Full-Mouth Rehabilitation of a Completely Edentulous Patient Using Four Axially Placed Implants per Arch With Delayed Loading: A Clinical Case Report With 12-Month Follow-Up
- 1Department of Prosthodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, IND
- 2Department of Periodontology, Swami Vivekanand Subharti University, Meerut, IND
Abstract
Comprehensive full-mouth rehabilitation of patients with extensive tooth loss requires careful integration of implant distribution, prosthetic design, occlusal reconstruction, esthetics, phonetics, and biological considerations to achieve a stable and functional outcome. A 55-year-old female patient presented with extensive tooth loss associated with compromised mastication, esthetics, and oral function and was considered for comprehensive implant-supported prosthetic rehabilitation. A prosthetically oriented treatment strategy was formulated in which the anticipated definitive prosthesis and desired occlusal relationships were considered during implant planning and restorative sequencing. Four implants were strategically placed in an axial configuration in each arch, providing an alternative to the posterior tilted-implant configuration commonly associated with four-implant full-arch concepts. Despite adequate primary stability, a six-month delayed-loading protocol was adopted to permit osseointegration before definitive functional loading. The prosthodontic phase incorporated multi-unit abutments, splinted open-tray impression making, verification of the master cast using a rigid verification jig and one-screw test, passive framework assessment, controlled maxillomandibular registration, and individualized occlusal development before delivery of screw-retained hybrid prostheses. At 12 months, all eight implants remained clinically stable and functional, with satisfactory prosthetic retention, occlusion, esthetics, and patient-reported masticatory function, and without clinically evident biological or mechanical complications. The significance of this case lies in the integrated use of four axially positioned implants in each arch with delayed functional loading and a structured prosthodontic verification workflow for bimaxillary hybrid rehabilitation. Although a single case cannot establish comparative effectiveness or long-term predictability, it illustrates a prosthetically driven approach for carefully selected completely edentulous patients in whom axial implant placement is anatomically feasible.
Related
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- Clinical outcomes and surgical applications of 3D-printed patient-specific implants for traumatic bone defects: a scoping review
- Retrospective clinical artificial intelligence-assisted study of loaded peri-implant versus edentulous bone
BibTeX
@article{srivastava2026fullmouth,
title = {{Full-Mouth Rehabilitation of a Completely Edentulous Patient Using Four Axially Placed Implants per Arch With Delayed Loading: A Clinical Case Report With 12-Month Follow-Up}},
author = {Shubham K Srivastava and Supriya Singh and Rabia Khan and Akshim Rana and Shilpi Asthana},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117481},
url = {https://doi.org/10.7759/cureus.117481},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Full-Mouth Rehabilitation of a Completely Edentulous Patient Using Four Axially Placed Implants per Arch With Delayed Loading: A Clinical Case Report With 12-Month Follow-Up
AU - Shubham K Srivastava
AU - Supriya Singh
AU - Rabia Khan
AU - Akshim Rana
AU - Shilpi Asthana
PY - 2026
DA - 2026/10/05
JO - Cureus
DO - 10.7759/cureus.117481
UR - https://doi.org/10.7759/cureus.117481
AB - Comprehensive full-mouth rehabilitation of patients with extensive tooth loss requires careful integration of implant distribution, prosthetic design, occlusal reconstruction, esthetics, phonetics, and biological considerations to achieve a stable and functional outcome. A 55-year-old female patient presented with extensive tooth loss associated with compromised mastication, esthetics, and oral function and was considered for comprehensive implant-supported prosthetic rehabilitation. A prosthetically oriented treatment strategy was formulated in which the anticipated definitive prosthesis and desired occlusal relationships were considered during implant planning and restorative sequencing. Four implants were strategically placed in an axial configuration in each arch, providing an alternative to the posterior tilted-implant configuration commonly associated with four-implant full-arch concepts. Despite adequate primary stability, a six-month delayed-loading protocol was adopted to permit osseointegration before definitive functional loading. The prosthodontic phase incorporated multi-unit abutments, splinted open-tray impression making, verification of the master cast using a rigid verification jig and one-screw test, passive framework assessment, controlled maxillomandibular registration, and individualized occlusal development before delivery of screw-retained hybrid prostheses. At 12 months, all eight implants remained clinically stable and functional, with satisfactory prosthetic retention, occlusion, esthetics, and patient-reported masticatory function, and without clinically evident biological or mechanical complications. The significance of this case lies in the integrated use of four axially positioned implants in each arch with delayed functional loading and a structured prosthodontic verification workflow for bimaxillary hybrid rehabilitation. Although a single case cannot establish comparative effectiveness or long-term predictability, it illustrates a prosthetically driven approach for carefully selected completely edentulous patients in whom axial implant placement is anatomically feasible.
SN - 2168-8184
ER -