By: Lee Ann Brady DMD
This topic originally appeared on Pankey.org. Dr. Brady granted permission for igniteDDS to share with our readers.
Over time, even the best dental work needs attention, nothing is guaranteed for life. Recently, I saw a patient who had chipped a tooth on her lower hybrid denture and loosened an implant screw.
The denture had been placed 18 years ago, so she had an old titanium bar with denture teeth and pink acrylic. That day, I put the screw back in and smoothed out where the tooth was chipped. During this visit we had a great conversation about the future of her hybrid denture.
I have had a similar conversation with several patients in recent months. They have the original, traditional bar retained hybrid denture that is nearing the end of its lifespan. And so, what are the options?
Choosing Between Available Options
For patients with older bar-retained hybrid dentures, there are two primary paths to consider:
- Adjust the Existing Bar: If the titanium bar is in great shape, you can preserve it while replacing the denture teeth and base. This option allows for the new components to be milled and placed over the existing structure, ensuring a continued secure fit. Before moving forward, however, the bar should be thoroughly examined by a lab under microscopy to ensure it’s still viable after years of use.
- Transitioning to an All-Zirconia Solution: Another option is to change the entire denture system to an all-zirconia solution, which offers excellent strength and durability. However, if the patient has both upper and lower dentures, transitioning just one arch to zirconia may cause accelerated wear on the opposing denture if there are parafunctions. The zirconia arch is likely to fracture the opposing original prosthetic teeth.
Setting Realistic Patient Expectations
We have options today we can think about with our patients, but many have in their minds that when they got their hybrid dentures years ago, the dentures would last. All the time, energy, and dollars to freshen up or replace their denture is a big deal to them. Shifting their mindset from “I thought I was done investing in dentistry” to “My denture is at the end of its lifespan” is a big hurdle. So, the earlier we can start those conversations before they need to invest, the easier they can transition their minds to accept care with grace when the time comes.
When your bar retained hybrid denture patients visit for perio maintenance and your exams, inform them of the lifespan of their denture is at most 20 years and set expectations for discussing the best available options at some point in the future.
In Conclusion
Excited to learn more about complexities of surgical and prosthetic implant treatment planning? Stay tuned for mastering anterior implant esthetics with me at the The Pankey Institute . Make success predictable and handle any case that comes in your practice with expertise.
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