PART SELECTION HYBRID DENTURE

Intermediary    abutment

Regardless of the production method (wax up or CAD-CAM), if the implants are set very deep (more than 2mm) under the tissue it becomes necessary to place intermediary abutments specially designed for screw retained restorations. These abutments are already placed by the restorative dentist and impressed with special impression copings or the laboratory will select appropriate collar height abutments for screw retained restorations. The UCLAs as well as the analogs for screw retained abutments are designed differently than UCLAs that screw directly to the implant or fixture level analogs and are not interchangeable.

1. Wax and cast

Non indexing UCLAs

Hybrid dentures (wrap around) have to be waxed and cast with non engaging UCLAs. All plastic or gold plastic combinations are utilized for this type of restoration. All plastic parts are considerably cheaper but sacrifice the precision fit of gold plastic combination UCLAs. Choose appropriate platform diameter UCLAs from the implant manufacturer or clone parts. Implant placement is critical in in the facial-lingual plane because the screw access holes should come through the center of the occlusal surface for posterior teeth and the lingual for anterior teeth. Implant placement in the mesio-distal plane is less critical. Vertical clearance needs to be carefully evaluated to leave enough room for the denture acrylic and denture teeth.

2. CAD-CAM

Verification index

Modern CAD CAM technology enables the manufacture of titanium frame works machined from one piece titanium disks without the purchase of UCLA abutments or metal cost. As with a waxed frame work the use of intermediary abutments may be indicated. The abutment to implant interface is machined in a non engaging fashion. A verification index made with non engaging metal temporary abutments is highly recommended because it is almost impossible to laser weld a titanium frame. The verification index needs to be tried in the patients mouth to ensure the working model is accurate.

CAD CAM substructure manufacturers

Biomet 3i™ PSR® CAM StuctSURE®

CAM StructSURE® bars for hybrid dentures can be milled for a wide selection of implant brands. There are many design options, some with and some without metal to tissue portion. It is also possible to have a prototype mock up copy milled. Send only the master model with the incorporated analogs, soft tissue mulange, diagnostic wax up, verification jig and or mockup prototype. Compatibility chart and design options. Procedure and laboratory manual. Rx .

CAGENIX™, AccuFrame®

The list of AccuFrame® supported implant brands is limited and most have to be machined with intermediary abutments. Send only the master model with the incorporated analogs, soft tissue mulange, diagnostic wax up and verification jig. Procedure manual, RX.

Dentsply Compartis® ISUS™

Compartis® ISUS™ bars can be milled out of titanium and chrome cobalt. Send only the master model with the incorporated analogs, soft tissue mulange, diagnostic wax up and verification jig. RX

Glidewell

Glidewell offers a package price including analogs and model work. Rx

Nobel Biocare™, Biocad

Biocad produces the most beautiful finished titanium bars for the widest selection of supported implant brands. Laboratories with Procera® capabilities are able to virtually design the bar in house after sending the master model to Biocad. Send only the master model with the incorporated analogs, soft tissue mulange, diagnostic wax up and verification jig. Rx

Nobel Biocare™, Procera®

Laboratories with Procera® capabilities are able to virtually design the bar in house or copy mill a bar design. Scan master model and prototype mock up with a Forte scanner.

Whip Mix, Vericore®

Whip Mix can copy mill your design or virtually design and mill titanium bars. Direct to the implant or with intermediary abutments for many implant brands and diameters. Send only the master model with the incorporated analogs, soft tissue mulange, diagnostic wax up and verification jig. Rx