Case of the Month: A Life-Changing Full Mouth Rehabilitation With All-on-X & Smile Makeover

For many patients, the journey to a new smile begins long before they sit in our chair. This month’s featured case highlights a remarkable transformation using digital dentistry, digital smile design, upper arch Emax crowns, and a lower All-on-X implant-supported fixed prosthesis — a true full mouth rehabilitation that restored both confidence and function.

Patient Story

Our patient, a 41-year-old female from Portland, came to us in 2023 seeking help for what she described as "ugly teeth that don't work." She was unhappy with the dark, yellow discoloration and severe crowding. Smiling was something she avoided. Eating was difficult. Her lower teeth were painful and mobile, bleeding easily when brushing or chewing. Dental anxiety and financial concerns prevented her from moving forward at first — but a year later, motivated and ready, she returned determined to change her life.

Initial Findings

On examination:

Upper Arch

• Teeth were discolored, worn, crowded and decayed.
• Arch form was narrow with a missing upper lateral incisor.
• Bone support was better than the lower arch, making these teeth restorable.

Lower Arch

• Advanced periodontal disease with significant bone loss.
• Multiple teeth were mobile and symptomatic.
• Two impacted retained teeth added complexity.
• Only a small number of posterior teeth were technically restorable — not ideal for long-term function.

Given her goals and clinical condition, restoring just a few teeth wouldn’t provide the stability or esthetics she needed. Instead, we developed a comprehensive plan that combined conservation where possible and replacement where necessary.

Treatment Planning With Digital Dentistry

Using digital smile design, we planned her entire rehabilitation digitally from day one. By visualizing her ideal smile and bite relationship first, we were able to design both arches cohesively and reverse-engineer the final outcome.

Phase 1 — Upper Arch Rehabilitation

• Teeth were restored with Emax ceramic crowns for natural translucency and esthetics.
• Shade was selected based on patient preference — she wanted brighter teeth than she ever had before.

Phase 2 — Lower All-on-X (Teeth-in-a-Day)

• All remaining mandibular teeth were extracted, including the impacted ones.
• Ridge grafting was completed.
• Five implants were placed using a fully guided surgical protocol.
• A same-day immediate–load provisional prosthesis was delivered — Teeth in a Day.
• The temporary was pre-planned digitally and 3D printed, ensuring precise fit and esthetics.

After healing, we designed and delivered her final monolithic zirconia prosthesis for strength, longevity, and a beautiful, bright result.

Final Result

The transformation speaks for itself.

Her final shade choice?
A bold bleach white, reflecting the new chapter she envisioned — and it looks stunning.

Today, she attends regular hygiene visits, proudly shares vacation photos from Disneyland and Europe, and tells us how she smiles freely for the first time in years. Her words:
"I feel like a new person. I can finally smile without hiding."

This is why we love what we do.

Clinical Highlights 

• Full Mouth Rehabilitation
• All-on-X Dental Implants in Portland
• Teeth-in-a-Day Implant Procedure
• Digital Dentistry & Digital Smile Design
• Smile Makeover with Emax and Zirconia
• Conservative approach — save what’s savable, replace what’s not
• Immediate function & esthetics with same-day provisionalization
• Final result: bright, confident smile that changed a life

If you’ve been living with broken, painful, or embarrassing teeth — you’re not alone. Modern cosmetic and implant dentistry can restore not just your smile, but chewing ability, confidence, and quality of life.

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