All-On-4 Hybrid Treatment Options

Written by Andrew Sedler

One of the most common options for treating an All On 4® case is a hybrid prosthesis. But all “hybrids” are not created equal. We are a long way from the days of the only option being a cast metal substructure with traditional acrylic and denture teeth.

To begin, allow me to define what a hybrid is, as there are various vague interpretations out there. It appears that the term was coined because this prosthesis combines denture technology with screw-retained implant restorations, resulting in a hybrid denture, also known as a fixed/removable. The objective was to offer patients a non-removable alternative that could still be removed by the clinician for regular cleaning, tightening, and screw replacement.

In 2024, hybrid dentures offer a range of material options such as traditional metal with acrylic or metal-free alternatives like zirconia. These dentures are designed to mimic the appearance and functionality of natural teeth.

At Burbank Dental Lab, you can choose from four categories of implant hybrid restorations for screw-retained full arch “denture” prosthesis. Let me give you a brief overview of each category and compare and contrast them.

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4 Types of Implant Hybrid Restorations

1. Traditional Acrylic with Titanium Substructure

This restoration is fabricated using a titanium frame designed to merge with the implant interface. Its retentive design accommodates the adherence of acrylic and denture teeth.

Features & Benefits

Has resiliency that reduces impact forces so that it is not transferred to the implant.
Easily repaired should you sustain trauma, which is a great advantage.
It does stain over a period of time, but this can be readily cleaned and polished.
This prosthetic denture has a cured acrylic base. Teeth can be dislodged, but they are easily repaired.
Acrylic is generally cheaper and lighter but won’t last as long as zirconia.
Acrylic teeth have the longest track record.
May wear and will chip, but they are easily repaired in a few days.
Wears faster than natural teeth but will not wear opposing natural teeth.

2. SmartComposite Hybrid Prosthesis

SmartComposite Hybrid - Burbank Dental Lab

A unique approach within the fixed hybrid category of restorations, SmartComposite is a combination of milled CO/CR and Milled Monolithic Composite.

Features & Benefits

Strong, rigid metal bonded to resilient hybrid composite.
Highly polishable, it can be repaired in the mouth.
Less likely to chip compared to acrylic options.
Lightweight compared to Zirconia.
Very durable but may not be quite as durable as full zirconia.
Kind to opposing teeth; wears at about the same rate as natural teeth.

3. ZIRMAX M Hybrid (Monolithic Zirconia Screw Retained Full Arch Prosthesis)

The ZIRMAX M Hybrid is one of the most esthetic and durable restorations for the edentulous patient seeking an implant-retained solution. ZIRMAX M Hybrid Restorations exhibits a flexural strength of up to 1200 MPa, allowing you to deliver a smile restoration that looks natural and will endure even challenging occlusal loads.

Features & Benefits

This is the option with the greatest combination of strength and cosmetics.
Most patients feel this option is the closest to the feel of their natural teeth.
It has been around for approximately 10 years.
As far as durability, zirconia will tend to be the most durable option and will be the least likely to chip.

4. Porcelain Fused to Metal Hybrid Prosthesis

Features & Benefits

Requires the least vertical of any other hybrid option.
This is the most esthetic option.
It is more likely to chip than monolithic zirconia but has decades of acceptable longevity.
Typically the most expensive option.
Has the most versatility of treatment solutions.

With these four hybrid treatment options, there is something for virtually every All On 4 case requirement. The implant department at Burbank Dental Lab can assist you in determining which type of hybrid will work best for your case.

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Products

ZIRMAX Zirconia Dental Restoration

Esthetic All-Ceramic

Zir-MAX.M, and Zir-MAX.Me are high strength monolithic zirconias that exceed your expectations for zirconia restorations, ideal for use in full and single crowns and bridges.

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IPS e.max®

Esthetic All-Ceramic

IPS e.max® Product Description With over 100 million restorations, IPS e.max data shows over 97% survival rate and longitudinal evidence proves e.max to have a flexural strength of 500 MPa.

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SMART 1 Implant Abutments

Implant Restorations

SMART 1® abutments are custom engineered to best meet each patient’s case needs. Burbank Dental Lab uses the most advanced design and milling technologies to deliver the most precise fits available.

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SMART 1 Screw Retained

Implant Restorations

Burbank Dental Lab offers three distinct options within the screw retained category of implant restorations: Smart1 porcelain fuse to milled Co/Cr, Smart1 Screw Retained Zirconia, and the traditional Porcelain Fused to Cast UCLA abutments.

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Hybrid Restorations at Burbank Dental Lab

Implant Restorations

Burbank Dental Lab offers 3 different categories of implant hybrid restorations (screw retained full arch “denture” prosthesis): Traditional Acrylic with titanium substructure, SmartComposite Hybrid Prosthesis, and ZIRMAX M® Hybrid (Monolithic zirconia screw retained full arch prosthesis).

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Implant Provisionals

Implant Restorations

DuraTemps for Implant restorations are available in screw retained or cementable options. Burbank Dental Lab PMMA provisionals are CAD/CAM-generated and are recommended for long-term provisional needs such as implant or surgical cases.

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Articles

Improving Case Success: The All On 4 Workflow

Elevating the Paradigm of Dental Restorations with SmartComposite Hybrids

SmartComposite: When is Composite the Best Option?

ZIRMAX M: Strength in Zirconia Implant Fixed Prosthesis

Indirect Composite: A Great Restorative Option

ICam4D: Providing Accuracy in Multi-Unit Implant Cases

SmartComposite Hybrid: When Composite Is The Best Option

Resources

IPS e.max All-Ceramic Prep Guide

Resource Type: PDF

Implant Edentulous Hybrid Case Checklist

Resource Type: PDF

Cosmetic Full Mouth Checklist

Resource Type: PDF

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Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

Fabrication
of the future
is here!

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

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All-On-4 Hybrid Treatment Options

4 Types of Implant Hybrid Restorations

1. Traditional Acrylic with Titanium Substructure

Features & Benefits

2. SmartComposite Hybrid Prosthesis

Features & Benefits

3. ZIRMAX M Hybrid (Monolithic Zirconia Screw Retained Full Arch Prosthesis)

Features & Benefits

4. Porcelain Fused to Metal Hybrid Prosthesis

Features & Benefits

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