When I first started doing hybrids, many were getting different types of metal bars and added teeth and acrylic gums by waxing them up on a model and then processing them, just like a denture. This type of y rid is called a “wraparound” as the acrylic completed covered the bar. When Zirconia hybrids first came out, I was not a fan for two reasons. First, they were butt ugly! The Zirconia was really opaque, ginigival porcelains were pretty new and it took a lot to cut them back and look good. The second is true today, it was not repairable. If you broke a Zirconia Hybrid, you had to start over and completely remake it. This is still true today. If you have read some of my posts you may know I volunteer at a clinic associated with a homeless shelter in Phoenix, Brighterway. I live in LA, so the concept of making a hybrid that could be repaired by anyone was really appealing. This guy loves two things, to eat and to break hybrids. So far he has broken two converted dentures, a metal frame re inforced hybrid, a 3D printed hybrid, and a Zirconia hybrid. Free 3D face scan with the Bellus 3D Face Scan App on the iphone. Scanned using DESS titanium scan bodies with CEREC Primescan only, no dominos like Imetric. The bite was scanned and the models matched with composite. Burbank Dental Lab donated the awesome lab work on this case.
Burbank designed and milled the frame as well as 3D printed on the Carbon 3D, plastic overlays to test the midline and the bite. Great fitting frame. Unlike the Y bar hybrid pictured above, the CAD bars here have a cemented PMMA overlay, so the metal goes down to the gingiva.
You can see how nicely Burbank milled and characterized the Meharry gums, not an easy task. Due to the placement of the implant on my #10 we had to add some composite. At the clinic we don’t have a lot of composite, hence the lighter shade. You can also see how the milled PMMA overlay is cemented to the bar with the bar touching the gums. Overall this guys got a great but most importantly, repairable prosthesis. A nice story about him, he was homeless at living at the shelter and through getting is All on X and converted denture, gained the confidence to leave the shelter and now works at the shelter!
You can see the hybrid in action. What I love, and many criticize, that this was done all digitally and no models or facebows. He has a working prosthesis in his mouth and we copy the bite relationship and use that within ExoCAD to simulate the movements of a semi adjusted articulator
We are doing a CEREC Live Patient Implant Course in Phoenix where we will cover CEREC Guide 2, Scanning with Scan Posts for Abutments and Crowns, as well as demoing full arch scanning with Primescan and Digital Dentures! Feb 20-22 2020. If you are a Trios user we can adapt the hands on for you!
If you want to know how to make guides, aligners, digital dentures and more, come to a 3D Printing party!! jan 17-18 in Minneapolis!!