Full-arch rehabilitation

A fixed set of teeth,
planned to last decades.

For patients facing the loss of an entire arch, a fixed implant-supported bridge restores chewing, speech and appearance without a removable denture. It is the most complex treatment I provide, and the one where planning matters most.

Who this is for

When a whole arch has reached the end

Full-arch rehabilitation is considered when the teeth in an upper or lower jaw can no longer be saved predictably, or already have been lost. Most commonly that is the result of advanced periodontal disease, decades of decay and repeated restoration, extensive tooth wear, or a set of older bridges and crowns that have failed together.

It is also the option for patients who already wear a full denture and cannot tolerate it, the loose lower denture, the palate covered, the constant calculation about what can safely be eaten in public.

What it involves

A planned number of implants, typically four to six per arch, are placed into the available bone and used to support a single fixed bridge spanning the whole arch. The bridge is not removable by you; it is secured to the implants and only removed by me, at review, for cleaning and inspection.

Where bone in the back of the upper jaw is insufficient, implants may be angled to engage denser bone, or a sinus augmentation carried out to create the height required. Which of those applies to you is determined from your CBCT scan, not assumed in advance.

Why I plan it digitally

The CBCT scan is merged with intraoral scans and a proposed tooth set-up in planning software, so the implants are positioned to serve the teeth we intend to build. A surgical guide is then printed from that plan, which transfers the planned positions accurately into the mouth on the day.

The alternative, placing implants where the bone happens to be and asking a laboratory to compensate afterwards, produces prostheses that are harder to clean, harder to repair, and mechanically compromised. Planning the restoration first is what makes a full arch maintainable ten years later.

The pathway

How a full-arch case runs

01

Full assessment

Comprehensive examination, periodontal charting, photographs, radiographs and CBCT of both jaws. Medical history reviewed in detail, anticoagulants, bisphosphonates, diabetes and smoking all change the plan.

02

Design & consent

A digital plan and proposed tooth set-up, reviewed with you before anything is agreed. Written consent covers the sequence, the alternatives, the risks and what maintenance will be required of you for life.

03

Surgery

Remaining teeth removed, the site prepared and the implants placed through a guide. Carried out under local anaesthetic, with sedation available. Usually one appointment per arch.

04

Fixed provisional

A fixed provisional bridge is attached so you leave with teeth. It carries a soft diet for the first weeks while the implants integrate.

05

Testing the design

Months of real-world use: speech, bite, lip support, cleanability, appearance. Anything that needs changing is changed in the provisional, which is far easier than changing it in the definitive bridge.

06

Definitive prosthesis

The final bridge is made to the approved design in a durable material, fitted and torqued, and you move onto a lifelong review and hygiene schedule.

Straight talking

What full-arch treatment asks of you

This is major treatment and it deserves to be described honestly. It involves surgery. It involves months, not weeks. It involves a soft diet for a period. Implants can fail to integrate and occasionally need replacing. Prosthetic components can loosen or fracture and need servicing. And it commits you to a cleaning and review routine for the rest of your life.

Set against that: teeth that do not move, a palate left uncovered, chewing function restored, and bone that continues to be loaded rather than melting away. For the right patient, properly planned and properly maintained, it is transformative. For the wrong patient, it is an expensive disappointment, which is why the assessment comes first and the answer is sometimes no.

Radiograph showing a placed dental implant, Dr Steve Conteh
Radiographic confirmation of implant position after placement.
Questions

Full-arch, answered

Will I ever be without teeth?
No. The plan is built so that you leave every appointment with a fixed or secure set of teeth in place. In most cases a provisional fixed bridge is fitted at the time of surgery or shortly afterwards, and it stays in until the final work is ready.
How many implants does a full arch need?
It depends on bone volume, bone quality, the opposing bite and whether you grind. Four to six implants per arch is the usual range, but the number is decided from your CBCT scan and the mechanics of your particular case, not from a fixed formula.
How long does the whole thing take?
Typically six to twelve months from surgery to the definitive prosthesis. The provisional phase is deliberately unhurried: we use it to test speech, bite, cleanability and aesthetics in real life before anything final is manufactured.
Is it better than a denture?
For most patients, considerably. A fixed arch does not move, does not cover the palate, and restores a far greater proportion of natural chewing force. It also loads the bone, which slows the resorption that makes long-term denture wearers' faces collapse inwards. It is, however, a bigger commitment surgically and financially, and it demands more of you in maintenance.
What happens if an implant fails?
Occasionally an implant does not integrate. Because full-arch designs carry redundancy, this is usually recoverable, the site is allowed to heal and a replacement implant placed, with the provisional bridge adjusted in the meantime. It extends the timeline rather than ending the treatment.
What is the maintenance like?
Daily cleaning under the bridge with interdental brushes or a water flosser, hygiene appointments several times a year, and periodic review with radiographs. The bridge is removed and professionally cleaned at intervals. This is a lifelong commitment, a full arch that is not maintained will not last.
Can I have this if I smoke or have gum disease?
Gum disease is treated and stabilised first; in full-arch cases the remaining teeth are often the source of the problem and are removed as part of treatment. Smoking significantly increases the risk of complications and long-term implant loss, and I will be direct with you about that before we plan anything.
For colleagues

Referring a full-arch case

I accept referrals for implant and full-arch assessment from general dental practitioners across the South West, and return every patient to their referring practice for ongoing general care.

Full-arch implant treatment for the South West

Full-arch rehabilitation is a significant undertaking, and most patients research it for months before making contact. If you are searching for fixed teeth, implant-supported bridges, or an alternative to dentures anywhere in Somerset, Wiltshire or Bristol, I am happy to start with a conversation rather than a commitment. Many patients begin with an online video consultation from home, then travel to Bath, Marlborough, Crewkerne or Bristol only when there is a clear plan worth travelling for. Book a video consultation.

Next step

Start with a conversation

Every case begins with an unhurried consultation: a proper look, a proper listen, and a written plan you can take away and think about. There is never any pressure to proceed.