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Successful Cases

All on X, Zygomatic Implants and Pterygoid Implants
Dental Implants
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All on Four - Zygomatic implants

Sherryl Case - Upper Full-Arch Bridge using Zygomatic Implants

Sherryl has been a loyal patient of Brighton Implant Clinic since 2009, when she first met Dr. Silva for her lower All-on-4 implant. Living with psoriatic arthritis and osteoporosis, Sherryl needed a clinic that understood her needs, and Brighton Implant Clinic delivered exceptional results - at just a third of the cost compared to other clinics. Fast forward to 2024, she returned for an upper full-arch bridge, overcoming her health challenges thanks to Dr. Silva's experience and advanced dental technologies.

Sherryl’s story is a powerful reminder of why staying local for dental implants can be the best choice. With a trusted clinic nearby, she enjoyed personalized care every step of the way, without the need to travel abroad. Watch her inspiring story and see how Brighton Implant Clinic makes a real difference for patients in the UK.

ALL ON FOUR - ZYGOMATIC IMPLANTS

A Full-Arch Bridge for a Patient with Psoriatic Arthritis and Osteoporosis

Dr. Bruno Silva
DENTIST

Living with chronic illness often brings challenges that go far beyond physical symptoms. For our 62-year-old patient, a long-standing history of psoriatic arthritis and osteoporosis didn’t just affect her joints and bones—it impacted her ability to smile, eat, and feel confident in daily life.

Her upper denture had become increasingly unstable. Difficulty chewing, impaired speech, and frequent soreness made it clear: she needed a long-term solution. But with her complex medical background, this wouldn’t be a typical full-arch restoration.

A Complex Case with Clear Goals

From the first consultation, it was evident that this patient’s case required a highly tailored approach. In addition to the discomfort caused by her denture, she also struggled with limited manual dexterity, making removable appliances difficult to manage. The diagnosis of osteoporosis raised further concern about bone density and implant success, while her immunosuppressive medication for psoriatic arthritis added layers of risk to the surgical process.

Goals of Treatment:

  • Provide a fixed, stable full-arch restoration
  • Minimise surgical trauma
  • Ensure longevity despite compromised bone quality
  • Create a prosthetic design that’s easy to maintain with limited hand function
Fig. 1 - Close up on dental implant screw inserted into the gingiva.

Multidisciplinary Planning: Building the Foundation

A case like this required collaboration—not just between prosthodontist and oral surgeon, but also her rheumatologist and general physician. We conducted a thorough CBCT scan, revealing significant maxillary bone resorption and close proximity to the sinuses, making implant placement in the posterior region challenging.

Treatment considerations included:

  • Avoiding sinus augmentation if possible
  • Selecting implants with a design optimised for lower bone density
  • Using a minimally invasive approach to reduce post-operative inflammation and healing time
Fig. 1 - Close up on dental implant screw inserted into the gingiva.

Precision Meets Compassion: The Surgical Approach

Using computer-guided implant placement, we placed six implants in the upper jaw—strategically avoiding sinus areas and ensuring maximum use of remaining bone. A flapless surgical approach helped minimise trauma, allowing for quicker healing and reducing discomfort.

Following the integration period, a custom-milled zirconia bridge was placed. It was screw-retained for retrievability and designed with concave intaglio surfaces for easier hygiene access.

A Functional and Aesthetic Transformation

The final result was more than a set of teeth—it was a transformation of daily life. She could eat comfortably, speak clearly, and no longer worried about dentures slipping during conversations. The design of the bridge allowed her to clean and maintain it with ease, despite her limited finger movement.

Her words said it best:

“I finally feel like myself again. No more worries about movement or discomfort.
It’s changed everything.”

Clinical Reflections

This case is a clear reminder that dental implant therapy is not one-size-fits-all.

For patients with autoimmune or systemic bone conditions, successful outcomes depend on precision planning, interprofessional collaboration, and a deep understanding of both anatomy and the patient’s lifestyle.

Key Takeaways

  • Dental implants can be successfully placed in patients with osteoporosis and arthritis with proper planning.
  • Guided surgery and minimally invasive techniques are valuable tools for medically complex cases.
  • A customised prosthetic design can significantly improve hygiene access and long-term maintenance.
  • A collaborative, patient-centered approach leads to the best functional and emotional outcomes.
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