All you need to know about hybrid dentures ? 

What are hybrid dentures ? 

Hybrid dentures are implant-supported dentures that are secured to the implants with the help of screws and can’t be removed at home. They sit on the dental implants fused to the jaw bone. The implants provide more stability to the dentures than the conventional removable complete dentures supported by a residual bony ridge (u-shaped projection on the jaws where teeth were previously present) or denture adhesives.

How do hybrid dentures works? 

Four or six implants are placed at different locations in the mouth. If you don’t have enough bone in the mouth, bone grafting can be done to increase the bone volume to support the future implant. 

The implant body fuses with the jaw bone, and the protruding implant abutment in the mouth supports the denture. The implants work as tooth roots, and the denture is supported over them. 

Implant denture care 

Implant denture requires the same care as your natural teeth. Dentists advise cleaning it with a soft bristle toothbrush and toothpaste in the morning and at night to remove all the food particles. 

If the dentures are not kept clean, bacteria or fungi may grow around them, causing bad breath and redness of the gums. It is also advised to visit the dentist as scheduled so the prosthesis can be removed, cleaned, and placed back in the mouth.  

What are the steps required for the fabrication of hybrid dentures?

Hybrid dentures take time as they involve the initial stage of implant placement, followed by denture fabrication. 

Four or six implants are surgically placed in the bone, and the gums are closed to allow them to fuse to the jawbone. The implant integration with the bone takes three months. 

After 3 months, the gums are opened, a healing abutment is placed over the implant fixture, and gums are allowed to heal around the abutment. Gums take another 4-6 weeks to heal. Lastly, an impression of the jaws is taken, and a denture (false teeth) is fabricated in the laboratory.

The hybrid dentures are placed in the mouth and tightened with screws to secure them and prevent unnecessary movement. 

Patients who can get hybrid dentures 

You can get hybird dentures if:

Patients who can’t get hybrid dentures 

Implant osteointegration is critical for implant stability and supporting the overlying denture. Anything that can risk the implant stability is directly going to affect the retention of the denture.

For patients with recent valvular prosthesis placement, implant surgery is delayed until the patient is in stable condition. It is usually advisable to wait 15 to 18 months after heart surgery. An implant surgery can lead to low resistance to disease and increase the likelihood of an infection. 

Patients with particular medical conditions and addictions can’t take an implant or bone graft surgery. Therefore, these patients are not eligible for hybrid denutres. The patients are listed below:  

  • Severe kidney disorders such as nephritis, kidney tumors 
  • Uncontrolled diabetics have impaired healing
  • Severe osteoporosis affecting all the bones in the body – These patients have significant loss of bone mass and volume to retain the implants.
  • Chronic and severe alcoholics – These people present with retarded healing due to malnutrition, psychological disorder, inadequate hygiene, and significant infection risk.
  • Severe hormone deficiency – Several hormones, like a parathyroid hormone, affect bone density and regulate calcium levels in the body. 
  • Drug addicts – They have a low resistance to disease and a greater risk of infection, malnutrition, and psychological disorder.
  • Heavy smokers – They have delayed healing due to inadequate oral hygiene. 

What are the benefits and drawbacks of permanent denture compared to removable complete dentures? 

There are several benefits and drawbacks of permanent implant-supported over removable complete dentures. 

Benefits of hybrid denture over conventional removable complete denture

A hybrid denture is a fixed denture hence more comfortable for the patient. Four or six implants are placed at different sites in the jaw to support and stabilize the denture placed over them. However, a complete removable denture sits on the bony ridge and roof of the mouth either directly or with a denture adhesive.  

Chewing efficiency is greatly improved with implant overdentures compared to traditional dentures. According to different studies, a removable complete denture wearer shows a 30-60% decrease in chewing efficiency.

However, there is only a 10% decrease in chewing performance in patients with hybrid dentures. A traditional complete denture patient can only exert 5-50 lb force.

The biting forces are generated by artificial teeth and the denture plate sitting on the bony ridge previously bearing the teeth and roof of the mouth, respectively. Patients with implant dentures gain up to 85% of the original, biting forces within two months of denture placement.  

As implants support the denture, the implants preserve the bone height with fewer chances of ridge resorption (dissolution) over time. 

A removable complete denture requires 1.5 to 3.6 times more chewing strokes to break the food down than people with implant dentures. The teeth in the traditional removable denture sitting on the ridge don’t provide enough force to break the food into tiny pieces.  

Implant dentures require less soft tissue coverage. On the other hand, removable complete dentures cover the roof of the mouth, which affects the patient’s speech. However, patients get used to it over time. 

Drawbacks of hybrid denture over removable complete denture 

  • It takes a couple of months for the implant body to fuse to the jawbone. The prosthesis is made after that. You may have to wait longer to get the dentures. 
  • It is more costly than a removable denture. 
  • Denture teeth wear faster in implant overdenture due to greater chewing forces. Many cases require replacement after 5-7 years. Bear in mind the implants don’t need replacement unless they are loose.
  • For long-term retention of implants, plaque control and proper denture care are required. 
  • A hybrid denture is more prone to breakage than a completely removable denture.

Conclusion 

Hybrid dentures are fixed implant dentures that are secured in place with the help of screws and are only removed by dentists. They sit on the dental implants fused to the jawbone and provide excellent retention to the appliance. 

Implant supported dentures have an advantage over the conventional removable complete dentures in providing better esthetics and better chewing and grinding of food. They also prevent progressive jaw bone loss and give more patient satisfaction. However, due to denture teeth wear, the denture may require replacement after 5-7 years but not the implants unless they are loose.

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