Maxilla implant placement in Class 3 Occlusion?

I have a patient who presented with missing maxillary anterior teeth #7,8,9 and 10. She currently wears a removable partial. She is in a Class III occlusion. The overjet of her lower incisors extends approximately 6mm labial to the maxillary crestal ridge. If I were to place implants at sites 7 and 10 with fixed 4 unit bridge(7,8,9,10), the custom abutment would need to be at least 45 degree labially. I think it will look very odd, not to mention the cantilever force it will create. So my question is, how many of you would refer to an oral surgeon for block graft. I have been placing implants for 5 years but this case I’m thinking of referring out. By the way, the patient is of Asian ancestry.  What do you recommend?

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4 thoughts on “Maxilla implant placement in Class 3 Occlusion?

  1. So I spoke with the patient today, and she doesnt sound thrilled about the idea of getting any additional surgery or bone block graft augmentation in premaxilla buccal region. She currently wears a cast partial denture with the maxillary denture teeth labial to maxillary crestal ridge. The next option im considering is FP3 restoration saddle where the denture teeth would be labial to the maxillary ridge retained by either dolder bar and zest locators.
    Thank everyone in advance for the input. I will try to post some pics

    Mike

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