Full Mouth Rehabilitation with All-on-4 Implants Using Paulo Malo Technique – A Case Study

Introduction 

Full mouth rehabilitation is a life-changing solution for patients with extensive tooth loss or failing dental prostheses. At Suman Dental Care, we recently treated a 63-year-old female patient who came with concerns about her full-mouth bridge supported by periodontally weak abutments. She experienced mobility of the bridge and difficulty in chewing, impacting her overall quality of life. 

After a thorough medical and dental assessment, a customized treatment plan was created to restore function, aesthetics, and comfort using the All-on-4 implant technique with the Paulo Malo approach for the upper jaw. 

Patient Assessment & Treatment Planning 

Chief Complaint: Mobility of full-mouth bridge and difficulty in chewing 

Medical Considerations: The patient was in a postmenopausal state, leading to vitamin deficiencies, for which Vitamin D and B-complex supplements were prescribed. 

CBCT Analysis: Revealed bone deficiency in the maxilla, requiring modification of the treatment plan to include bone grafting before implant placement.

Surgical Phase – Implant Placement & Bone Graft 

Maxillary Treatment Plan: 

Removal of bridge and periodontally weak abutment teeth. 

All-on-4 implant placement with varying angulation for better stability 

Bone grafting to compensate for maxillary bone loss

Post-Surgery Management: 

The patient experienced swelling at the bone graft site, which was effectively managed with steroids for a week and other supportive medications. 

Swelling completely subsided within a week.

Prosthetic Phase – Restoring Function & Aesthetics 

After three months, follow-up assessments confirmed successful osseointegration of the implants. The next steps included: 

1. Open impression using parallel pins for precise framework fit

2. Temporary prosthesis provided to establish jaw relations

3. Jig trial with bite block to ensure occlusal accuracy

4. Metal framework trial, followed by final prosthesis delivery

Final Outcome & Patient Satisfaction 

The patient was extremely satisfied with the outcome. She regained proper chewing function, stability, and confidence in her smile. The All-on-4 approach with the Paulo Malo technique proved to be an effective and minimally invasive solution for full-mouth rehabilitation, even in cases of bone deficiency. 

Conclusion 

At Suman Dental Care, we prioritize customized treatment plans to ensure optimal patient outcomes. This case demonstrates the effectiveness of All-on-4 implants with bone grafting in restoring oral function and aesthetics for patients with severe bone loss and failing prostheses. We have also placed a video presentation for this case for reference. 

If you're facing similar dental challenges, book a consultation with us today to explore personalized treatment options!