noted a significant improvement in the quality of life, the disappearance of the feeling of embarrassment when smiling and the restoration of chewing function.

1. Aesthetic and functional indicators correspond to a high level of rehabilitation, which is confirmed by both the clinical assessment and the high satisfaction of the patient.

1. Final result.