By David Hudnall, DMD
When it comes to utilizing dental implants to replace an entire arch of missing teeth, there are several treatment options available to the clinician. The most permanent and natural-looking method involves placing traditional crowns and bridges upon multiple dental implants spaced within the arch that replace the roots of almost every missing tooth. Clearly, this method restores the patient’s teeth and gives them the feel and function of real teeth.
But very few edentulous patients have an adequate quantity of bone throughout an arch to replace the roots of every tooth without undergoing extensive bone augmentation surgery. Not to mention the price; the procedure is cost-prohibitive for the majority of edentulous people. Is there an alternative treatment that accomplishes similar restorative benefits while not breaking the bank? Enter hybrid implant dentures.
Types of Hybrid Dentures
What is a hybrid denture? A hybrid denture is a cross between a removable implant-supported denture and a fixed bridge. Because a hybrid denture is secured into place with fixed screws, it can only be removed by the clinician for periodic maintenance.
Hybrid dentures can be made from different materials, some of which are more durable and long-lasting than others. We’ll discuss two of the most commonly used types of hybrid dentures available and talk about the advantages and disadvantages of each.
Acrylic Hybrid Denture
Imagine a cast metal partial denture that encompasses an entire arch and is secured to multiple implants by screws. That is what an acrylic hybrid denture is. Using a custom metal substructure, usually made from titanium, the acrylic hybrid denture possesses both strength and rigidity that allow it to function as a free-end appliance beyond the constraints of the implant abutments.
Pros
- A less expensive option compared to a zirconia bridge or traditional crown and bridgework
- Minor repairs to the acrylic may be made on site in the dental office
- The material is lightweight
Cons
- Acrylic is a porous material that can trap bacteria in cracks or crevices
- The denture is somewhat difficult for the patient to clean
- Denture teeth and acrylic can stain with use
- Diminished longevity; average life expectancy is 5 to 10 years
- Acrylic is prone to cracking and breakage
Zirconia Hybrid Denture
The entire arch of teeth with any necessary flange is fabricated as a single unit via CAD/CAM milling technology from a solid block of zirconia. Since zirconia is an incredibly strong material, it provides sufficient strength and durability to function as a long-span bridge. Ceramic is layered and fired onto the surface of the zirconia denture to custom stain and color the teeth and the gum material for a lifelike appearance.
Pros
- All-ceramic material resists stains and bacteria accumulation
- Its smooth, glassy surfaces are easy to clean and aid in the patient having improved oral hygiene
- Excellent wear resistance
- Longevity can be 20 years or longer provided that the appliance is properly maintained
Cons
- Expensive; zirconia hybrid bridges easily cost double compared to acrylic counterparts
- The appliance is heavier and weighs more than an acrylic denture
- Repairs must be performed by a dental laboratory, requiring the patient to be without teeth
Choosing Hybrid Dentures
Although a hybrid implant denture can be a wonderful final restoration for cases involving six or more implants, it is most routinely used to restore all-on-4 dental implant cases. Using the all-on-4 technique, the entire prosthesis is supported by four implants total: two endosteal implants located in the canine areas and two much longer implants placed at 45-degree angles toward the distal from the premolar region.
Using this method allows the implant surgeon to take advantage of the greater bone density present in the premolar area while extending support for the hybrid denture further distally for greater stability and evenly-distributed contact with the opposing dentition.
Benefits of Hybrid Dentures
Whether you choose an all-ceramic restoration or a final restoration made from a metal framework covered by acrylic resin, a hybrid implant denture offers restorative options unmatched by any removable appliance. Some of the added benefits include:
- A more affordable way to restore an entire dental arch than dental implants that replace individual missing teeth
- Look, function, and feel like natural teeth
- Stability; offers maximum support from the dental implants
- More convenient for patients because they do not need to remove the appliance
- Embarrassment is avoided because friends and loved ones never see the patient without their teeth
- Less bulky than traditional dentures or even removable implant-supported dentures
- Taste buds and temperature sensors are more fully exposed
- Because the restoration is fully supported by implants, gum irritation is eliminated
Hybrid Dentures: One Step at a Time
Realistically speaking, hybrid denture cases are a huge undertaking for both the dentist and the patient. Aside from the implant surgery, the cost of the final restoration can be considerably more than many patients are able to manage within a short period.
However, just because a full-arch implant case is first restored with a removable appliance doesn’t mean that the patient doesn’t have more-permanent treatment options available to them in the future.
Stomadent Dental Laboratory can help you improve your patient’s quality of life by upgrading them to a fixed hybrid denture that provides beauty and comfort that a removable appliance can’t offer. When your patient is ready to experience the very best, trust Stomadent to be your hybrid denture experts!
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