A 50 year male patient with no medical history presented for a failing maxillary bridge. I had no choice other than extractions. Before surgery we agreed on placing 4 or 5 implants, splinting them with a bar and restoring with an overdenture. He refused sinus lift because of the costs and the extend waiting time. I grafted the site and placed just the distal implants. After 3 months we took a CBCT and I realized that things went very well and had enough bone and space to place 4 more implants. Now I wonder if the the overdenture is still the best option in this case or I might migrate to a screw retaind option (PM2 to PM2). I am worried about the cantilever I would create in the 1st quadrant although I realize that the overdenture will be also a pure implant supported construction but the advantage will be that the force on the overdenture will be considerably lower. He still refuses sinus lift. What would be your approach to this particular case?
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