Five Implants to Retain Overdenture: Should I Do a Ridge Augmentation Also?

Two points 1 - is an extra implant not an option and possibly look at a fixed type of hybrid prosthesis - obviously the site and available bone are factors. 2 - With an over denture you should be able to compensate for the ridge discrepancy with acrylic, unless your surgeon needs a graft for the implants.With the support of 5 implants you should be able to remove most of the palatal coverage.

Dear Dr FK. If you have planning to places implants to insert overdenture on maxilla probably you are going to place MINI Implants NOT implants.In this case you do not needed bone graft and alveolar ridge augmentation because border of the overdenture should cover vestibular for denture stability.In otherwise,if you are going to places implants you may needed more than 5 implants to retained denture on maxilla,however, if defect of the bone is on static zone you needed alveolar ridge augmentation on the left side,so the left side would be at the same occluso-gingival right level and static will be favorable. Good luck Dr vaziri from Iran

Root form implants are the best option and if the appliance is to be tissue born but implant retained there should be no need to augment the ridge (providing adequate bone is available for the implants)

I agree with the comments from Drs Mac and Cason in the fact that since you are using a maxillary overdenture, The height of the ridge on either side will not make any esthetic difference as you can compensate with the acrylic and your teeth set-up. Different story would be if the bone augmentation is required for surgical reasons to accomodate your implants.

I just want to leave simple reminding, that the ridge augmentation may compromise your inter occlusion space that you need for normal occlusion, thank you

The longer that I am involded with implant dentistry, the more and more I think the only reliable grafting methods are the following: ridge expansion, sinus lifts, 4 and 5 walled defects.

If you are placing 5 conventional implants, you might as well place one more to make it 6 and have a fixed prosthesis. A fixed prosthesis will be more reliable than a removable one because there will be less pulling and pushing of the implant during removal and placement if a removable is used. And some will also convince you that 4 is enough....all on four. But if you are placing minis for a removable prosthesis, then place 6 for balance, three on each side between the centrals to the premolars. Place the longest you can and bicortical if possible, because the maxillary bone is softer....and therefore more piling is needed....yeah...like building a house....see. Bone augmentation is unnecessary and very difficult, as is suggested by Dr Richard Hughes. To raise the height of the maxillary ridge, you will have to use a titanium mesh with bone graft mixed with bone marrow.....and it will take a much longer time, incur more pain to the mouth as well as the pocket. Go with minis and forget about the bone graft as there will be adequate aesthetics with an acrylic prosthesis with plenty of pink acrylic to fill up the deficiencies.

Dear dr.F K In order to make an implant tissue supported removable overdenture, if for implantation you have enough bone,the pink acrelic resin can compensate the unleveling.so no graft is needed. good luck.

Some block grafts are successful and again the ridge expansion, sinus lifts, 4 and 5 walled defects are very predictable. Over all, I am much more conservative and I am using other modalities more and more such as Blades and Subperiosteal Implants (subs require that the implantologist has alot more knowledge and skill). The extensive grafting is questionable, expensive and takes way too much time for treatment.

I am surprised that no one has inquired as to what the patient has on the opposing arch. No one has asked how much alveolar bone height the patient has posteriorly. It is possible that the longer bone may be caused by supraeruption of the teeth. Ther is simply not enough information here.

Dr. Kimsey, You are most correct!