Milled Hybrid Bridges

Milled Titianium bridgeHere is a case we have been doing recently. We were asked by one of our clients for a implant retained 12 unit Hybrid bridge. This was to be a on 4 Straumann RN implants, consulting the clinician we decided that a milled Titanium framework with high end Enigma life acrylic teeth with lip support would be right for this patient. It was a lower case and the patient hadn’t had any prosthesis in situ for quite some time. The first step would be to get an implant model with analogs poured. Then we made a model verification jig on this model to ensure that the model was 100% accurate before any framework was milled. This was done by using temporary metal bridge cylinders and placing these in to the analogs on the model and screwing them in. We then wrapped dental floss around the top of the cylinders to create a web to which we could use pattern resin to splint them together. Once this had cured it was unscrewed from the model and sent off to the dentist to be tried in. Wax up with frameworkThis was tried in and accepted. We then had to do a wax set up on this verified model, to show the milling centre where the final position of the teeth would be, to allow them to mill a framework within these parameters. This was done and a web order was created with Atlantis and the case was sent off for scanning and milling. After approximately 3 days a CAD file was sent to us for approval, we wanted some adjustments to be made to the thickness of the bar and to reduce to length. This was adjusted and again sent back to us for approval, which we did. A few more days and we received the milled case back to the laboratory. We waxed the teeth onto the framework and sent it back to the dentist to try in. This was accepted with a few minor adjustments and was sent back to us for processing and finishing. Finished Hybrid BridgeWe then processed using high impact acrylic and Engima Life teeth.