Dental Implants
Carefully planned options to replace one tooth, several teeth or a full arch.
See real implant treatment decisions
Photographs show what treatment involved and why the final design was chosen. Explore the full case details, including before photographs and the options considered.
Full-arch rehabilitation
A patient with extensively compromised upper teeth was treated with a fixed implant solution. The case photographs show the restored smile and the starting condition; the full case explains the treatment context.
Considering a different implant problem? View the implant bridge case, where tooth length and gum display shaped the final FP2 design.
Dental Implant Treatment Options
What are dental implants?
Dental implants can be considered for replacing one missing tooth, several teeth or a full arch. Treatment uses titanium implant fixtures in the jawbone to support a crown, bridge or removable or fixed implant prosthesis. Suitability depends on your oral health, available bone, medical history, goals and ability to maintain the result.
Single missing tooth & small span bridges.
A single implant with a crown can replace one missing tooth. This is our most common procedure. If you have several missing teeth in a row, you can consider a dental implant bridge. This involves placing two or more implants that support multiple teeth. Sometimes, you may also need to replace the missing gum in these cases.
Full mouth implant treatment (Full arch treatment)
Full mouth dental implant treatment can replace all your missing teeth. This involves placing several implants that anchor your false teeth. You can choose from different types of false teeth, such as acrylic or zirconium, with or without titanium reinforcement. Some are fixed and some are removable. To find out the best option for you, talk to our expert implant dentist on the Gold Coast.
3 on 6
Three-on-Six generally uses six dental implants to support three separate fixed bridges across one arch. Dividing the teeth into three sections may make some repairs or maintenance more localised, whereas All-on-X usually uses one continuous full-arch bridge. Suitability depends on the available bone and gum, bite and aesthetic requirements.
Read our patient guide comparing Three-on-Six and All-on-X dental implants.
Hybrid Dentures – implant retained fixed and removable
These are advanced types of implant retained dentures. They can be either permanently screwed onto the implants or removable but supported by more sophisticated means. These include custom milled bars, telescopes and specially tapered conus abutments. These dentures feel as secure as fixed bridges, but you can remove them for cleaning. This can help prevent infection.
All on 4 : All on X
All on “x” treatment involves placing a minimum of 4 implants in the jaw and using them to support a bridge. Often a temporary bridge is used for 12 months + after which the final titanium reinforced porcelain/ or acrylic is delivered.
Implant retained dentures.
This treatment uses implants to stabilize a loose denture and make you more comfortable and confident with your false teeth. You can still remove your denture and it rests on your gum and jawbone, not the implants. The implants help prevent the denture from moving around. This is a great option for someone who has worn a full denture for a long time and has little bone left. You can also clean the implants easily by removing the denture. This can be harder with fixed (non-removable) options.
Another reason to choose this option is if you need a lot of facial support (lips, cheeks) to avoid a sunken face. Fixed implant bridges cannot support the face as much as removable dentures.
If your existing denture is good, you only need the implants and the components to attach them to the denture. If not, you need a new denture.
Patient case photographs: the smile and upper-right panel show the restored appearance; the lower-right panel shows the teeth before treatment. Individual treatment needs and results vary.
Comparison of Full Arch Treatments
Fixed implant solutions like fixed hybrids or all of 4 are very secure options and provide the maximum biting force and strength. On the flip side, since they cannot be removed by the patient, cleaning is difficult and requires extra visits for cleaning and maintenance with the occasional major visit for full bridge removal and cleaning.
Furthermore, if issues arise such as an implant needs replacement or a repair must be carried out, the entire bridge has to be removed for a few days.
Removable implant retained dentures offer a near fixed experience to the patient that they can clean at home and this helps prevent implant infections by being able to clean them daily. For patients who really want a fixed option, then the 3 or 6 approach is the best balance of both options. The bridge is split into 3 smaller units so if repairs are needed on one section or an implant needs replacement, the other sections remain unaffected.
Designing and verifying the final prosthesis
Working photographs from this case show the prosthesis outside the mouth from several viewpoints. They help assess tooth position, contours, the transition between teeth and prosthetic gum, occlusion and the location of the implant access channels before delivery.
Implant bridge: FP2 vs FP3 and alveolectomy to reduce a gummy smile
This case involved alveolectomy as part of treatment to reduce a gummy smile, together with careful review of the implant bridge design. The final restorations were FP2 bridges with longer teeth and no pink gum material.
Before treatment
The original photograph is small and has been kept at a modest size to preserve its clarity.
Final result — FP2
How the design developed
The patient initially wanted to preserve the gummy appearance she had always known and was concerned that teeth without pink gum material would look too long. Using our in-house 3D printing, we produced FP1, FP2 and FP3 prototypes so she could explore different tooth lengths and amounts of pink gum material before deciding on the final design.
With time to assess the prototypes and guidance from Dr Andrew Hamadi, she became comfortable with a different smile appearance. The final choice was an FP2 design with longer teeth and no pink gum material, creating the result shown above.
The bridge pictured below is a hybrid FP2/FP3 design from the development process, rather than the final FP2 restoration.
These photographs document different stages of one patient’s treatment. Lighting, framing and smile position differ between photographs. Treatment needs and results vary between individuals.
Full-arch treatment: the X-ray views
These paired panoramic X-rays show the same patient before and after upper-jaw implant placement. They illustrate the implant placement stage, rather than the final appearance of the replacement teeth.
Before implant placement
After implant placement
X-ray positioning differs between appointments. These images are shown together for context, rather than as an exact overlay.
A closer look at implant planning
The upper panel shows a digital planning view with virtual implants. The lower panel shows an X-ray following implant placement.
The coloured markers and alert icons belong to the planning software and have been retained in this image.
All-on-5 full-arch rehabilitation: provisional PMMA to final zirconia
This patient was treated with a fixed upper full-arch restoration supported by five implants. A provisional PMMA bridge was designed and milled in-house on our Roland DG 52DCi, allowing the bite, tooth position and function to be assessed before the definitive zirconia bridge was completed.
Provisional PMMA bridge
PMMA provisional bridge — intraoral close-up
Why the bridge could extend slightly further back
In this particular case, the slightly extended posterior cantilever was considered acceptable because there was no opposing lower molar contacting that region, giving a favourable bite for the extension. This is a case-specific design decision rather than a standard feature of All-on-5 treatment.
If there had been an opposing molar or greater posterior loading, we would generally have needed to shorten the prosthesis or consider additional posterior implant support, such as a sixth pterygoid implant where appropriate.
Every full-arch case is planned individually. Implant number, implant position, bridge length and material depend on bone, bite, opposing teeth and functional loading.
Associated Dental Implant Procedures
Bone grafting for implants
A pre-requisite of dental implant therapy is the availability of adequate bone. In some cases, there isn’t enough bone and so bone augmentation (grafting) must be performed. Bone grafting procedures can range is scope from straightforward to complex. In some cases, it must be carried out prior to the dental implant being placed, whereas in others it can be done at the same time.
Socket grafting
Once a tooth is removed, the socket remaining can be left to heal without intervention or grafted. In some cases, natural healing results in bone that is too thin to place an implant in. Preventative grafting at the time of extraction may save the need for future more complicated grafting or reduce the complexity of future grafting. Socket grafting after an extraction can occur on the day of tooth removal OR some weeks later. Factors such as pre-existing infection and how much bone has already been lost via infection can play a role in the decision. Note if delayed grafting is decided upon, then there is a narrow window of opportunity for it to be performed.
Sinus grafting
After an upper molar or premolar tooth is removed, the sinus cavity located above the teeth begins to expand into the jawbone once occupied by the tooth roots. When this occurs, there may not be enough bone left to place a dental implant. Fortunately, we can regain the lost bone by grafting into the sinus cavity such that implants can be placed.
Mixed evidence exists for the benefits of socket grafting at the time of tooth removal and it’s effectiveness is preventing the need for sinus grafting, which is typically a more complex procedure.
Soft tissue grafting for dental implants
There are two broad categories of gum types that lines our mouth and surrounds our teeth. One is thicker, the other thinner. The thicker type of gum tissue is the preferred type for surrounding both teeth and implants. When an implant is placed into an area that is lined by only the thin type of gum, a soft tissue graft can be performed to re-establish the thick gum layer that is beneficial for the health of the implant. A second reason to perform a gum graft is for a cosmetic improvement as the gum tends to sink in and shrink (lose volume) after an extraction and as we age. This can impact the appearance of the implant treatment. Finally, if a person is prone to gum recession, then gum grafts can aid is preventing the implant threads from showing, particularly after an infection.
Temporary teeth
Patients undergoing implant treatment often have lost a tooth and if its in the smile zone request a temporary tooth while waiting for the implant to integrate. Several options are available such as a temporary plate (denture), Essix (Invisalign style tray) denture and sometimes a temporary implant crown.
The temporary type having the LEAST impact on implant while it’s trying to heal is the Essix tray. Only a limited number of cases can have a temporary implant crowns and this depends of bone density.