Case presentation: full mouth implant treatment via a trio of modalities.

Mr. P is a 69-year-old male who presents with a chief complaint of, “I have neglected my teeth for 20 years and I’d like to have them fixed.” He is a lifelong nonsmoker, in good health, with no known drug allergies and no significant past medical history. Dental findings are notable for significant edentulousness: teeth numbers 1, 2, 3, 5, 7, 10, 13, 16, 17, 18, 19, 20, 30, 31, 32 are not present. Fixed acrylic/gold restoration supported by teeth numbers 4, 6, 8, 9, 11, 12, 14, 15 at the maxilla; no mandibular restorations are present. Oral examination of the hard tissue reveals failure of maxillary restoration due to recurrent root decay of all supporting abutments and lack of posterior occlusion. Mandibular premolars exhibit excessive occlusal wear. Lower anteriors exhibit incisal wear and class I mobility. The soft-tissue exam is significant for generalized inflammation and plaque buildup. Lower anteriors exhibit hard and soft-tissue loss, more likely secondary to traumatic occlusion than active periodontal disease. Based on the above findings, a treatment plan was discussed with the patient and included the following: 1. Extraction of maxillary teeth with socket preservation and placement of transitional full denture; 2. Periodontal treatment of remaining mandibular teeth; 3. Restoration of mandibular premolars; 4. Replacement of mandibular posterior teeth with implants and fixed restorations; 5. Replacement of maxillary teeth with implants and fixed restorations; 6. Occlusal guard.