Greg Kammeyer, DDS, MS comments:
No I wouldn't waste my time with mini implants. Too many fail or fracture. I don't know ANY residence trained surgeons that use them, even here, in the anterior mandible where the predictability is at its best. The literature shows this as well: 2 standard implants have fewer problems than 4-5 mini's. Dennis, how can you determine how thick this mandible is? If the patient wants minimal change Tim's 2 implant, tissue supported OD is predictable. As the bone and tissue resorb, the prosthetic becomes implant supported in the anterior, so use a metal mesh in your denture. The research shows no significant difference with a 2 implant bar versus 2 implant locator set up. Either way you are stuck with changing retention elements every 2 years. If they want moderate change, 4 implants w locators which can be upgraded to an implant supported prosthetic, if they want a great amount of change. Personally I like implant support (bar OD or FCD) as that thickens and increases the density on the posterior bone and gives them the most chewing force. Of the 2, the bar OD has a higher failure rate due to less metal than the FCD. I agree with Gordon as well that cross sectional imagery, Health history, patients expectations would help us help you more accurately help you.