The lecture presents an All-on 4 treatment in a complex case, on a patient with Huntingtons chorea with constant parafunction. The anatomic challenges comprise unfavorable biomechanics, alveolar mandibular hypertrophy and super-erupted lower teeth, absence of maxillary alveolar bon

A 47-year-old male patient diagnosed with a maxillary osteosarcoma, treated with excision, leaving a large oro-antral / oro-nasal fistula. He had to wear an obturator which leaked and was uncomfortable, affecting speech & function with a severe impact on his quality of life.

A 53-year-old female patient lost the teeth when she was 30-year-old and was wearing a denture for many years. The patient was informed about the different therapeutic possibilities and she accepted the quad zygoma technique. 

A 22-year-old male patient presents with ectodermal dysplasia with resultant lack of permanent maxillary and mandibular teeth. He has only 4 malformed maxillary teeth and mandibular cuspids.

A female patient lacks the maxillary posterior support and has tardive dyskinesia. The treatment illustrates virtual planning for the use of zygomatic implants coupled with posterior retraction of the anterior replacement teeth for a more aesthetic result.

A 52-year-old female patient presented a failure of 6 implants supporting a fixed bridge, after 6 years after their placement. The failing implants were removed and all the zygomatic implants were inserted at the level of the zygomatic bone and allocated in the maxillary bone.

A male patient had advanced cancer of the face/sinus, for which he received life-saving surgery with loss of his left eye, cheek, and jawbone and much of his skull. He could not have a surgical reconstruction due to his medical history.

A 68-year-old female patient suffered from tooth loss and removable dentures for more than 20 years.  A protocol considering four zygomatic implants was chosen to avoid lengthy and invasive bone grafting procedures.

A 62-year-old male presented with tooth #16 FDI (#3 US). Despite the lack of bone volume posteriorly, he had sufficient volume anteriorly and an abundant amount of keratinized tissue making him a good candidate for an All-on-4® treatment concept with a hybrid restoration.