This is my first post on Osseonews. I am a general practitioner, and I will be taking on 2 other specialists (prosthodontist as well as an implantologist) for this case. I would like to get your opinions on your evaluation of this case.
The patient is 57 year old female with no medical contraindications to treatment. She has been edentulous for 11 years, has had 3 sets of unsatisfactory complete dentures and hence does not want removable prostheses. In the maxilla, my patient has some spicules which I can remove and smooth out with an alveoectomy, and I am confident that I can make a retentive complete denture.
I have attached clinical records done on March 3. OPG made on March 19, and CBCT made on April 9.
Opinion I: All-on-6/8 on the upper arch and 2-implant supported overdenture on lower arch since the lower arch has resorption and placing 6 implants is not possible.
My doubt is whether an acrylic overdenture will be compatible strength wise opposing a castable/milled/hybrid upper fixed prosthesis or will it we better to have an acrylic denture opposing the overdenture?
Opinion II: 4-implant supported upper overdenture, 2 implant supported lower overdenture
Opinion III (from another implantologist): All-on-4 in the lower arch and All-on-6/8 in the upper arch using short implants in the lower arch, indirect sinus lift for upper left side and ridge split for maxillary anterior region. My doubt is whether implants can be placed avoiding the left maxillary sinus instead of a sinus lift or will the distal cantilever till the first molar region cause imbalance in force distribution.
Please provide any comments you have on the case, the scans, the treatment options mentioned above, any other solution you may have and the best probable options along with any other observations that can help planning prosthesis for the case. Thanks in advance and apologies for image quality, as these needed to be compressed to upload to the site.