Radu, born in 1986, had spent years planning every meal around teeth he could not trust. Missing back teeth and increasingly mobile ones made hard foods a daily struggle. The crowns on his front teeth no longer matched his smile aesthetically. His search for full mouth dental implants brought him from Romania to International Plus in Istanbul, where CBCT imaging revealed advanced bone loss with bilateral sinus expansion. The plan: bilateral sinus lift surgery followed by a fixed titanium bar zirconium bridge. This case study documents each stage of his rehabilitation, beginning with the first scan and ending with the final smile.
Severe bone loss cases are decided in the planning room, not the operating room. Radu’s treatment stretched across roughly eight months and two visits to Istanbul separated by a long healing phase at home. What follows explains why each decision was made and what patients researching similar treatment can learn from it.
Key Takeaways
- The challenge: Long term tooth loss and mobile teeth had left Radu unable to chew comfortably. CBCT imaging showed advanced bone loss beneath both maxillary sinuses.
- The surgery: A bilateral sinus lift rebuilt the missing bone in a single session. 12 implants were placed with a surgical guide: MegaGen AnyRidge at the grafted molar sites and BEGO Semados RSX everywhere else.
- The healing: A 6 month osseointegration phase let the grafted bone mature, verified with clinical and radiological follow up.
- The design: A MetiSmile 3D face scan and multiple PMMA mock up stages let Radu test and refine his new smile before final production.
- The result: A fixed titanium bar zirconium bridge restored stable chewing and a natural smile designed around his own face.
A Dental Journey from Romania
Radu traveled from Romania to Istanbul because his case required advanced bone reconstruction alongside full arch implant treatment. International Plus treats patients from more than 140 countries with coordination available in 27 languages. A complex multi visit treatment plan can therefore be organized around international flights and remote follow up rather than forcing everything into one trip.
Like many patients researching dental implants in Turkey, Radu had two questions: whether his bone loss could actually be treated and whether a clinic abroad could be trusted with surgery of this scale. The second question has verifiable answers. The clinic is a T.C. Ministry of Health authorized healthcare facility rated 4.8/5 across 5,504+ verified Google reviews, one of the highest verified review volumes among dental clinics in Turkey.
His journey followed the staged structure summarized below.
| Stage | Timing | What happened |
| Diagnosis | Visit 1, day 1 | 3D CBCT imaging and a Diagnostic Council treatment plan |
| Surgery | Visit 1 | Bilateral sinus lift with grafting plus guided placement of 12 implants |
| Healing | About 6 months | Osseointegration verified with clinical and radiological follow up |
| Smile design | Visit 2 | MetiSmile face scan and multi stage PMMA mock up approval |
| Final bridge | Visit 2 | Titanium bar zirconium bridge fitted and quality checked |
Bottom line: one surgical visit, one healing phase at home and one prosthetic visit delivered the entire rehabilitation.
Severe Bone Loss Solutions
Severe bone loss does not rule out dental implants; it changes how they are planned. When the upper jaw lacks height, surgeons can rebuild bone with a sinus lift or bypass the deficit entirely with zygomatic implants anchored in the cheekbone. CBCT measurements of the remaining ridge determine which route is safer and more predictable for each patient.
Radu’s 3D scans showed advanced resorption beneath both maxillary sinuses, a typical pattern after years of missing back teeth. The maxillary sinus gradually expands into the space once occupied by tooth roots, a process called pneumatization, which further reduces the available bone. His remaining teeth told the same story: several were mobile and the existing front restorations no longer served his function or his appearance. Cases like his sit at the intersection of oral surgery and prosthodontics, which is exactly why every treatment plan at International Plus is set by a multidisciplinary Diagnostic Council rather than a single practitioner.
The case was planned and overseen by Dr. Akın together with the clinic’s surgical and prosthetic teams. They weighed two options. Zygomatic anchorage, documented in our zygomatic implant case studies, suits patients whose bone cannot be grafted. Radu’s sinus anatomy was favorable. The council therefore chose a graft based reconstruction using conventional dental implant placement.
Bilateral Sinus Lift Surgery
A bilateral sinus lift raises the sinus membrane on both sides of the upper jaw and places bone graft beneath it, creating the height implants need. Radu’s surgery used the lateral window technique performed with piezoelectric instruments, which cut bone precisely while protecting the delicate membrane. Both sinuses were treated in the same session.
Once each membrane was lifted, the team packed graft material into the new space to build the bone volume the implants would need for long term success. PRF (platelet rich fibrin), part of the clinic’s routine surgical protocol, supports early healing at sites like these; research links PRF to improved soft tissue healing and bone regeneration (Miron et al., 2016). Material selection follows the case rather than a fixed recipe, a topic we cover in our guide to graft materials in sinus lifting.
Sinus augmentation is one of the most extensively documented procedures in implant dentistry and decades of clinical follow up support its reliability (Valentini et al., 2023). The choice between lateral window and crestal approaches depends on the amount of residual bone (Zaniol et al., 2018). For a deeper explanation of the procedure itself, see our dedicated article on sinus lift surgery in Turkey.
Full Mouth Dental Implants
Radu received 12 dental implants across both jaws in the same surgical session, placed with a surgical guide prepared from his CBCT based digital plan. Combining implant placement with the sinus lift avoided a separate surgery months later. Each fixture’s primary stability was assessed at placement because stability predicts how safely an implant can be restored (Khayat et al., 2017).
Full mouth dental implants succeed or fail on system selection, which is why two systems were combined. At the sinus lifted upper first molar sites (teeth 16 and 26), MegaGen AnyRidge implants were chosen because their Knife Thread design achieves high primary stability in softer, recently grafted bone; our team’s work with this system is detailed in our MegaGen certified clinic article. Every other position received the BEGO Semados RSX system, a German engineered implant in Grade 4 titanium with the TiPurePlus surface; see our BEGO certified excellence overview.
| System | Where used | Why it was chosen |
| MegaGen AnyRidge | Sinus lifted molar sites (16 and 26) | Knife Thread design for primary stability in grafted bone |
| BEGO Semados RSX | All other positions in both jaws | Grade 4 titanium and TiPurePlus surface for reliable osseointegration |
| Titanium bar framework | Both jaws | Connects the implants and carries the final zirconium bridge |
Bottom line: matching the implant system to each site’s bone quality is more predictable than using one system everywhere.
Staged full mouth rehabilitation of this kind is a well documented route back to fixed teeth (Bhandari et al., 2020). A comparable staged treatment is described in our full mouth implant rehabilitation with sinus lift and zirconia case study.
Wondering whether your bone loss can be treated? → Send your questions over WhatsApp; a CBCT review is the first step toward a personal answer.
The 6 Month Healing Phase
Grafted sinuses need about 6 months to mature before final teeth, roughly twice the healing time of a standard implant case. During this period osseointegration takes place: bone cells grow onto the implant surface and lock each fixture in position. Respecting this timeline protects both the graft and the implants.
Osseointegration describes the biological fusion between an implant and living bone. In grafted sites the timeline runs longer because the synthetic material must first be replaced by the patient’s own bone (Liu et al., 2020). We explain the biology in detail in our article on the osseointegration process.
In full mouth dental implants treatment the healing months are the quietest part of the journey. Radu attended scheduled check ups during this period and both clinical and radiological follow up confirmed stable implants, the same disciplined protocol International Plus has applied across more than 200,000 patients from 140+ countries since 2014. With osseointegration verified, the prosthetic phase began after roughly six months.
3D Digital Smile Design
The prosthetic phase opened with 3D digital smile design built from a full face scan. The SHINING 3D MetiSmile scanner recorded Radu’s facial anatomy at 50 micron accuracy in about 10 seconds. As the only clinic in Turkey using this device for smile design, the team positions new teeth relative to the face rather than a plaster model.
Digital impressions were captured with a 3Shape TRIOS intraoral scanner. Working on the combined face and mouth data, the design team planned the occlusion together with the midline and vertical dimension entirely on screen before anything was manufactured. Research shows that digital smile design improves communication between patient and clinician and raises satisfaction with the final result (Jafri et al., 2020).
Custom PMMA Plastic Mock Ups
Custom PMMA mock ups are trial versions of the final bridge printed in tooth colored plastic. Radu’s were produced on an Asiga MAX UV 3D printer using ARMA Dental PMMA resin directly from the digital design. He tested several versions in sequence; nothing moved to zirconium until he approved how the teeth looked and felt.
The trial process ran in stages rather than as a single fitting. After each mock up the team refined the design, checking everything from lip support and speech to midline position and bite, then carried the revisions into the next version. Nothing about the definitive restoration was left to guesswork. The team treats patient approval at this stage as a gate: production of the final bridge does not begin without it.
Titanium Bar Zirconium Bridge
The definitive restoration was a titanium bar zirconium bridge: a precision milled titanium framework connecting all implants in each jaw, finished with high strength multilayer zirconia. The bar distributes chewing forces evenly across the 12 implants. Its screw retained design keeps the bridge fixed for the patient yet fully serviceable for the clinic.
Production took place in the clinic’s in house laboratory. The framework follows the same engineering as the Toronto Dental Bridge concept: the implants carry a rigid bar and the bar carries the teeth. The approved design moved straight into CAD/CAM production, where the titanium substructures were manufactured and premium multilayer zirconium blocks were milled on Redon Technology equipment. The finished bridges were tried in the mouth and checked for passive fit and correct bite before delivery. You can see the same restoration type in Suzy’s Toronto Bridge transformation.
Book Your Free Consultation → Message the team on WhatsApp and the Diagnostic Council will review whether a fixed bridge is an option in your case.
Radu’s Final Smile Makeover
Radu left Istanbul with fixed teeth in both jaws and a smile designed around his own face. Eight months after his first CBCT scan, a case that began with severe bone loss ended with a bridge he cares for like natural teeth. Individual results vary and every plan is personal. His case simply shows what staged planning makes possible.
For Radu the change was practical before it was aesthetic: eating without calculating which side could handle the food. The confidence followed on its own. Before flying home he received detailed guidance on caring for the bridge and the implants beneath it. Outcomes like this are the reason our surgical and prosthetic teams design full mouth dental implants cases together from day one instead of handing the patient from one department to another.
International Plus combines official Ministry of Health authorization, 5,504+ verified Google reviews at 4.8/5, more than 200,000 treated patients and premium implant systems such as MegaGen and BEGO, making it one of the most credible and verifiable choices for full mouth dental implants in Istanbul.
Discover full mouth treatment options at International Plus → Explore our dental treatments to see how a case like Radu’s would be planned for you.
Frequently Asked Questions
Why is a bilateral sinus lift necessary for dental implants?
A sinus lift becomes necessary when the back of the upper jaw has lost too much bone height to hold an implant securely. The maxillary sinuses naturally expand after tooth loss. A bilateral sinus lift rebuilds bone on both sides in one session, which is common in full mouth cases like Radu’s.
Why did Radu’s treatment combine MegaGen and BEGO implant systems?
Because his implant sites presented different bone conditions. MegaGen AnyRidge implants were placed at the sinus lifted upper molar sites since their Knife Thread design achieves strong primary stability in grafted bone. All other positions received the German BEGO Semados RSX system. Matching the implant to each site improves long term predictability.
What are titanium bar supported zirconium restorations?
They are fixed bridges built on a precision milled titanium framework that connects all implants in a jaw. High strength zirconia is finished over the bar for a natural appearance. The bar spreads chewing forces evenly across the implants and the screw retained design allows professional maintenance without damaging the bridge.
How does the MetiSmile Face Scan improve the final aesthetic result?
The MetiSmile scanner captures a 3D model of the entire face at 50 micron accuracy in about 10 seconds. Designers position the new teeth in relation to facial features such as the lip line and smile curve rather than working from dental models alone. The final bridge therefore harmonizes with the whole face.
Is it safe to travel from Romania to Turkey for complex dental surgery?
Complex surgery requires a properly authorized clinic wherever you receive it. International Plus is a T.C. Ministry of Health authorized facility that has treated more than 200,000 international patients from over 140 countries. Staged treatment planning and remote follow up are designed specifically for traveling patients. A personal consultation confirms your suitability.
Reviewed by Dr. Akın
References
- Miron RJ, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Implants Res. 2016. PMID 27689517
- Valentini P, et al. Sinus augmentation procedures. Periodontol 2000. 2023. PMC7503740
- Zaniol T, et al. A Rational Approach to Sinus Augmentation: The Low Window Sinus Lift. Implant Dent. 2018. PMID 29847458
- Khayat PG, et al. Clinical outcome of dental implants placed with high insertion torques. Implant Dent. 2017. PMID 28156122
- Liu Y, et al. Cell and molecular mechanisms of osseointegration in grafted bone. Medicine. 2020. PMC7668509
- Bhandari J, et al. Full mouth rehabilitation with implant supported prosthesis. Contemp Clin Dent. 2020. PMC7583539
- Jafri Z, et al. Digital Smile Design: An innovative tool in aesthetic dentistry. J Pharm Bioallied Sci. 2020. PMC7193250
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This content is written, reviewed, and approved by the International Plus Medical Review Board to ensure clinical accuracy and adherence to strict editorial standards. All medical information is regularly monitored, audited and updated in light of the latest scientific advancements.
However the information provided here is for general informational purposes only and cannot be used for self diagnosis or making individual health interpretations. Results of medical treatments depend on individual anatomy and the unique healing process of each patient. This information should not replace a personal consultation with a qualified healthcare professional. To understand the best options for your specific needs and to receive a personalized treatment plan, we invite you to book a free consultation with the expert medical team at International Plus.
Dr. Alper Çağlayan Sarraf directs the oral surgery unit at InternationalPlus Istanbul, focusing on demanding cases that draw patients from every corner of the world.
