Customized implants and All-on-4 in the rehabilitation of anodontia: A case report

This report aims to present the rehabilitation of a patient with complete anodontia in both jaws using a customized implant-supported prosthesis in the maxilla and the All-on-4 concept in the mandible.

A 21-year-old male presented with complete anodontia of both the maxilla and mandible. Initially, the patient reported impaired speech, poor chewing, aesthetic dissatisfaction, and social difficulties. Intraoral examination showed severely resorbed edentulous ridges; maxillary atrophy precluded zygomatic implant placement. Customized implants were used as an alternative. Over a 2-year period, the patient showed improved masticatory efficiency, maintained normal speech, and favorable esthetics. No biological or mechanical complications occurred. Bleeding on probing (BOP) was 0, implants remained stable, and radiographs confirmed osseointegration. The patient also received full-arch implant rehabilitation with a maxillary biocompatible high-performance polymer (BioHPP) framework supporting lithium disilicate crowns and a mandibular titanium framework with high-impact polymer composite (HIPC) crowns. Occlusal wear adaptation was observed on the HIPC crowns at the 2-week follow-up after final prosthesis delivery and remained stable at the 2-year follow-up. The mean OHIP-14VN score decreased from 30.0 at baseline to 8.0 at 2 years, while VAS for esthetic satisfaction increased from 5.0 to 10.0.

This case highlights the practicality, adaptability, and clinical benefits of combining a customized implant-supported prosthesis with the All-on-4 concept in patients with severe anatomical deficiencies. The outcomes suggest potential improvements in oral health-related quality of life and aesthetic satisfaction. The patient also successfully reintegrated socially and got married following treatment.