The all-on-4 implants are a well-established treatment approach considered for completely edentulous patients. Although they are more clinically significant in resorbed ridge cases, bone grafting can often be avoided. A 58-year-old male patient reported to the Department of Prosthodontics and Crown and Bridge with the complaint of difficulty in mastication and compromised facial esthetics. A clinical and radiographical examination with a cone-beam computed tomography (CBCT) scan was performed to evaluate the close proximity of anatomic structures to the planned implant position and also to assess the bone quantity. The CBCT scan showed severely resorbed maxillary bone, limiting the placement of a conventional implant. This case report demonstrates the esthetic and functional rehabilitation using the all-on-4 concept in a patient with compromised maxillary bone, which aids in the scientific literature. An all-on-4 implant treatment approach involved the placement of four implants – two in the premaxilla region and two posteriorly tilted at 45° to maximize bone support and avoid anatomical structures. Following the healing period of 3 months, a screw-retained hybrid prosthesis was fabricated, restoring the patient’s occlusion, function, and facial aesthetics with no biological or mechanical complications observed at follow-up. The patient expressed satisfaction with the prosthesis and reported effective mastication during function. This case report highlights the all-on-4 concept as a predictable, graftless treatment option for rehabilitating edentulous patients with severe maxillary bone resorption with a complete step-by-step prosthetic phase.
Doshi et al. (2026) studied this question.