Which bridge should I choose: Cast Metal Bridge, Titanium Hybrid Bridge, or Monolitic Zirconium Bridge ?

Question

What is the differences between Cast Metal Frame Hybrid Bridge, Titanium Frame Hybrid Bridge, and Monolitic Zirconium Hybrid Bridge used in All on 4 procedure? Is one better then the other?

Scott Young, DDS · Answer

The simple answer is that I like to use Zirconium for any bridges in the premolars or molar regions of the mouth.  They are incredibly strong and aesthetic.  Good luck.

James Magee, DDS · Answer

It all depends on what is priority. Obviously, if you are desiring a more lighter product the titanium hybrid denture is the best option. However, the zirconium is making major headway in the advancement of its product. The metal is the cheapest and the heaviest of them all. So if you are looking for economics, this would be your choice. However, I would warn you when you are investing in this type of material that you are getting what you pay for. It is your choice, but this treatment can be very costly to choose the cheaper option.

Dan Hagi, DDS · Answer

That's a great question.  It's really a question of what is really important to you.  I'm going to describe the various materials below.  The choice should be a bit clearer once you read through below.   1) Cast Metal Bridge - this type of material tends to be the cheapest.  The metals used are usually cobalt chromium.  On top what is used is acrylic or composite resin for the gums and most commonly acrylic for the teeth.  The drawback is metal reactivity as well as often popping off or breakage of the teeth.   2) Titanium Milled Bridge - this is middle road cost.  Benefit of a stronger framework.  The gum and teeth are usually still acrylic or composite.  The downside still remains breakage of teeth.  You get less reactivity to metal as titanium alloy is better but the fractures are still there.  You can upgrade to porcelain teeth on the framework which can look better but are more expensive to produce and fix if they break.  3) Zirconia Full Contour - this type of bridge is made entirely of high strength ceramic so teeth can't break off.  The gums are made of layered pink porcelain so the need for a great technician is important to make everything look real.  The stained monolithic zirconia is very aesthetic but most high end labs add a layer of porcelain on the front of the teeth to make things look better.  This option is like the Bentley of dentistry. Beautiful, nearly indestructible and biocompatible.  It carries the highest cost.  The he occurance of acrylic teeth fracturing can be as high as 10-20%.   With the monolithic zirconia this doesn't happen.   Now not all zirconia is created equal and not all technicians know how to handle it.  This is one place where price does determine quality.  If the price for zirconia is too good to be true it may not be what you think.  I would insist on Prettau zirconia to be used and ensure that the laboratory has worked with this before and is not outsourcing the job.  Hope this helps.

Which bridge should I choose: Cast Metal Bridge, Titanium Hybrid Bridge, or Monolitic Zirconium Bridge ?

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