An upper arch replaced in a day

The situation

Nine upper teeth left, every one of them loose to some degree from long-standing gum disease. Several had been splinted together. He had been quoted for a full upper denture by his own dentist and had come to us to ask whether there was any alternative, having watched his father wear a denture unhappily for twenty years.

The lower teeth were, by contrast, in reasonable condition — which mattered, because whatever went in the top had to bite against them.

What we suggested, and why

There was no case for saving individual upper teeth. The bone supporting them was too far gone, and rescuing two or three would have produced an expensive plan that failed in stages.

The realistic options were a full upper denture at around £1,600, or a fixed bridge on four implants at £12,500. He wanted to know why it was not six or eight implants. The answer is that four, when two of them are angled to pick up the denser bone at the front of the jaw, will support a full arch — and angling them meant avoiding a sinus graft that would have added months and cost.

We were explicit about one thing: the bridge would be a bridge, not fifteen separate teeth. It is cleaned underneath with a brush and a floss threader, and if he was not going to do that, the plan was the wrong one.

What we did: All-on-4, upper arch

Surgery took just under three hours under intravenous sedation. The remaining teeth were removed, the ridge was contoured, four implants were placed through a printed guide, and a temporary fixed bridge — already made in the laboratory from the planning scan — was adjusted and screwed into place the same afternoon.

He left the clinic that day with fixed teeth. Not a denture placed over the top, not a gap: a bridge fixed to the implants that does not come out.

Four months later the final bridge was made in titanium-reinforced acrylic, tried in, adjusted over two appointments for the way the teeth met and the way certain words sounded, and fitted.

Timeline

• Day 0 — extractions, four implants, temporary fixed bridge fitted the same day
• Week 1 — review and adjustment
• Month 4 — final scan and try-in
• Month 5 — final bridge fitted
• Month 11 — review with the hygienist

What it cost

£13,400: £12,500 for the arch, £540 for sedation and £360 for the extraction of nine teeth. Spread over 60 months at 0% APR, working out at £223.33 a month.

The treatment is described on All-on-4 implants and on same day teeth. Prices are on the costs page.

“I came in with teeth I was ashamed of and left the same afternoon with teeth. I keep expecting somebody to tell me there is a catch.”

Fictional testimonial on a concept site. Real patient testimonials in the UK are subject to GDC advertising guidance and require written consent.