{"id":9326,"date":"2026-01-09T21:19:10","date_gmt":"2026-01-10T03:19:10","guid":{"rendered":"https:\/\/laclinicadental.org\/complex-cases-bone-loss-grafting-all-on-4-and-elderly-patients-what-to-expect\/"},"modified":"2026-09-12T23:56:15","modified_gmt":"2026-09-13T05:56:15","slug":"complex-cases-bone-loss-grafting-all-on-4-and-elderly-patients-what-to-expect","status":"publish","type":"post","link":"https:\/\/laclinicadental.org\/en\/complex-cases-bone-loss-grafting-all-on-4-and-elderly-patients-what-to-expect\/","title":{"rendered":"Complex cases: bone loss, grafting, All-on-4 and elderly patients (what to expect)."},"content":{"rendered":"<p>Complex cases in dentistry &#8211; such as significant bone loss, the need for grafting, All-on-4 treatments or elderly patients with multiple problems &#8211; require detailed evaluation, complementary studies and a phased plan. It is not just a matter of &#8220;putting in implants&#8221;, but of analyzing bone, gums, medical conditions and expectations, in order to achieve the <strong>most comfortable, stable and functional<\/strong> rehabilitation <strong>possible.<\/strong> <\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/casos-complejos-de-odontologia.webp\" alt=\"casos complejos de odontolog\u00eda\" srcset=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/casos-complejos-de-odontologia.webp 1024w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/casos-complejos-de-odontologia-800x800.webp 800w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/casos-complejos-de-odontologia-300x300.webp 300w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/casos-complejos-de-odontologia-768x768.webp 768w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<h2>What is a &#8220;complex case&#8221; in dentistry?<\/h2>\n<p data-start=\"6177\" data-end=\"6252\">A case is considered complex when several of these elements are combined:<\/p>\n<ul data-start=\"6254\" data-end=\"6555\">\n<li data-start=\"6254\" data-end=\"6308\">\n<p data-start=\"6256\" data-end=\"6308\">Multiple teeth missing (partially or completely).<\/p>\n<\/li>\n<li data-start=\"6309\" data-end=\"6379\">\n<p data-start=\"6311\" data-end=\"6379\">Significant bone loss due to periodontitis or time without teeth.<\/p>\n<\/li>\n<li data-start=\"6380\" data-end=\"6436\">\n<p data-start=\"6382\" data-end=\"6436\">History of failed or complicated treatments.<\/p>\n<\/li>\n<li data-start=\"6437\" data-end=\"6492\">\n<p data-start=\"6439\" data-end=\"6492\">Systemic diseases requiring precautions.<\/p>\n<\/li>\n<li data-start=\"6493\" data-end=\"6555\">\n<p data-start=\"6495\" data-end=\"6555\">Older patient, with severe wear or unstable prostheses.<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"6557\" data-end=\"6645\">Complex does not mean &#8220;impossible&#8221;, but rather that it is necessary to <strong data-start=\"6617\" data-end=\"6644\">plan more carefully<\/strong>.<\/p>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><br \/><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a>\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/perdida-osea-dentista.webp\" alt=\"perdida osea dentista\" srcset=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/perdida-osea-dentista.webp 1024w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/perdida-osea-dentista-800x800.webp 800w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/perdida-osea-dentista-300x300.webp 300w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/perdida-osea-dentista-768x768.webp 768w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<h2>Bone loss: what does it mean and why does it matter?<\/h2>\n<p data-start=\"6702\" data-end=\"6807\">When a tooth is lost and time passes, the <strong data-start=\"6750\" data-end=\"6768\">alveolar bone<\/strong> may be resorbing. This affects: <\/p>\n<ul data-start=\"6809\" data-end=\"6960\">\n<li data-start=\"6809\" data-end=\"6853\">\n<p data-start=\"6811\" data-end=\"6853\"><strong data-start=\"6814\" data-end=\"6829\">Stability<\/strong> of future implants.<\/p>\n<\/li>\n<li data-start=\"6854\" data-end=\"6914\">\n<p data-start=\"6856\" data-end=\"6914\"><strong data-start=\"6859\" data-end=\"6871\">Aesthetics<\/strong> (lips and gums may look sunken).<\/p>\n<\/li>\n<li data-start=\"6915\" data-end=\"6960\">\n<p data-start=\"6917\" data-end=\"6960\">The <strong data-start=\"6920\" data-end=\"6947\">distribution of forces<\/strong> during chewing.<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"6962\" data-end=\"7006\">In these cases, it may be necessary to assess:<\/p>\n<ul data-start=\"7008\" data-end=\"7136\">\n<li data-start=\"7008\" data-end=\"7054\">\n<p data-start=\"7010\" data-end=\"7054\"><strong data-start=\"7010\" data-end=\"7028\">Bone grafts<\/strong> (autologous or bank).<\/p>\n<\/li>\n<li data-start=\"7055\" data-end=\"7091\">\n<p data-start=\"7057\" data-end=\"7091\">Guided regeneration techniques.<\/p>\n<\/li>\n<li data-start=\"7092\" data-end=\"7136\">\n<p data-start=\"7094\" data-end=\"7136\">Adjustments of position and number of implants.<\/p>\n<\/li>\n<\/ul>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><br \/><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a>\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/tramientos-dentales-integrales-cdmx-3.png\" alt=\"tramientos dentales integrales cdmx 3\" srcset=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/tramientos-dentales-integrales-cdmx-3.png 1024w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/tramientos-dentales-integrales-cdmx-3-800x800.png 800w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/tramientos-dentales-integrales-cdmx-3-300x300.png 300w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2026\/01\/tramientos-dentales-integrales-cdmx-3-768x768.png 768w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<h2>What is a dental bone graft?<\/h2>\n<p data-start=\"7179\" data-end=\"7346\">A <strong data-start=\"7182\" data-end=\"7198\">bone graft<\/strong> is a procedure whose objective is to <strong data-start=\"7236\" data-end=\"7266\">recover bone volume<\/strong> to allow the proper placement of implants or to improve tissue support.<\/p>\n<h3 data-start=\"7348\" data-end=\"7373\">When is it considered?<\/h3>\n<ul data-start=\"7374\" data-end=\"7522\">\n<li data-start=\"7374\" data-end=\"7422\">\n<p data-start=\"7376\" data-end=\"7422\">When the bone is too thin or low.<\/p>\n<\/li>\n<li data-start=\"7423\" data-end=\"7476\">\n<p data-start=\"7425\" data-end=\"7476\">After old extractions with high resorption.<\/p>\n<\/li>\n<li data-start=\"7477\" data-end=\"7522\">\n<p data-start=\"7479\" data-end=\"7522\">In some cases of advanced periodontitis.<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"7524\" data-end=\"7552\">What to expect from grafting:<\/h3>\n<ul data-start=\"7553\" data-end=\"7783\">\n<li data-start=\"7553\" data-end=\"7625\">\n<p data-start=\"7555\" data-end=\"7625\">Evaluation with imaging studies (X-rays, often 3D tomography).<\/p>\n<\/li>\n<li data-start=\"7626\" data-end=\"7694\">\n<p data-start=\"7628\" data-end=\"7694\">Surgical procedure with local anesthesia (sometimes sedation).<\/p>\n<\/li>\n<li data-start=\"7695\" data-end=\"7783\">\n<p data-start=\"7697\" data-end=\"7783\">Healing time before implant placement (weeks or months, depending on the case).<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"7785\" data-end=\"7856\">The goal is to create a more stable and secure base for rehabilitation.<\/p>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><br \/><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a>\t\t\t<\/p>\n<h2>All-on-4: concept and reality<\/h2>\n<p><strong data-start=\"7897\" data-end=\"7909\">All-on-4<\/strong> is a technique in which <strong data-start=\"7935\" data-end=\"7950\">4<\/strong> strategically placed <strong data-start=\"7935\" data-end=\"7950\">implants<\/strong> support a <strong data-start=\"7991\" data-end=\"8008\">fixed prosthesis<\/strong> (usually for an entire dental arch).<\/p>\n<h3 data-start=\"8051\" data-end=\"8076\">Potential advantages:<\/h3>\n<ul data-start=\"8077\" data-end=\"8279\">\n<li data-start=\"8077\" data-end=\"8144\">\n<p data-start=\"8079\" data-end=\"8144\">Fewer implants to rehabilitate a complete arch.<\/p>\n<\/li>\n<li data-start=\"8145\" data-end=\"8202\">\n<p data-start=\"8147\" data-end=\"8202\">May reduce need for grafting in some cases.<\/p>\n<\/li>\n<li data-start=\"8203\" data-end=\"8279\">\n<p data-start=\"8205\" data-end=\"8279\">Possibility of placing a provisional fixed prosthesis relatively soon.<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"8281\" data-end=\"8301\">Not for everyone<\/h3>\n<p data-start=\"8302\" data-end=\"8361\">To decide if someone is a candidate for All-on-4, they are evaluated:<\/p>\n<ul data-start=\"8363\" data-end=\"8561\">\n<li data-start=\"8363\" data-end=\"8405\">\n<p data-start=\"8365\" data-end=\"8405\">Quantity and quality of remaining bone.<\/p>\n<\/li>\n<li data-start=\"8406\" data-end=\"8475\">\n<p data-start=\"8408\" data-end=\"8475\">General health status (diabetes, smoking, medication, etc.).<\/p>\n<\/li>\n<li data-start=\"8476\" data-end=\"8520\">\n<p data-start=\"8478\" data-end=\"8520\">Hygiene and maintenance expectations.<\/p>\n<\/li>\n<li data-start=\"8521\" data-end=\"8561\">\n<p data-start=\"8523\" data-end=\"8561\">Condition of gums and soft tissues.<\/p>\n<\/li>\n<\/ul>\n<p>In some patients, other configurations (All-on-6, individual implants, removable prostheses on implants, etc.) may be recommended.<\/p>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a>\t\t\t<\/p>\n<h2>Elderly patients: particularities and care<\/h2>\n<p data-start=\"8763\" data-end=\"8802\">Older patients usually present:<\/p>\n<ul data-start=\"8804\" data-end=\"9008\">\n<li data-start=\"8804\" data-end=\"8841\">\n<p data-start=\"8806\" data-end=\"8841\">Loss of several or all parts.<\/p>\n<\/li>\n<li data-start=\"8842\" data-end=\"8884\">\n<p data-start=\"8844\" data-end=\"8884\">Old prostheses with poor adaptation.<\/p>\n<\/li>\n<li data-start=\"8885\" data-end=\"8946\">\n<p data-start=\"8887\" data-end=\"8946\">Bone resorbed by years of use of removable prostheses.<\/p>\n<\/li>\n<li data-start=\"8947\" data-end=\"9008\">\n<p data-start=\"8949\" data-end=\"9008\">Chronic diseases (hypertension, diabetes, medication).<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"9010\" data-end=\"9046\">Keys for a good treatment:<\/h3>\n<ul data-start=\"9047\" data-end=\"9399\">\n<li data-start=\"9047\" data-end=\"9140\">\n<p data-start=\"9049\" data-end=\"9140\"><strong data-start=\"9049\" data-end=\"9078\">Complete medical history<\/strong> and communication with the treating physician when necessary.<\/p>\n<\/li>\n<li data-start=\"9141\" data-end=\"9233\">\n<p data-start=\"9143\" data-end=\"9233\">Prioritization of <strong data-start=\"9159\" data-end=\"9182\">function and comfort<\/strong> (chewing, speaking, cleaning) as well as esthetics.<\/p>\n<\/li>\n<li data-start=\"9234\" data-end=\"9343\">\n<p data-start=\"9236\" data-end=\"9343\">Realistic options: implants when they are feasible, improved prostheses or other solutions when they are not.<\/p>\n<\/li>\n<li data-start=\"9344\" data-end=\"9399\">\n<p data-start=\"9346\" data-end=\"9399\">Clear and easy to follow maintenance plans.<\/p>\n<\/li>\n<\/ul>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a>\t\t\t<\/p>\n<h2>Typical process in a complex case<\/h2>\n<h3 data-start=\"9445\" data-end=\"9471\">1) Advanced valuation<\/h3>\n<ul data-start=\"9472\" data-end=\"9592\">\n<li data-start=\"9472\" data-end=\"9503\">\n<p data-start=\"9474\" data-end=\"9503\">Detailed medical history.<\/p>\n<\/li>\n<li data-start=\"9504\" data-end=\"9549\">\n<p data-start=\"9506\" data-end=\"9549\">Examination of teeth, gums and bite.<\/p>\n<\/li>\n<li data-start=\"9550\" data-end=\"9592\">\n<p data-start=\"9552\" data-end=\"9592\">Revision of prosthesis or previous work.<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"9594\" data-end=\"9619\">2) Imaging studies<\/h3>\n<ul data-start=\"9620\" data-end=\"9700\">\n<li data-start=\"9620\" data-end=\"9637\">\n<p data-start=\"9622\" data-end=\"9637\">X-rays.<\/p>\n<\/li>\n<li data-start=\"9638\" data-end=\"9700\">\n<p data-start=\"9640\" data-end=\"9700\">3D tomography when planning implants or grafts.<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"9702\" data-end=\"9738\">3) Phased treatment plan<\/h3>\n<ul data-start=\"9739\" data-end=\"10023\">\n<li data-start=\"9739\" data-end=\"9775\">\n<p data-start=\"9741\" data-end=\"9775\">Infection and gum control.<\/p>\n<\/li>\n<li data-start=\"9776\" data-end=\"9837\">\n<p data-start=\"9778\" data-end=\"9837\">Necessary extractions and cleaning of infection sources.<\/p>\n<\/li>\n<li data-start=\"9838\" data-end=\"9915\">\n<p data-start=\"9840\" data-end=\"9915\">Grafts, sinus lifts or complementary surgeries if required.<\/p>\n<\/li>\n<li data-start=\"9916\" data-end=\"9944\">\n<p data-start=\"9918\" data-end=\"9944\">Implant placement.<\/p>\n<\/li>\n<li data-start=\"9945\" data-end=\"10023\">\n<p data-start=\"9947\" data-end=\"10023\">Prosthetic phase (fixed or removable prosthesis on implants, crowns, etc.).<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"10025\" data-end=\"10059\">4) Long-term maintenance<\/h3>\n<ul data-start=\"10060\" data-end=\"10200\">\n<li data-start=\"10060\" data-end=\"10086\">\n<p data-start=\"10062\" data-end=\"10086\">Periodic reviews.<\/p>\n<\/li>\n<li data-start=\"10087\" data-end=\"10112\">\n<p data-start=\"10089\" data-end=\"10112\">Professional cleaning.<\/p>\n<\/li>\n<li data-start=\"10113\" data-end=\"10161\">\n<p data-start=\"10115\" data-end=\"10161\">Evaluation of gums around implants.<\/p>\n<\/li>\n<li data-start=\"10162\" data-end=\"10200\">\n<p data-start=\"10164\" data-end=\"10200\">Prosthesis adjustments if necessary.<\/p>\n<\/li>\n<\/ul>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a>\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"760\" height=\"840\" src=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2025\/07\/gal-new-4.webp\" alt=\"\" srcset=\"https:\/\/laclinicadental.org\/wp-content\/uploads\/2025\/07\/gal-new-4.webp 760w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2025\/07\/gal-new-4-724x800.webp 724w, https:\/\/laclinicadental.org\/wp-content\/uploads\/2025\/07\/gal-new-4-271x300.webp 271w\" sizes=\"auto, (max-width: 760px) 100vw, 760px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<h2>What to expect as a patient<\/h2>\n<ul>\n<li data-start=\"10243\" data-end=\"10315\">\n<p data-start=\"10245\" data-end=\"10315\"><strong data-start=\"10245\" data-end=\"10275\">Clear explanation of the plan<\/strong>: what will be done, in what order and why.<\/p>\n<\/li>\n<li data-start=\"10316\" data-end=\"10384\">\n<p data-start=\"10318\" data-end=\"10384\"><strong data-start=\"10318\" data-end=\"10341\">Approximate times<\/strong> for each phase (and what can modify them).<\/p>\n<\/li>\n<li data-start=\"10385\" data-end=\"10468\">\n<p data-start=\"10387\" data-end=\"10468\">Honest information about <strong data-start=\"10413\" data-end=\"10444\">treatment alternatives<\/strong> (not just one option).<\/p>\n<\/li>\n<li data-start=\"10469\" data-end=\"10507\">\n<p data-start=\"10471\" data-end=\"10507\">Budget broken down by stages.<\/p>\n<\/li>\n<li data-start=\"10508\" data-end=\"10573\">\n<p data-start=\"10510\" data-end=\"10573\">Close accompaniment and follow-up, especially after surgeries.<\/p>\n<\/li>\n<\/ul>\n<h2>Frequently asked questions about complex cases<\/h2>\n<details id=\"e-n-accordion-item-1770\" open>\n<summary data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"true\" aria-controls=\"e-n-accordion-item-1770\" >\n\t\t\t\t\t What is considered a complex dental case?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>A complex case is one in which several problems are combined: significant bone loss, many missing teeth, unstable prostheses, advanced periodontal disease, history of failed treatments or medical conditions that require special precautions.<\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1771\" >\n<summary data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1771\" >\n\t\t\t\t\t What is All-on-4 and in which cases is it used?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>All-on-4 is a rehabilitation technique in which four strategically placed implants support a full-arch fixed prosthesis. It is usually indicated in patients with many missing teeth or unstable removable prostheses, provided that studies show that they are candidates. <\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1772\" >\n<summary data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1772\" >\n\t\t\t\t\t What kind of maintenance do implants and prostheses require in complex patients?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>They require periodic check-ups, professional cleanings, gum control around the implants and, if necessary, adjustments of the prosthesis. Maintenance is key to the long-term duration of treatment. <\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1773\" >\n<summary data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1773\" >\n\t\t\t\t\t What studies are needed to plan a complex case?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>In addition to the clinical examination, X-rays and, in many cases, a 3D tomography are usually necessary. These studies make it possible to measure the available bone, plan the position of implants and assess the need for grafts. <\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1774\" >\n<summary data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1774\" >\n\t\t\t\t\t Is a treatment with grafts and implants very painful?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>The goal is that it is not. Procedures are performed under local anesthesia and, when indicated, with additional comfort control techniques. After surgery there may be swelling or discomfort, but this is managed with medication and follow-up.  <\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1775\" >\n<summary data-accordion-index=\"6\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1775\" >\n\t\t\t\t\t Can older patients receive dental implants or All-on-4?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>In many cases yes. Age alone is not a contraindication; what is important is to evaluate the general state of health, medication, available bone and the ability to maintain good hygiene and attend check-ups. <\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1776\" >\n<summary data-accordion-index=\"7\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1776\" >\n\t\t\t\t\t Do I always need bone grafting if I have a small amount of bone?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>Not always. It depends on how much bone there is, its quality and the implant technique chosen. In some cases grafts are recommended; in others, the plan can be adapted (e.g., with All-on-4 configurations) without extensive grafting.  <\/p>\n<\/details>\n<details id=\"e-n-accordion-item-1777\" >\n<summary data-accordion-index=\"8\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1777\" >\n\t\t\t\t\t How long can a treatment with grafts and implants in complex cases last?<br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t<svg aria-hidden=\"true\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t<\/summary>\n<p>The time varies according to the number of procedures and the need for healing. It can range from several months to more than a year, considering grafting phases, implant integration and placement of definitive prosthesis. <\/p>\n<\/details>\n<p>A complex case is one in which several problems are combined: significant bone loss, many missing teeth, unstable prostheses, advanced periodontal disease, history of failed treatments or medical conditions that require special precautions.<\/p>\n<p>All-on-4 is a rehabilitation technique in which four strategically placed implants support a full-arch fixed prosthesis. It is usually indicated in patients with many missing teeth or unstable removable prostheses, provided that studies show that they are candidates. <\/p>\n<p>They require periodic check-ups, professional cleanings, gum control around the implants and, if necessary, adjustments of the prosthesis. Maintenance is key to the long-term duration of treatment. <\/p>\n<p>In addition to the clinical examination, X-rays and, in many cases, a 3D tomography are usually necessary. These studies make it possible to measure the available bone, plan the position of implants and assess the need for grafts. <\/p>\n<p>The goal is that it is not. Procedures are performed under local anesthesia and, when indicated, with additional comfort control techniques. After surgery there may be swelling or discomfort, but this is managed with medication and follow-up.  <\/p>\n<p>In many cases yes. Age alone is not a contraindication; what is important is to evaluate the general state of health, medication, available bone and the ability to maintain good hygiene and attend check-ups. <\/p>\n<p>Not always. It depends on how much bone there is, its quality and the implant technique chosen. In some cases grafts are recommended; in others, the plan can be adapted (e.g., with All-on-4 configurations) without extensive grafting.  <\/p>\n<p>The time varies according to the number of procedures and the need for healing. It can range from several months to more than a year, considering grafting phases, implant integration and placement of definitive prosthesis. <\/p>\n<h2>Schedule your assessment (CDMX) and receive a clear step-by-step plan.<\/h2>\n<p>Whether you are looking for a complete rehabilitation, comprehensive dental treatment or a total smile makeover in CDMX, the first step is a professional assessment to define priorities and build a phased plan with realistic expectations.<\/p>\n<p><em><a href=\"https:\/\/laclinicadental.org\/en\/\">The Dental Clinic<\/a>, <a href=\"https:\/\/laclinicadental.org\/en\/tratamientos-dentales\/\">See treatments.<\/a><\/em><\/p>\n<\/p>\n<p><a href=\"https:\/\/ff.healthatom.io\/qQQYK9\" rel=\"noopener\">Appointment with specialist<\/a><br \/><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=5215529468885&amp;text=Hola+me+comunico+con+La+Cl%C3%ADnica+Dental\" target=\"_blank\" rel=\"noopener\">WhatsApp<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Complex cases in dentistry &#8211; such as significant bone loss, the need for grafting, All-on-4 treatments or elderly patients with multiple problems &#8211; require detailed evaluation, complementary studies and a phased plan. It is not just a matter of &#8220;putting in implants&#8221;, but of analyzing bone, gums, medical conditions and expectations, in order to achieve [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":9344,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"elementor_theme","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[34,41],"tags":[80,81,59,83,82],"class_list":["post-9326","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-implantology","category-smile-designs","tag-all-on-4","tag-bone-loss","tag-dentist","tag-elderly-patients","tag-grafts"],"acf":[],"_links":{"self":[{"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/posts\/9326","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/comments?post=9326"}],"version-history":[{"count":2,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/posts\/9326\/revisions"}],"predecessor-version":[{"id":18228,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/posts\/9326\/revisions\/18228"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/media\/9344"}],"wp:attachment":[{"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/media?parent=9326"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/categories?post=9326"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/laclinicadental.org\/en\/wp-json\/wp\/v2\/tags?post=9326"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}