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12 extrations plus All on 4 maxilar

This was a complex case that took 3 hours in total to perform and was done with the patient awake with only local anesthesia.

The patient's postoperative period was excellent and he reported that he did not feel any pain, he even felt very well because he had removed the teeth that had been bothering him for some time.


Patient was dissatisfied with the aesthetics of the teeth, positioning, shape and aesthetics of the smile. He came to consult about possibilities to recover his teeth, but when evaluated I noticed that he had extensive gum disease, teeth with grade 3 mobility and the presence of pus in almost all teeth.


We performed periodontal treatment to try to keep the teeth and recover oral health, we did the cleaning/scraping associated with antibiotic therapy.

We managed to make the tissue healthy, but the teeth did not come back to be firm, the patient reported that even if the teeth were firm, he did not like the smile and would like to have an aesthetic treatment.


I contraindicate aesthetic treatment on the patient's teeth due to the lack of bone support and that if he were to undergo an aesthetic treatment he would have to start aligning the position of the teeth and this would already cause the loss of several teeth.


I explained what the treatment possibilities would be and the patient opted for the removal of all teeth and installation of the protocol.


I started the procedure by removing the teeth, due to mobility I was able to remove all the teeth and detach the flap in 20 minutes and then I performed the upper protocol.

The sockets were all filled with bovine bone graft to avoid bone loss in the region causing a future problem for adaptation of the prosthesis.




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