STRAUMANN

Implant Restorative Study Club

May 9, 2013Follow-up on Fixed Hybrid Solution

www.prosthodonticsin.com

Overview: Fixed Hybrid Solution

Accelerated treatment timeline (extractions w/ immediate placement; no distal grafting to develop bone required for straight-placed implants

Hybrid prosthetic option= a FRACTION of the $ of fixed PFM restorations

Functional and esthetic benefits of a fixed prosthesis

Benefits of Treatment Option:

From here…

…to here in one clinical day.

Overview: Fixed Hybrid Denture

This treatment option is NOT suited for every patient!

Successful outcomes are highly reliant on multi-disciplinary planning (Surg/GP/Lab/TM)

Patient expectations must be managed by Surg & GP: Goal is long-term outcome, not immediate. NO Chewing/Function for 8 weeks

ALL CASES receive a temporary denture, ideally fixed w/in 24hrs of surgery. Primary stability of implants is mandatory for immediate loading

Fees quoting as package: Surgery, Temp & Final Prostheses coordin-ated by surgeon & GP is the “ClearChoice” pricing model. (Good idea…)

N-B early cases didn’t use metal-reinforced hybrid prostheses

Considerations:

Straumann® SolutionPatient Profile:

Surgeon’s Reservations:

Younger/more demanding patients who want esthetics & function of fixed prosthesis (not LOCATOR®…), but don’t want to spend for a C&B restoration

Patients facing full mouth extractions, or currently edentulous patients interested in avoiding time & GBR to establish adequate bone dimension for good posterior cross-arch stability of a prosthesis

Many surgeons won’t consider 4-implant treatment as legitimate option No “fall back” position if one of 4 fails… Surgical and Restorative complexity: major alveoplasty required for ideal

prosth design (12-15mm implant-to-incisal edge, 6-8mm implant-to-CEJ) reluctant to perform extractions w/ immediate placement.

Patient Acceptance limited due to considerable cost of treatment

STRAUMANN

Final considerations and follow-up on issues raised in Q&A

• Significant and rapid evolution of prosth design options affords ability to deliver esthetic AND cleansable temp and final prostheses.

However, This is Reliant upon:

• The Surgical protocol developed advocates for drastic alveoplasty (12-15mm from top-of-implant to planned incisal edge, and 6-8mm from top-of-implant to temp and final prosthesis’ CEJ) for most esthetic and cleansable prosth outcome.

Options: 1) Either accept drastic alveoplasty needed to provide optimal prosth design or, obtain patient commitment to maintenance appointment of longer-flange prosthesis every 12 mos.

2) Non-Fixed Prosthetic option– many time-proven options available: (Locators, Bar & Clip, Spark-Erosion denture, etc…)