Treatment planning for implants: recommendations?

Do the perio first of all.

Restore 26 and maybe 28 before starting 25 and 27. Perhaps extract 28?

believe I would extract the molar, graft the site and do two or three implants. Looks like you have the bone. Good luck

Extract 26 and place bone graft in the socket. You may place an 11.5 /4.2 implant in 25. Just behind 26 make a direct sinus lift, and place an implant.if you place the implant posterior to 26 you have place also to extract 28 and put the third tilted implant. If you don’t want the third implant, Put the 25 an implant, and the second one in 27 with a sinus lift. Then extract 28. In any case , treat the perio. Regarding the restoration- always try using screw bridge. Good luck 👍.

Thanks for posting. Whats the situation in Quadrant 1? If the bone support is not good then why not extract all and give all on 4? Im just new so would like to get feedback whats wrong with my thinking...thanks again

Yes you can! Try to put a 8 mm long, 6 wide. Ant you can avoid the sinus lift . Even if it will be a little tilted (not too much).

I agree with Mak. Clear house on the upper and do the all-on-four. This would help enhance chewing function, esthetics and oral health. Though based on the limited view this single cbct provides, in relation to the balance of this patient’s dentition, that may be the best treatment to provide both arches: max & mand. If the patient came to be in the present state of health at this point now, what will motivate them to extremely enhance their personal oral hygiene care to the level needed to maintain implant dentistry?

I try to understand why all on 4?There seems to be enough bone in the second quarter, if there is the same quantity of bone in the first quarter, it is possible to perform 6-8 implants. The problem with all on 4- If you lose a single implant you can not progress with rehabilitation. I do all on 4 only if there really is no other option. In conclusion - personally I would remove everything and perform 8 implants and screwed rehabilitation