Preoperative retracted view.

Teeth extracted, bone healing.

Six upper implants placed.

A fixed (non-removable) temporary bridge. This will serve as the prototype for the wax-up (mock-up) and the final zirconia hybrid (All-on-4).

Full face picture of fixed (non-removable) temporary bridge. This will serve as the prototype for the wax-up (mock-up) and the final zirconia hybrid (All-on-4).

This is the master cast of the upper jaw with implants, also known as a working model or a replica.

Frontal view of mock-up in wax and plastic. By using the photographs and model of the temporary bridge the laboratory makes any changes the dentist or the patient desires for an improved aesthetic outcome.

Occlusal view of mock-up in wax and plastic. By using the photographs and model of the temporary bridge the laboratory makes any changes the dentist or the patient desires for an improved aesthetic outcome.

Full face photograph of the wax try-in are made from multiple angles to determine if the mock-up is exactly the way the dentist and the patient want it. Changes can still be made if all parties are not satisfied.

Smile photograph of the wax try-in are made from multiple angles to determine if the mock-up is exactly the way the dentist and the patient want it. Changes can still be made if all parties are not satisfied.

It is important to take photographs without facial animation (repose) so that tooth length can be evaluated.

It is important to take photographs with minimal facial animation so that tooth length can be evaluated.

Fully animated smiles are encouraged at the mock-up appointment. The ultimate evaluation of tooth length is best judged during full smile. Many patients have guarded their smile due to embarrassment for so many years these pictures are not always easy to obtain.

Right lateral view of mock-up.

Left lateral view of mock-p.

Right lateral view, lips retracted of mock-up.

Left lateral view, lips retracted of mock-up.

Even though the shade has been discussed on previous visits we verify what the patient wants at multiple visits. This patient wanted “natural”. Many patients want the dentist’s input on tooth selection but, ultimately it is the patient who must decide on how long, how wide and how white.

Final Zirconia Hybrid (All-on-4) prosthesis, frontal view in lab.

Final Zirconia Hybrid (All-on-4) prosthesis, right lateral view in lab.

Final Zirconia Hybrid (All-on-4) prosthesis, left lateral view in lab.

Final Zirconia Hybrid (All-on-4) prosthesis, occlusal view in lab.

Final Zirconia Hybrid (All-on-4) prosthesis, tissue surface, off model in lab.

Final Zirconia Hybrid (All-on-4) prosthesis, tooth surface, off model in lab.

Final Zirconia Hybrid (All-on-4) prosthesis, tissue surface, off model in lab. This view shows the artistry of the tooth color and character. Less then 1% of labs, worldwide are capable of this outcome. Don’t be fooled by the dark appearance, Zirconia is very opaque (bright) and this shows through in later pictures.

Final Zirconia Hybrid (All-on-4) prosthesis, in mouth, occlusal view. Note that even the occlusal surfaces (biting surfaces) look like teeth. This is another rare detail few labs can accomplish.

Final Zirconia Hybrid (All-on-4) prosthesis, in mouth, occlusal view. Note the characterization of the front of the teeth. This may look extreme but ALL natural teeth have some variation. By incorporating these natural striations, stains and simulated fractures the natural light is diffracted in a more natural way rather than the way it bounces off of bright, monochromatic white. This is the main reason that people getting teeth from corporate dental implant centers look so fake. This is another rare detail few labs can accomplish.

Note the contrast of the upper zirconia to the lower natural teeth. This patient wanted natural looking upper teeth. Even by toning them down his lowers are five times darker. Imagine if we had decided upon bright white.

Final Zirconia Hybrid (All-on-4) prosthesis, in mouth, Smile, right lateral, facial view. Notice how much whiter the teeth look in the mouth. This is due to the opaque nature of the zirconia.

Final Zirconia Hybrid (All-on-4) prosthesis, in mouth, Smile, left lateral, facial view. Notice how much whiter the teeth look in the mouth. This is due to the opaque nature of the zirconia.

Final Zirconia Hybrid (All-on-4) prosthesis, in mouth, Smile, frontal facial view. Notice how much whiter the teeth look in the mouth. This is due to the opaque nature of the zirconia.

Upper Zirconium Fixed Implant Bridge, All-on-6

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