Mrs SW is 60 years old and had had a full upper denture for about two years. She did not like it and asked about alternatives. She is an attractive and lively person, but her husband had died about a year before and she was finding it difficult to adapt to a social life on her own. She said she really wanted a fixed restoration because the difficulty of having a full denture made her self-conscious and lacking in confidence. She was finding her job difficult, as it involved a lot of talking on the phone and she felt the denture had changed the way she spoke. She acknowledged that some of the problem was in her mind and most people would not notice anything amiss, but that did not make it any less of a problem. She was unaware of implants until she discussed the problem with me and, after considering the implications, felt the cost of £9400 would be justified by the benefit.

After a full clinical and radiographic examination it was mutually decided that an upper fixed restoration on five implants would solve Mrs SW’s problem. Although the patient smokes a little it was not considered enough to prejudice the treatment. The procedure was explained and the patient elected to have both first and second stages performed under intravenous sedation.

At first stage surgery the five fixtures were placed and the flap sutured. Primary stability was excellent. A week later the sutures were removed and the F/- relined with Visco-Gel. Three months later the second stage surgery was performed, the abutments chosen and healing abutments placed.

After two weeks the Multi-Unit Abutments were attached to the fixtures and impressions taken. Two weeks later the provisional prosthesis was placed and the process of perfecting the occlusion, function and appearance began.

After approximately three months more the final fixed prosthesis was placed. Throughout the process the patient has been able to wear her original denture or the temporary prosthesis and has therefore been able to work and socialise as she was doing before the process started. Some months after the final bridge was fitted she said to me that the bridge was everything she had hoped and her self-confidence had returned. ‘I have got my life back’ were her words.

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