Canine-to-Canine Implanted supported Fixed partial Denture?

It all depends on the width you have to play with and the quality of the remaining teeth. On the opt I would suspect you could find room for 6 - 8 implants and ultimately use a cad cam bridge. Either using an immediate or delayed protocol.

Thank you Dr Hacker, I will follow your plan of All-on-6. (4-6-7) & (10-11-13). Bone seems most viable in these regions plus we can avoid the sinus lifts. Ultimately a hybrid spanning from 3-14 should be sufficient. Can I immediately load the implants I place with a locator retained overdenture? Will this not impact osseointegration? Thank you.

If you are doing an all on four or six the point is that it is immediately loaded per protocol with adequate reduction for the framework at surgey. The time to plan the prosthesis is at implant placement if reduction is inadequate the prosthesis will break. The only way to tell if the reduction is adequate is with the provisional. If you are planning a hybrid then bone has to be added to prevent long crowns. If you just place implants with no regard for the final prosthesis you will end up with locators and a denture to make up for the lack of soft tissue, bone and transition line. I would advise picking a prosthesis and working with a surgeon who understands the treatment protocols and the type of surgery required. It is determined by the final prosthesis, the trick is knowing what to do with the bone quality during implant placement. If you load the provisional on locators osteointegration will be compromised and the denture can cause bone resorption if not balanced the lower teeth will also help. This is a complex case and the treatment parameter need to be respected. I like Omar's advice below with a little grafting it us more conservative, keep the patient on a full liquid diet advance as tolerated and see what you get.

Dr. Omar, Well said. This is a full upper case, not just the anterior quadrant. Judging by the perio issues seen here, it may be worthwhile to stay with a LOCATOR supported overdenture. I have never done a provisional denture that actually used the LOCATORs in the first three months. Too risky. My plan: 1) Make preparations to make an immediate upper, have it ready on day of surgery. 2)Extract all uppers, clean sockets 3) Place implants in a minimum of four locations on the upper. First molar and canine sites are best. Healing abutments as well. Graft as necessary. 4) Deliver the immediate with chairside hollowing for the healing abutments. 5) Reline after 3-4 months and include LOCATOR attachments underneath, and LOCATOR abutments on implants. Inexpensive treatment, plus you can always add two more implants at a later date and convert to an "All-on-six Hybrid" Your thoughts?