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Fixed-Detachable Denture: 8 or 6 Implants?

posted in Treatment Planning & Complications, Implant Supported Overdentures

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Mike asks:

I have always been taught that when treatment planning a fixed-detachable implant denture for an edentulous maxilla, 8 implants are the norm. I have recently seen many clinicians placing only 6 dental implants in the edentulous maxilla for this type of restoration, thereby eliminating the need for bilateral sinus lifts. Is this clinically acceptable?

5 Responses to “ Fixed-Detachable Denture: 8 or 6 Implants? ”

• M. John Matos, DDS May 1st, 2007

  
  

  I have been placing 5 between the areas of 5 and 12 in the edentulous, atrophic maxilla for about 8 years with excellent success. The key is 5 as long as you can, enganging the floor of the nose, into the dense bone of the piriform aperture and even the anterior sinus wall… the key is then the occlusion and what is opposing - nightguards are also mandatory to remove any parafunction.

• M. John Matos, DDS May 1st, 2007

  
  

  oh… if you can get 8, assuming the patient can afford it… is ideal… the more the merrier… have had some success with 4… few cases in case where four in maxilla and five in the mandible with perfecty balanced occlusion and fully consented patient… and as always… informed consent and reasonable patient expectations/understanding.

• Dale May 3rd, 2007

  
  

  Mike, I would say that no one formula fits all pt’s. 8 implants is ideal, but in a small female for example 6 implants may suffice. In a large male with large masseter muscles (bruxing potential) I would not do anything less than 8 implants for the maxilla. Also must consider the opposing arch. Implant supported fixed detachable with plastic teeth or natural dentition. many things to consider when treatment planning your case.

• L. Scott Brooksby, DDS, DICOI May 7th, 2007

  
  

  Why the aversion to a sinus lift? Cost? If it costs $4000 for a sinus lift and the success rate is substantially higher, what is the problem?

  If you place too few implants and then overload them and they begin to fail, what have you gained? I am sure at that point, the patient will be glad that you did not have them spend as much money in the beginning.,

• Yazad Gandhi May 20th, 2007

  
  

  Scott’s absolutely right. If you rquire a sinus lift just go ahead n do it. Otherwise 4-6 implants is what you would generally see in the edentulous maxilla. A good way to judge is (A)The patient’s build {big or small} (B)Systemic factors.
  Big built males would never survive with 4 implants. Any evidence of Diabetes Mellitus or underlying bone disorders again you would never succeed with 4.
  Recently had a case where 4 implants were placed in the maxilla n were rock solid for 3 months after which within a week 2 got infected and showed frank purulent discharge.
  The blood sugar was proved as the culprit (Fasting value was 238).

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