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Patients arriving with widespread tooth failure, bone loss and collapsed bite don’t need a miracle; they need a plan.
This featured case from Hospital One in Shkodër demonstrates how evidence-based planning, CBCT-guided surgery, guided bone regeneration and CAD/CAM zirconia prosthetics can recover function, aesthetics and confidence with predictable stability.
We include the treating doctor’s case narrative in full, then unpack the protocol with current research so patients and clinicians can see exactly why it worked.
Doctor’s Clinical Summary
Full-Mouth Oral Rehabilitation in a Patient with Advanced Tooth Structure Loss: A Multidisciplinary Approach with Implant Placement, GBR, and Zirconia Crowns
This clinical report presents a complex case of full-mouth oral rehabilitation in a patient with advanced loss of dental structure and alveolar bone, due to failed endodontic treatments and the absence of long-term prosthetic management.
Through a multidisciplinary protocol involving selective extractions, implant placement, guided bone regeneration (GBR), and final restorations with customized zirconia crowns, a complete restoration of oral function, esthetics, and long-term stability was achieved. The case was preceded by three-dimensional diagnostics with CBCT, ensuring predictable planning and successful clinical outcomes.
Medical History and Clinical Evaluation
- The patient presented with severely compromised dental structure, with many non-vital teeth and non-functional restorations.
- Significant tooth loss, particularly in the mandible, with impaired masticatory function and esthetic concerns.
- Pathological mobility (grade II–III) in the remaining teeth, associated with bone resorption and periapical infections.
- Oral hygiene below recommended clinical standards, contributing to periodontal deterioration.
Radiological Diagnosis (CBCT)
- A Cone Beam CT (CBCT) scan was performed to assess three-dimensional bone volume and implant positioning.
- Significant bone deficits in the posterior mandibular and maxillary regions, requiring regenerative interventions.
- Multiple apical lesions and unfavorable morphology for conservative restoration were noted.
Surgical Phase
Mandible:
- Total extraction of teeth due to chronic infections and severe mobility.
- Placement of 6 dental implants in strategic positions.
- Application of guided bone regeneration (GBR) using alloplastic graft material and collagen membrane.
Maxilla:
- Preservation of 5 stable natural teeth.
- Placement of 3 dental implants in the posterior regions.
Final Prosthetic Phase
- After 6 months, osteointegration and surrounding soft tissue conditions were evaluated.
- Precise measurements were taken using both analog and digital techniques.
- Design of a fixed full-arch prosthesis in the mandible over 6 implants using monolithic zirconia milled via CAD/CAM.
- In the maxilla, a hybrid structure with crowns fixed over natural teeth and implants was fabricated.
- Final cementation with bioactive materials and comprehensive occlusion control were performed.
Clinical Outcomes
- Complete restoration of oral functions: mastication, phonetics, esthetics, and prosthetic stability.
- Perfect integration of zirconia structures with healthy gingival tissues.
- Significant improvement in the patient’s psychological state and self-confidence.
- Long-term predictability achieved through evidence-based surgical and prosthetic protocols.
Conclusion:
This case highlights the importance of a multidisciplinary, evidence-based approach in advanced full-mouth rehabilitation, demonstrating how modern surgical and prosthetic techniques using implants, GBR, and zirconia restorations can restore oral health, function, and esthetics with predictable long-term outcomes.
Why This Approach Works: The Evidence Behind Each Step
CBCT-driven diagnostics and planning
Three-dimensional assessment improves identification of defects, safe distances to vital structures and prosthetically driven implant positioning. Recent consensus updates reaffirm CBCT’s role in guided implantology and complex reconstructions, with emphasis on justification and optimisation to minimise dose.
Guided Bone Regeneration with alloplastic graft and collagen membrane
GBR remains a stable, effective augmentation method for horizontal and combined defects. Resorbable collagen membranes are widely supported, and recent reviews confirm favourable outcomes compared with block grafting or distraction osteogenesis.
Implant number and distribution for full-arch function
Systematic reviews of full-arch implant prostheses report survival rates above 97% in the short-to-mid term. Six strategically placed implants, as used in this case, help balance load, allow a slimmer framework and maintain long-term stability.
Hybrid rehabilitation: combining implants with strategic natural teeth
Where salvageable teeth exist, tooth–implant support is possible with careful case selection and rigid splinting. Meta-analyses show good survival when biomechanical and periodontal principles are respected.
Monolithic zirconia for strength and tissue compatibility
Modern evidence supports zirconia crowns and full-arch prostheses for strength and soft-tissue integration. Compared with veneered ceramics, monolithic zirconia has lower chipping risk and excellent aesthetics.
Occlusion and maintenance determine longevity
Across full-arch implant prostheses, prosthetic complications outnumber biological ones. Establishing controlled occlusion, hygiene protocols and regular reviews reduces risks like screw loosening or prosthetic fracture.
Patient-reported outcomes matter
Implant rehabilitation not only restores function and phonetics but also improves quality of life. The psychological uplift reported by this patient echoes findings across current literature.
Technology and workflow at Hospital One
At Hospital One, outcomes are enabled by an integrated digital-surgical pathway:
- CBCT imaging and diagnostics for precise 3D planning.
- Intraoral scanning for accurate, comfortable impressions.
- Chairside CAD/CAM zirconia prosthetics for strength and aesthetics.
- Laser-assisted soft-tissue management for improved healing.
- Dedicated implant theatre protocols for sterility and safety.
Who benefits from this protocol
- Patients with failed endodontics and recurrent infection.
- Severe posterior bone loss needing regeneration.
- Mixed dentitions where stable natural teeth can be retained.
- Patients prioritising durability, hygiene access and ceramic aesthetics.
Transforming Lives With Full-Mouth Oral Rehabilitation
This case illustrates the transformative power of Full-Mouth Oral Rehabilitation with Implants. By combining CBCT-guided planning, guided bone regeneration and CAD/CAM zirconia prosthetics, Hospital One restores not just function and aesthetics but also patient confidence and quality of life.
Take the first step towards your own confident smile. Contact Hospital One today to book your consultation.
FAQs
GBR rebuilds missing ridge volume under a membrane so implants can be placed prosthetically and functionally.
CBCT provides 3D detail of bone height, width and proximity to nerves and sinuses, ensuring safe implant planning.
Six implants balance the load and improve long-term outcomes in full-arch rehabilitation.
Yes, in carefully selected cases. Evidence supports survival when biomechanical principles are followed.
It offers strength, fewer complications, and excellent soft-tissue response compared with veneered ceramics.
In this case, six months. Timelines vary depending on bone regeneration and implant stability.
Prosthetic issues such as screw loosening or veneer chipping. Controlled occlusion reduces risk.
Yes, most patients report greater function, comfort and self-confidence.
With modern anaesthesia and digital workflows, discomfort is usually less than expected.
Hospital One follows strict implant theatre protocols with validated sterilisation workflows.
References
- Lübbers HT, et al. Revised consensus guidelines for the use of CBCT in dentistry, 2024. sgdmfr.ch
- Chandrasekaran D, et al. Treatment outcome of using guided bone regeneration for alveolar augmentation, 2024. PMC
- Inchingolo F, et al. Guided bone regeneration with growth factors: systematic review, 2024. PMC
- Ramanauskaite A, et al. Efficacy of full-arch implant rehabilitation approaches: systematic review, 2022. Wiley Online Library
- Kwon T, et al. Survival of full-arch fixed hybrid prostheses: systematic review, 2014. PubMed
- Francetti L, et al. Implant success in full-arch rehabilitations, 2015. PMC
- Khijmatgar S, et al. Fifteen-year recall of zirconia-based crowns and FPDs, 2024. Nature
- Lolos D, et al. Five-year survival of zirconium oxide restorations, 2025. PMC
- Takaesu Y, et al. Long-term outcomes of monolithic vs porcelain-fused zirconia crowns, 2025. PubMed
- Yoon D, et al. Occlusal considerations for full-arch implant prostheses, 2022. ScienceDirect
- Stilwell C, et al. Occlusal maintenance for implants, 2024. Nature
- García-Valdez D, et al. Guided implant dentistry and patient QoL, 2025. MDPI
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