HYBRIDDENTURE

A traditional hybriddenture ( also called a fixed detachable) can combine the benefits of a fixed restoration and cost savings of an overdenture. Hybriddentures are fastened with screws to the implants by the practitioner and the patient can not remove the restoration at will. A one piece frame is created either with the wax and cast technique or through CAD CAM technology. If CAD CAM technology is employed to manufacture the metal substructure a verification index needs to be made and passive fit confirmed in the patients mouth. Denture teeth and pink acrylic are processed around the frame work to hide the sub structure. This type of restoration can easily be repaired chair side in case a denture tooth factures.

Implant placement and angulation in the lingual-facial plane is critical since the screw access holes should emerge through the occlusal for posterior teeth and the lingual for anterior teeth. Placement and angulation in the mesial-distal plane is less of a concern.

The number of implants necessary to support a hybriddenture is somewhat controversial. One concept ( All-on-4) relies on the placement of only four implants while others advocate a minimum of five implants. Placement of only four implants results in cost savings for the patient but if one implant fails the denture is no longer functional and becomes a total loss. Five implants afford better stress distribution and if one implant fails the denture can in most cases be modified and saved.

If finances are of no concern and the patient desires a full complement of teeth without sacrificing esthetics, a sub group (PIB) of hybriddenture can be manufactured to meet those demands. The framework is designed as if individual teeth had been prepped for a traditional crown and bridge restoration. Single cementable crowns ( PFM, Lava, Procera and other restorative materials) are produced to fit over the individual preps and the frame is festooned either with pink porcelain or pink acrylic.