All-on-6 Dental Implants: Restoring Chewing Function After Decades of Missing Teeth
Dr. Glenn Mascarenhas • Impladent® Dental Clinic, Malad West, Mumbai • CBCT-Guided All-on-6 Implant Placement • Full Arch Chewing Function Restored
PATIENT DETAILS
Age: 63 | Gender: Female
Medical History: Progressive loss of upper teeth over approximately two decades due to chronic periodontal disease, with the majority of the maxillary arch extracted between her 40s and 50s. Patient has worn a complete removable upper denture for the past twelve years. Mild controlled hypothyroidism on regular medication. Non-smoker, no diabetes, no known drug allergies, no history of prior implant therapy. The patient is a retired schoolteacher who wanted a fixed, permanent replacement after years of denture instability.
CASE PRESENTATION: Restoring Chewing Function with All-on-6 Dental Implants
A 63-year-old female patient presented at Impladent® Dental Clinic in Malad West, Mumbai, with the chief complaint of a loose, uncomfortable upper denture that had made eating and speaking increasingly difficult. Her natural teeth had been lost gradually over roughly twenty years due to long-standing periodontal disease, and she had relied on a removable complete denture for the past twelve years. Over time, the denture had become progressively less stable as the underlying bone continued to resorb, leading to sore spots, frequent slipping while eating, and a growing reluctance to eat in social settings.
On clinical examination, the patient presented with a fully edentulous maxillary arch and moderate but adequate residual ridge width in the anterior and premolar regions. CBCT imaging confirmed sufficient bone volume at six proposed implant positions across the arch, with healthy sinus anatomy and no need for preparatory bone grafting. The mandibular arch retained several natural teeth in good periodontal health, requiring no surgical intervention.
The patient was evaluated by Dr. Glenn Mascarenhas, senior prosthodontist and implantologist at Impladent®. Based on the diagnostic findings, she was confirmed as a suitable candidate for a full-arch All-on-6 implant-supported fixed prosthesis. The treatment plan included CBCT-guided placement of six implants with a same-day provisional restoration, followed by a definitive CAD/CAM-fabricated fixed prosthesis once osseointegration was confirmed.
“I had been wearing a denture for so long that I had stopped believing anything better was possible. I avoided nuts, raw vegetables, even biting into an apple. I just wanted to eat a normal meal again without worrying.” — Patient
All-on-6 Dental Implant Journey — From Decades of Tooth Loss to Restored Function
| STEP 1 Consultation & Denture Assessment | STEP 2 CBCT & Digital Planning | STEP 3 Implant Placement & Same-Day Provisional | STEP 4 Osseointegration Phase | STEP 5 Soft Tissue & Bite Review | STEP 6 Final Prosthesis Fabrication | STEP 7 Fixed Full-Arch Delivery |
| Patient examined with a failing 12-year-old denture and long-standing edentulous upper arch | CBCT confirmed adequate bone volume at six implant positions with no grafting required | Six titanium implants placed under local anaesthesia; fixed provisional arch attached same day | Three to six-month healing period for implants to fully integrate with the jawbone | Provisional prosthesis reviewed and adjusted for bite balance and soft tissue comfort | Final prosthesis designed and milled using CAD/CAM technology, shade-matched to her smile | Definitive fixed prosthesis delivered, restoring full chewing function across the arch |
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The All-on-6 dental implant patient journey — from a failing denture to a CBCT-guided, fixed full-arch restoration.
DIAGNOSIS
Long-term denture wear, while functional in the short term, does not stop the underlying bone loss that follows tooth extraction. Each year, the jawbone beneath a denture continues to resorb, which is why dentures that fit well initially tend to loosen progressively over the years. This case reflects a common pattern in patients with decades of missing teeth: acceptable but diminishing bone volume, growing frustration with a removable prosthesis, and a bite that has been compromised for years without correction. Where six implants can be placed with good primary stability, an All-on-6 restoration replaces both the missing roots and the full arch of teeth in one integrated, fixed solution.
TREATMENT
- Pre-operative Assessment — Clinical examination, CBCT imaging, digital impressions, and medical fitness clearance
- Digital Surgical Planning — Implant positions mapped virtually across the arch based on CBCT bone volume data
- All-on-6 Implant Placement — Six titanium implants placed under local anaesthesia in a single surgical session
- Same-Day Provisional Restoration — Fixed provisional prosthesis attached immediately, avoiding a denture-free healing period
- Osseointegration & Monitoring — Three to six-month healing phase with periodic clinical review
- Final Prosthesis Fabrication — CAD/CAM-milled definitive prosthesis, shade and contour matched to the patient’s face
- Fixed Full-Arch Delivery — Definitive prosthesis fitted, restoring stable, natural-feeling chewing function
DETAILED DESCRIPTION OF TREATMENT
After reviewing the CBCT findings, Dr. Glenn Mascarenhas confirmed that the patient’s bone volume was sufficient to proceed directly to six-implant placement without preparatory grafting. Patients considering full-arch options often ask about All-on-4 vs All-on-6 before treatment; in this case, the additional two implants were recommended specifically because her bone density allowed for the wider load distribution that All-on-6 provides, which supports better long-term stability for an active, otherwise dentate lower arch biting against it.
Implant surgery was carried out under local anaesthesia in a single session. Six implants were placed across the maxillary arch following the digital surgical plan, and primary stability at each site was sufficient to proceed with a fixed provisional prosthesis on the same day. This meant the patient did not spend any time without a functional set of teeth, which was an important consideration given how self-conscious she had become about her denture slipping. She was also guided through what to expect financially, since dental implant cost for a full-arch case depends on the number of implants and the final prosthesis material, and this was discussed in detail before treatment began.
“With All-on-6, the goal is to give the patient fixed, functional teeth from day one, and then let osseointegration happen quietly in the background. Patients coming out of years of denture use notice the difference in bite stability almost immediately, even with the provisional.”
Dr. Glenn Mascarenhas, Senior Prosthodontist, Impladent® Dental Clinic
Over the following months, the patient was reviewed periodically to confirm healing and soft tissue comfort around each implant. Once osseointegration was confirmed on radiographic review, a digital scan was taken and the definitive prosthesis was fabricated using CAD/CAM technology, with tooth shape, shade, and arch contour customised to suit her facial proportions and her natural smile line before tooth loss.
POST-OPERATIVE ASSESSMENT
The patient was reviewed two weeks after delivery of the final prosthesis. She reported stable, comfortable chewing across the arch, no looseness or movement of the prosthesis, and no sore spots. Her bite was checked and adjusted to ensure even contact against the natural lower teeth.
Patient testimonial
“I ate an apple for the first time in years without thinking twice about it. The teeth feel like they belong to me now, not like something I have to take out at night.” — Patient |
At the six-month follow-up, clinical and radiographic evaluation showed stable bone levels around all six implants with no signs of inflammation or mobility. The patient has been placed on a structured recall schedule with six-monthly professional cleaning and annual radiographic review, with the opposing natural dentition monitored at the same visits to ensure the bite remains balanced on both sides.
This case reflects a pattern seen often in patients with decades of missing teeth: the longer a failing denture is tolerated, the more bone and confidence are quietly lost in the process. Where adequate bone volume remains, All-on-6 offers a fixed, stable alternative that restores both function and the ability to eat without limitation — often years after a patient had assumed that ship had sailed.
CONTACT — IMPLADENT® DENTAL CLINIC, MALAD WEST, MUMBAI
| Surgeon: | Dr. Glenn Mascarenhas, Senior Prosthodontist & Implantologist |
| Co-Specialist: | Dr. Sonia Butta, Prosthodontist |
| Clinic: | Premier Tower, 201/301, Marve Road, Orlem, Malad West, Mumbai, Maharashtra 400064 |
| Phone: | +91 022 31912633 | +91 022 31424745 |
| Website: | impladent.in | Dental Implants in Malad, Mumbai |
Impladent® is a premium dental clinic in Malad, delivering advanced dental solutions with a commitment to precision, safety, and excellence in patient care.