Abby T. Case Study
A failing lower arch, rebuilt the day of surgery.
Abby came in with a dentition that could not be patched back together. The plan was a full-mouth reconstruction, staged so she was never left without a path forward. The upper teeth were removed and she was placed in a maxillary interim denture. The lower arch was the FlexOnX case: extract, place implants with a wide AP spread — including posterior implants for stability — graft, and convert a temporary lower prosthesis the same day using chairside FRA pickups.
The story
Same-day conversion used four housings, not every implant. That is deliberate. Attaching to the full complement at surgery makes later retrieval harder. Rubber-dam skirts and a lubricated suture line kept the pickup clean. She left that appointment with a usable lower bite and a temporary she could live in while the implants integrated.
After healing, she returned for master records: spacers, a polyvinyl impression, vertical-dimension and mush-bite records, and a wash for a stable bite. A separate 3D try-in was skipped because the converted lower denture had already proved midline and vertical. The laboratory returned a zirconia overlay on the titanium bar — same FRA pickup logic as the temporary, different material for the definitive.
Pink characterization can be refined on a future insert. The result that mattered was a stable lower arch, a bite she can use, and a prosthesis the team can retrieve.
What this case was built to do
- Get her back to a fixed-feeling lower occlusion instead of a collapsing dentition.
- Give her something she can clean, with coaching that is part of delivery, not a handout afterthought.
- Keep her on a short recall so the team can see how she is actually caring for the intaglio.
- Deliver a fixed-style prosthesis at a cost that made saying yes possible.
“When we are able to take a patient from this point to this point, we really feel that we have done them a service… a fixed prosthesis at an affordable cost.”
— Dr. Mark Whitefield, case narration
FOR PATIENTS
IF YOU WANT YOUR TEETH BACK
If most of your remaining teeth are failing, the answer is not always “live with a denture and hope.”
Abby left surgery with a lower prosthesis already in place. She was not sent home with nothing while implants hid under the gums for months.
The upper arch was staged. Full-mouth work does not have to mean everything happens in one overwhelming day.
Her job after delivery is the unglamorous one: clean under the bridge the way the team shows her, and keep the review appointments.
FOR DENTISTS
IF YOU PLACE IMPLANTS
Staged full-mouth: clear and interim the maxilla; immediate-load the mandible when primary stability and AP spread allow.
Surgical notes from the case: posterior implants for stability; graft before close; immediate conversion on four FRA housings even when more fixtures are in the field.
Pickup: rubber-dam skirts, Vaseline the sutures, chairside housing pickup — same motion as a locator overdenture, different destination.
Definitive: zirconia overlay on the titanium bar, same FRA logic. Try-in can be skipped only when the converted denture has already locked vertical and midline. Default remains: try in.
