Zirconia vs High Impact Acrylic screw retained bridge

[JeffT]

Hi all. I have been asked to do a 6 unit bridge on 3 abutments. The bridge will cover from the 14 to the 22.
Patient is a male and has no history of grinding. Span length is unknown at this stage and the implants have not been placed yet.

Dentist wants to know the good and the bad for each type so we can inform the patient and formulate the treatment plan.

These largish jobs are very rare with my client base and I do not have any experience with implant dentures at all. I would have done a Zi bridge with full palatal Zi with Buccal build but not sure about a denture type bridge so am asking the forum for the good and bad of each.
I have a lot of experience with Zi but not with 6 units on implants and knowing that Zi can have its problems I would be happy to recommend an acrylic bridge if it is more reliable and cost effective for the patient with this type of restoration. I would of course seek help from another lab if the patient wants an Acrylic type.

Acrylic is a cheaper option I am told but is it better?

Any thoughts from the forum would be very helpful.

all
Jeff

 

[zero_zero]

Apparently PEEK implant frames are coming into light lately given their good shock absorbing property and bone like flexibility...

 

[ceram1]

Apparently PEEK implant frames are coming into light lately given their good shock absorbing property and bone like flexibility...

From all of the research I have seen presented, the frame must be very rigid for long term success. This is especially important when you have angled implants as in the alll on 4 technique. All acrylic are for temporary only. They must be replaced with a frame supported prosthetic of any kind soon. That is what research is supporting any way. We select our prosthetic type of off the intra oral space we have to work with. Good luck, there are often many good solutions if the surgeon has given you an ideal space to work with.

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[JeffT]

Thanks ceram 1, I think we will be doing a Zi bridge unless the patient specifically asks for acrylic.
Out of interest, what is the cost comparison between both types in general?

cheers Jeff

 

[Labwa]

I think unless the surgeon is reducing a heap of the ridge to hide a transition line (which is impossible only spanning to the 22) you will end up having floating denture teeth with not a lot of supporting acrylic. I would rather have individual pontics that are strong and easier to clean than acrylic...and aesthetic.

 

[JeffT]

cheers Lachie
go port

 

[cadfan]

If i had to do this my primary option layered zirkon if their a some functional problems maybe only partially .Hybrid abutments and a normal bridge.Why zirkon ? its a material with very low plaque affinity and biofilm and the gingiva loves it and thats for me the most important thing in long therm success. If you use peek or pmma you have always more plaque affinity because of the composite facings, but this is only a plan that must be supported by pre operation planing .

 

[Juvora dental]

From all of the research I have seen presented, the frame must be very rigid for long term success.

Interestingly, in Europe, many surgeons are of the opposite view - that having a shock absorbing component that is of a similar property to bone on top of the osseointegrated metal implants helps comfort and also prevents stress shielding. plus they are placing the final denture earlier. The material is also more "forgiving" which helps with things like passive fit.
check out quick 2 minute video as a dentist can explain it better than me!

 

[Huntsky]

All depends on what surgeon gives you to work with. Proper bone reduction, properly placed implants, with acrylic wrapped bar is way to go.

 

[Huntsky]

Grantor, why do you disagree? There is 10'year retrospective clinical data backing up my post

 

[2thm8kr]

Grantor, why do you disagree? There is 10'year retrospective clinical data backing up my post

Who needs scientific data and peer reviewed papers? Zirconia is hot and trendy now.