Full-Arch Rehabilitation with
All-on-4

Patient profile and presentation

The patient is a 62-year-old female, lifelong non-smoker, controlled hypertension on medication, otherwise systemically well. She presented to Tower Dental Blackpool having become increasingly self-conscious about her smile and unable to eat with her existing upper partial denture, which she described as "constantly moving" and "embarrassing in social situations".

Clinical examination revealed: eight upper teeth remaining, six of which were periodontally compromised with grade II–III mobility, two with longstanding apical infections visible on periapical radiographs, and the existing chrome-cobalt partial denture poorly retained over remaining teeth that no longer offered effective support. The lower arch was largely intact and dentate, with sound periodontal support.

Patient priorities: stop the cycle of gradual tooth loss, regain the ability to eat normally, eliminate the visible front-tooth gap she found socially difficult, and avoid a full removable denture if at all possible. Cost was a major consideration, as was the desire to leave with fixed teeth on the day of surgery if clinically possible.

Clinical assessment and decision-making

A CBCT scan and full clinical assessment confirmed the upper-arch teeth were not realistically salvageable — periodontal bone loss, recurrent infections and the costs of trying to save individual teeth would have totalled close to the cost of a full-arch implant solution within 5–10 years on conservative projections.

Three options were costed at consultation:

Option 1 — Full upper denture (conventional). Fastest, lowest upfront cost (£800–£1,200), but the patient had explicitly stated she did not want a removable solution.

Option 2 — Implant-retained overdenture (4-implant locator). Removable but stable. Approximately £6,800. Compromise on the "fixed teeth" priority.

Option 3 — All-on-4 fixed full-arch bridge. Same-day teeth, fixed, no removable component. Approximately £9,800.

Bone volume on CBCT was favourable in the anterior maxilla with adequate height (>10mm) and width (>5mm) at the four planned implant sites following the standard All-on-4 protocol (two anterior axial, two posterior tilted).

The patient elected Option 3 — All-on-4 — and her V12 Finance application was approved at the consultation for 10 months at £980/month.

Treatment provided

Visit 1 — Consultation, CBCT, treatment planning (£40). Including digital impressions, photographic records and treatment-plan agreement.

Visit 2 (week 6) — Surgery and same-day fixed teeth. All eight remaining upper teeth extracted under local anaesthetic with conscious oral sedation. Four implants placed (two anterior axial, two posterior tilted at 30° per the All-on-4 protocol). Surgical time 2h 35min. A pre-fabricated screw-retained acrylic temporary fixed bridge was fitted the same day. The patient left the practice with fixed teeth.

Visit 3 (week 7) — Post-op review. Healing as expected, no infection, sutures removed. Patient eating soft diet successfully and reported no pain after day 3.

Visit 4 (week 12) — Integration assessment. Resonance frequency analysis showed all four implants successfully integrated (ISQ readings 72, 76, 74, 73). No signs of peri-implant infection.

Visit 5 (week 18) — Final-bridge impressions. Open-tray impression for the definitive prosthesis; bite registration; shade selection.

Visit 6 (week 22) — Try-in. Aesthetic and functional try-in of wax mock-up and metal-resin verification framework.

Visit 7 (week 24, 6 months from consultation) — Final-prosthesis fit. Definitive screw-retained metal-acrylic full-arch fixed bridge fitted, occlusion verified, photographs and bite registration recorded.

Outcome and measurable data

Total chair time: 8 hours 40 minutes across 7 visits. Total elapsed time from consultation to final prosthesis: 24 weeks (6 months). Implants integrated: 4/4 (100%). Same-day fixed teeth: Yes (the patient left with non-removable fixed teeth on the day of surgery). Patient diet at 6 months: unrestricted; reports comfortable mastication of all food types tested. Patient self-reported satisfaction at the 12-month review: 10/10. Quote in clinical record: "I haven't smiled this much in 20 years." Aesthetic outcome: symmetrical anterior smile-line, gingival contour clinically appropriate, midline within 0.5mm of facial midline.

This case is consistent with Tower Dental's broader All-on-4 outcomes: of the All-on-4 cases delivered between 2023 and 2025 at the practice, the recorded same-day fixed-teeth success rate is 100% and the recorded 12-month implant survival is 100%.

Aftercare and long-term plan

The patient was enrolled on the Tower Dental adult plan (£19.60 per month) covering routine examinations and hygienist appointments. A 6-monthly recall programme is in place. The fixed bridge can be removed at recall by the clinician for deep cleaning where indicated; this typically takes place at the 12-month and 36-month reviews and after that on a clinical-need basis.

The acrylic teeth on the fixed bridge can be replaced after 7–10 years of normal wear without replacing the underlying metal framework — this is an important distinction from porcelain prostheses and substantially extends the long-term cost-effectiveness of the All-on-4 solution.

Cost breakdown

10-month V12 Finance: £980/month interest-free, subject to status (approved at consultation).

Talk through your own case

If you have multiple failing teeth or an existing full upper denture you cannot tolerate, the £40 consultation at Tower Dental Blackpool will give you a clear, costed answer on whether All-on-4 is right for you. The CBCT scan included in the consultation determines bone availability and confirms (or rules out) suitability.

Dr San Chatterjee places All-on-4 cases at Tower Dental and holds the MID from the Royal College of Surgeons Edinburgh. The practice has delivered the All-on-4 protocol since 2023 with a 100% recorded same-day fixed-teeth success rate.

Call 01253 353759 to book a consultation. The £40 fee is credited against any treatment booked.