Planning hybrid on 4 implants?

I treatment planned a patient for an implant supported fixed detachable prosthesis [hybrid] in the maxilla.  I originally planned for 5-6 implants spaced around the arch.  During implant installation, I was only able to place 4 BioHorizon 3.4/9 implants in the #5, 9, 11 and 12 sites sites because of bone deficiency in th maxillary right anterior.  Will these 4 implants be able to support a hybrid?  I would also like to cantilever the first molars and second premolars.  Or should I do bone augmentation in the maxillary anterior and place additional implants?

4 thoughts on “Planning hybrid on 4 implants?

  1. carlos boudet says:

    There are guidelines and protocols established to allow predictable success in treatment planning an implant supported hybrid, and I do not think that you have followed any in this case.
    I think anyone will tell you that four small diameter 9MM implants are not adequate to support a full arch hybrid in the maxilla, much less cantilevering to the molar region.
    You had the advantage of a CT scan to treatment plan the case and you did not use it properly.
    I would suggest that you utilize one of the companies that help you treatment plan a CT guided case, and this will allow you to tap into their experience while treatment planning and learn how to do these cases at the same time.
    I would also suggest using a CT derived surgical guide and do a few cases guided. These larger cases have easier surgery that way.
    I do not want to sound harsh in any way, but just because you can place implants in the bone, does not mean that you are prepared to do cases like this. For the sake of your patients, you should get some training if you plan to do these cases.
    Good Luck,

  2. Ana Mateos says:

    I understand that the primary goal was to make a hybrid prosthesis, but just for the sake of thinking outside the box…it might be feasable to make a removable implant supported prosthesis instead. This prosthetic option allows you to have mucosal support while gaining retention from the implants, avoiding more grafting.
    Treatment planing is a complicated process, and 4 implants for cantilevering molars and premolars is extremely risky. The All-on-4 tecnique by Nobel requieres longer and regular platform implants, and they are placed at a 30-45 degree angulations. These have the added expense of multiunit abutments. Even on those type of prosthesis I would not cantilever a full molar.

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Cases, Surgical.
Bookmark Planning hybrid on 4 implants?

Videos to Watch:

Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]


Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!
Vertical and Horizontal Bone Augmentation with Khoury Bone Plates

This video shows a way to utilize thin autogenous bone plates to create stunning bone.[...]


Watch Now!
Maxgraft bonering: immediate implant placement

This video shows a live surgery using the maxgraft bonering, which is a pre-fabricated[...]

1 Comment

Watch Now!