Sarpe.
Maxillary premolar dental implants.
The two lower premolars you have left probably need to go. Wisdom teeth pulled. You won't have many lower teeth after this, but I know of no other way to create the necessary space. IPR won't be enough.
Braces to pull teeth into proper positions and inclinations.
Bimax. Maxilla impacted maybe 2mm left side 3mm right. Probably forward a few mm. Mandible forward to close nice big overjet that appeared after extractions, braces. and maxillary advancement.
This is only my best guess as to what you need to fix your teeth and jaw structure. And yes, I'd say you do need it.