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K. F. Chow BDS., FDSRCS July 19th, 2010
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.
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