Are these positions for implants acceptable for a full arch fixed replacement?

What are you going to do about the supraerupted maxillary teeth so you have room for the prosthesis? I would place another implant on the posterior left. Possibly have the patient wear a transitional prosthesis to open the bite and get rid of the upper teeth prior to the final fixed prosthesis.

Good insertion. The more implants, the better; it's supposed to be fine. Warn the patient that the left side is weaker and predisposed to overloading. I would not do a transitional prosthesis, because a 2D X ray does not reflect a real tooth position. Probably, the molars' "supraeruption" is not an obstacle for bite rehabilitation.

In this clinical case I would apply a composite as a veneering material due to shock absorbing property.

When the patient has periodontally involved teeth that are lose, it does make a bite registration questionable because the patient is splinting. I agree with CRS, remove the lose super erupted teeth. Also super erupted teeth can restrict mandibular movement. The corvette of Spee has to be leveled. Do the case right! I would like to see another implant in the 20 or 21 position and two more in the anterior mandible.

What is the age of this patient? Are the upper teeth mobile? I would consider a transitional lower temp., to open the bite 2-4mm. What does the patient feel about the upper teeth? Adding a implant in the 20,21 space would be nice but not vital. Nice placement... did you use a stent?

why are you asking this question after the implants are in? Shouldn't this have been asked before something irreversible was done? Why wasn't this discussed with your restorative colleague and a comprehensive treatment plan developed for both the maxilla and mandible before surgery? Don't mean to be difficult but proper prior planning prevents poor performance as they say. This implant placement may be OK for ceramometal but a disaster for a resin based hybrid since there is a lack of interarch space.

The upper teeth are in desperate need for attention! Patient has advanced chronic periodontitis to the extent that bone loss is approaching the apices of molars. What's your plan for uppers?!? In a big case where you are rehabilitating a full arch, a great deal of treatment planning had to be in place with considerations of the opposing arch. Watch for peri-implantitis as I expect you will have to deal with it soon.

mwjohnson has actually asked the best question - why ask about problems when you have already placed implants. A transitional prosthesis (like CRS mentioned and others) is ALWAYS advisable in such cases as progressive loading will allow the bone around the implants to mature under load and if there is a failure (again maybe the left side could do with another implant) then at least you have not made a porcelain bonded bridge. You do need to address the occlusion and it would be smart to open the vertical dimension in this case. You should look at levelling the upper occlusal plane but if you have not warned your patient about this to start with then you may have to bear the cost implications - and thats speaking as a prosthodontist

All you need is 6 Implants and 3 bridges to restore the lower 4-6 on both sides and 3-3 anteriorly .... As to the bite height , I feel the case has been overclosed at the time that the Pan was taken due to lack of lower dentition .... so just open to a level that the patient is comfortable...... Regards Peter

The original poster of this question does not say the max. teeth are loose. If they are not loose you can easily grind 2 mm off the max. molar. I assume this is an older patient so that will not sensitize the molar. If it does, treat the sensitivity. If the max. teeth are loose do a full mouth treatment plan. Consider adding 1-2 implants to LL.

Dear...it looks female patient with asian origin...Upper molars are concern..becasue as soon you place proshesis in lower ,upperr may get problem as it looks perio compromised...i would suggest to load with temporary one peace or three piece brige. Wait for upper teeth's outcome and then plan the lower..Implant position is not bad,will accept considerably good predictable prosthesis...

implant in area of #19 is too short for a long span bridge. That is the area that takes 200 or more psi during mastication

#19 looks fine for length plus if splint to the others then not an issue - I think if you zoom in on the radiograph then he has laeft enough room not to damage the ID nerve and its possible that he is at the same level as the mental foramen (looks like the anterior loop is visible) - without the surgeon telling us what lengths etc he has used then commenting on lengths etc may be a bit tricky