Restorative options for implant supported prosthesis?

Hi, 1. root canal on upper left second premolar and then extract upper left first premolar and place a long term temporary bridge. At time of extraction one can place an implant. 2.place implants in lower jaw when the retained roots are extracted 3. restore upper premolar to premolar occlusion 4. restore lower implants 5. place short implants, 6.25mm x 6mm Adin in posterior maxilla 6. restore implants splinting them.

take into consideration that this pt. has decay issues probably due to poor oral hygiene and a 6.5 mm implant when bone remodels leaves with a potential problem. I would probably extract 11 12 13 and place 4 implants 11-14 do a sinus graft on UR side place 2 implants with splinted crowns in the maxillary arch and then worry about lower arch. This is a very young pt that needs long lasting reconstruction..

This patient is young and her dentition seems to be failing her. Will she be able to control the risk factors that have brought her to this point? What will her natural dentition be like in 5-10 years? If she wants to transition into a fixed implant supported prostheses in the future, will alveoloplasty be needed to hide a transition line? Existing implants may limit your ability to do so. Think long term....I'm concerned about 5, 7,8 and 9. They could go at any time. I would at least present a full arch option for her maxilla.

This a" train wreck" happening in slow motion. Long term planning is the only way to approach this. Implants may not be the answer for her