I have a fixed hybrid denture on my lower jaw which is supported by 5 implants. I have been thinking about what is the best restoration for my upper jaw. Likely I can place 6 implants on my upper jaw. I visited a few prosthodontists and got different recommendations from them. Two options I am considering now are 4-implant retained locator over-denture (maybe place 2 extra implants and put them to sleep) and 6-implant supported fixed hybrid denture. Each solution has its pros and cons. My priority list for a decision is: 1) Easy hygiene, almost equivalent to less long term bone loss 2) Good lip support for a younger look 3) Speech difficulty 4) Maintenance (parts wearing and replacement) 5) Cost 6) Anything else to consider?

Three major concerns about the hybrid denture: No abutment with this structure from the dentist I visited. The hybrid denture will be directly screwed down to the implants. I have no idea how many times the hybrid denture can be unscrewed from and screwed back to the implant before the implant screw threads are worn out. But it certainly concerns me a lot.

The second concern is how much lip support a fixed hybrid can deliver. Can it be as good as a traditional upper denture. I have severe bone loss in my upper jaw. I am afraid that the hybrid denture cant give me a younger look.

The third concern is whether it can cause speech difficulty.

What are the disadvantages of the locator retained over-denture other than less-like-real-teeth feeling because it is removable? I know that it has to be relined around every 5 years and the nylon part on the denture needs to be replaced once a while. Is there anything else I need to take into consideration?

Last question: what is a reasonable cost of a 4-implant locator over-denture and a 6-implant supported fixed hybrid, excluding the cost to place the implants? Teeth will be acrylic.

I will greatly appreciate if you can provide me your opinion after you read my side of the story? Thanks a lot for reading case!

A patient that needs your generous help.