Full Fixed Hybrid Denture (All on 4)

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Elderly patients visit the dental clinics looking for a good smile and moderate chewing ability which was lost due to the loss of all teeth & supporting bone.  Removable Dentures were the only option earlier. After the implant revolution, it is possible to give back these patients normal healthy life for their functional and esthetic advantages.

When a person is looking for replacing a full set of teeth but not wanting traditional removable dentures, there were 2 options earlier.

Implant supported over dentures:  minimum 2-3 implants were placed in each jaw for support and normal denture is placed over them for stabilization without movements. But they are removable and need to keep out at night.

Implant supported traditional bridge: this requires 6-8 implants on each jaw and traditional ceramic or Zirconium Bridge is fixed to this. This is definitely the best choice. But looking at feasibility of available bone to place such many numbers of implants placement and financial aspects dictates this treatment choice.

Main hindearence encountered above “all on-6” or “all on–8” fixed bridge was lack of sufficient bone in elderly patients. Often this is not an option in the upper jaw due to combined vertical and horizontal resorption of bone. In this instance, a traditional fixed bridge would not meet the patient’s requirements for hygiene maintenance, esthetics, phonetics, and comfort. In addition to that, pink porcelain is less natural-looking and it usually requires more baking cycles that increase the risk of porcelain fracture.

These complications can be solved by a new technique that offers an excellent alternative which is called implant supported hybrid denture. Fabricating hybrid prosthesis can easily replace the soft tissue and it can reduce the mechanical and biological problems such as component fracture, screw loosening, and bone resorption. Also it requires a minimal number of implants placement (All on 4) unlike implant supported bridge.

It is also called as non removable hybrid implant prosthesis/ hybrid dentures or All in 4 technique fixed teeth.

Hybrid denture:

Hybrid dentures or hybrid prosthesis means it is a combination of removable denture and fixed bridge (It is like a removable denture fixed like a bridge). It falls between removable denture and fixed bridge.

A hybrid denture is one that is fabricated with acrylic material (even resin based PMMA, urethane dimethacrylate (UDMA) containing composite materials are used for the fabrication now days) over a metal framework and retained by screws threaded into the implant.

Dr. Sudhakar Reddy has extensive experience in fabricating hybrid prostheses. His experience includes placing several thousands of implants and more than 200 full mouth implant reconstructions and  multiple continuing education classes over the last decade.

Advantages:

The hybrid dentures achieve greater masticatory ( chewing) function and psychological satisfaction than with conventional over-dentures.

Producing a passive-fitting substructure.

Esthetically very pleasing in patients with excessive interocclusal space.

Works as shock absorbent and force distributer reducing the sudden load forces on implants

Self cleansing enhancement

Disadvantages:

Requires once in 6 months visit to dentist to get it removed for cleaning

Can’t withhold greater chewing forces / harder foods.

May need replacement of teeth set over couple of years

At Dental implant studio, Dr.Sudhakar Reddy places dental implant in single tooth replacement cases less than 15 minutes time without any pain either single stage or two stages depends on the situation and patients need. Also visit https://www.youtube.com/watch?v=K40wJ7UWA8I  for video.

Authored By DR. SUDHAKAR REDDY – Implantologist, Bangalore