Hybrid denture

[twaite]

What is your best advise on processing a hybrid denture. What should I watch out for.
I have an upper and lower to process both have six implants and a steal bar inside.

T

 

[Thedentureman]

Steal?

 

[nvarras]

I think he's hiding a stolen bar in one of the dentures

 

[Jo Chen]

Well, let us know what method you are using to process. Ivocap, packing or cold cure?

 

[Smilestyler]

Ivocap is the way to go. I'm pretty sure your bar is titanium.

 

[twaite]

The bar is titanium, I have spoken to a couple of techs and gotten different answers.
One tech says use long screws but my tech is insisting on short.
One tech says he cold cures his final hybrid. We are planning on heat cure with diamond d

We will flask it as usual, boil out, clean every thing up, press the acrylic and cook for nine hours.
Hopefully I haven't over simplified this but so far this is our plan.

 

[twaite]

Ivocap is the way to go. I'm pretty sure your bar is titanium.

Could you post a picture of you spruing for your hybrids? Or refer me to someplace to see it.

 

[droberts]

Another key here for processing also starts with your bar design. Leave your bar post as long as possible.
This will aid in having clean and uniform screw access holes. Fully waxed and ready to process, I leave a small
dimple where my access hole is. Injecting silicon "soft tissue" in the holes before injecting the acrylic.
Easily removable once cured and deflasked. I would highly recommend Ivocap for processing. Less pressure (stress),
90 lbs (6 bars) is applied to the bar during the process.

 

[Smilestyler]

I spruce on both distal ends. I put the 'dimples' like droberts mentioned then I grind it out ligtly afterwards and cold cure around guide pins. It may be too late for your case now, but get your bar milled with higher screw holes as also mentioned by droberts.

 

[JohnWilson]

While I respect Danny and find him to be a superior tech I must share that I process hybrids differently.

I use IVOCAP, I have compression packed them as well but Injecting is much easier. I want as much room for the denture tooth as possible, I want to have a minimum of 2mm of acrylic surrounding the denture tooth. I want to make sure things are waxed ideally and I do not process on the model. I do not cut access holes until after the case is processed. It allows me to make a clean cut and not have a pink ring of acrylic around the access hole or have a metal ring exposed.

While I am sure there are many around this world that do it like me I have developed special tools that I have retrofitted my surveyor with. Not everyone will be able to replicate how I achieve my product and I am not sharing pictures of this set of tools (trying to sell the idea). I know many that adjust denture teeth drill holes, wax the case, and double process to allow tooth shade around the teeth but I always thought this was a waste of labor.

Good luck let me know what you end up doing

 

[Tayebdental]

John,
What makes this site great is the exchange of idias and ( pictures) so John, please show us the pictures of your set of tools!!

 

[JohnWilson]

John,
What makes this site great is the exchange of idias and ( pictures) so John, please show us the pictures of your set of tools!!

I think my track record for sharing speaks for itself, this is a bit different,

Its an expensive process to get a patent, so for now I am not willing to give away.

 

[Tayebdental]

I think my track record for sharing speaks for itself, this is a bit different,

Its an expensive process to get a patent, so for now I am not willing to give away.

Johe,
I respect that, I was just kidding. I have some of my own inventions.

 

[twaite]

I spruce on both distal ends. I put the 'dimples' like droberts mentioned then I grind it out ligtly afterwards and cold cure around guide pins. It may be too late for your case now, but get your bar milled with higher screw holes as also mentioned by droberts.

I see what you guys mean about higher screw holes. Next time. I found an artical in genioess.com
and followed that method. We break out today.

 

[Rex Kramer]

John, whats your rule on hybrid wrap-around (upper-lower) wax-up to soft-tissue location, that is, prevent food trap but easily cleaned. Can you post a pic of final wrap-around hybrid?

Also, do you process for other labs? Being a one man shop I do everything BUT process acrylic. I'll have a lower waxed on a NobelProcera wrap-around bar I made ready next week. Normally use my local "pack'n" lab but your technique sounds a whole lot cleaner and love the idea its not done on a final model.

 

[droberts]

I see what you guys mean about higher screw holes. Next time. I found an artical in genioess.com
and followed that method. We break out today.

You'll get it Just waxed a simple 4 tooth, two implant sectional anterior hybrid that I designed the bar with the bar post 2mm sub-gingival on the lingual.
Leaving dimples in the wax works excellent. After the case was processed, used a #6 burr paralleling it up with the analogs , using the burr to open up the access hole.
Note: Always use a burr slightly smaller diameter than your internal bar post, then increase to the diameter of the bar post. Then remove the silicon, as most of the time it will slide right out.
Makes for a very clean access hole as mentioned in a previous post.

 

[JohnWilson]

The higher the extension or "tube" is in metal necessitates a tooth that has to be thin when you process over the bar extension. When I am using a high end tooth which I do on all hybrids they become brittle when you grind them too thin. By not having to grind the teeth you will create a stronger chip resistent access hole as well.

I never say MY way is the only way it just works for me. Your milage may vary, as some very fine techs sharing here have success with their technique.

Just sharing

 

[Smilestyler]

The higher the extension or "tube" is in metal necessitates a tooth that has to be thin when you process over the bar extension. When I am using a high end tooth which I do on all hybrids they become brittle when you grind them too thin. By not having to grind the teeth you will create a stronger chip resistent access hole as well.

I never say MY way is the only way it just works for me. Your milage may vary, as some very fine techs sharing here have success with their technique.

Just sharing

Sometimes when a tooth is too close to an access hole, you can have the surgeon rotate the multi abutment to move the access hole without compromising tooth position or the denture tooth. I prefer having the channels higher because it makes the intra oral aspect much easier and cleaner. If the access holes are filled with acrylic they are easier to find, and if they are filled with pvs they don't catch rough acrylic (hard to make smooth in there)

Regarding your invention; it sounds very promising. I have been using a net surveyor and statik laser for a few cases. Want to compare notes? I'm not interested in inventing anything.

Edit; make sure you make changes to abutments prior to impressions

 

[droberts]

Sometimes when a tooth is too close to an access hole, you can have the surgeon rotate the multi abutment to move the access hole without compromising tooth position or the denture tooth. I prefer having the channels higher because it makes the intra oral aspect much easier and cleaner. If the access holes are filled with acrylic they are easier to find, and if they are filled with pvs they don't catch rough acrylic (hard to make smooth in there)

Regarding your invention; it sounds very promising. I have been using a net surveyor and statik laser for a few cases. Want to compare notes? I'm not interested in inventing anything.

Edit; make sure you make changes to abutments prior to impressions

I am not sure what you are referring to " filled with pvs they dont catch rough acrylic". Any photos? Silicon is injected flush at the top of the bar post to fill the hole and protect the screw. With a wax dimple in acrylic that is aprrox 2mm directly above the bar post, it allows me to easily use a round burr and create a nice finished uniform access. Also, the hybrid is not processed to the master cast. Depending on the case, analogs are used for bar support during processing invested directly into the bottom half of the flask. As for extending the post up higher defeating the support of the tooth due to thinning it out, falls into the area of anterior teeth. Totally in the hands of the bar designer. Hopefully John your patent comes through that you can share your technique

 

[Smilestyler]

I am not sure what you are referring to " filled with pvs they dont catch rough acrylic". Any photos? Silicon is injected flush at the top of the bar post to fill the hole and protect the screw. With a wax dimple in acrylic that is aprrox 2mm directly above the bar post, it allows me to easily use a round burr and create a nice finished uniform access. Also, the hybrid is not processed to the master cast. Depending on the case, analogs are used for bar support during processing invested directly into the bottom half of the flask. As for extending the post up higher defeating the support of the tooth due to thinning it out, falls into the area of anterior teeth. Totally in the hands of the bar designer. Hopefully John your patent comes through that you can share your technique

Sorry if I was unclear. What I meant was if the channel is acrylic and not perfectly smooth, it is difficult to remove the silicone because it forms to the irregularities in the acrylic and rips when you pull them out. If they come out in one piece it is better than trying to fish fragments out. When the channels are milled they are perfect and the silicone comes out nice and clean. I would say it is not impossible for you to do this in acrylic, but it can get gouged with instruments after time.