All-On-4® Hybrid Treatment Options

mm 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.

First, let me clarify what a hybrid is. It seems that there are a reasonable number of foggy definitions out there. As best as I can determine, the term originated because the prosthesis is a marriage of denture technology and screw-retained implant restorations, thus a hybrid denture, and also called a fixed/removable. The goal was to give patients an option that was not removeable, but that was removable by the clinician to clean and tighten or replace screws periodically.

Hybrid dentures in 2021 have several material choices available now. From traditional metal with acrylic to metal-free options like zirconia, hybrid dentures look and function like natural teeth.

Burbank Dental Lab offers four different categories of implant hybrid restorations (screw-retained full arch “denture” prosthesis). I will highlight each of the four types and provide a comparison and contrast for each.

4 Types of Implant Hybrid Restorations

Acrylic & Titanium Hybrid

1. Traditional Acrylic with Titanium Substructure

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

Feature & 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 is made of cured acrylic base; teeth can be dislodged; however, 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.
  • Wear faster than natural teeth, but will not wear opposing natural teeth.
SmartComposite

2. SmartComposite Hybrid Prosthesis

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

Features and 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, may not be quite as durable as full zirconia.
  • Kind to opposing teeth; wears at about the same rate as natural teeth.
Full Zirconia Hybrid

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 exhibit a flexural strength of up to 1200 MPa, allowing you to deliver a restoration that looks natural and that will endure even challenging occlusal loads.

Features and Benefits

  • This is the option with the greatest combination of strength and cosmetics.
  • Most patients feel this is the option that 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.
PFM Hybrid

4. Porcelain Fused to Metal Hybrid Prosthesis

Features and 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 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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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.