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Complications and Solutions in Hybrid Prosthesis
Purpose: Implant fixed complete dental prosthesis (IFCDP) is a commonly preferred treatment option in the rehabilitation of completely edentulous patients since the “removability” of the prosthesis is no longer possible. The purpose of this oral presentation is to exhibit the common prosthetic and biological complications with acrylic veneered hybrid dentures with sample cases and recommend remedies for these complications. Debonding of the acrylic teeth and delamination (or fracture) of the acrylic veneering material are the common technical complications with hybrid prosthesis. Patients with severe bruxism are possible candidates for this type of complication. The cantilever height is another factor that should be focused on. The prosthesis should be repaired after retrievement and occlusal adjustments should be made. An occlusal nightguard may be needed as well. Screw access channel may have to be positioned buccally because of the facially inclined implants. In order to overcome the angulation problem, a Toronto bridge approach may be a wise solution for hiding the screw channel. Angulated multi-unit abutment options should be tried as well. Access channels can be closed by composites with an elaborate finishing and polishing stage. Poor oral hygiene is a contraindication for hybrid prosthesis. Bacterial accumulation under the prosthesis resulting with mucositis is stated as the most common biological complication with the hybrid prosthesis. Non-concave intaglio surface is strictly advised for better oral hygiene. The recalls should be more frequent in order to control the intraoral tissues and for the maintenance of the denture. Oral irrigators should be recommended. Conclusion: Hybrid prosthesis is the appropriate treatment option for the completely edentulous patients who demand for implant fixation, even though mechanical and biological complications may occur. In order to minimize the risks, the clinician should be well-informed on the complications and the solutions in case of a need.