The “hard” decision is concerning whether to have the All on 4 or All on 6 implants with a Permanent, screw retained, horse-shoe shaped restorations/denture/bridge.  You had asked about the differences between acrylic and Zirconia.  I can actually speak from many years’ experience and have complete lots of these procedures.  Let’s discuss each individually:

Acrylic supported by a Metal Hybid Bar

After the implants are placed and become solid in the bone (4-6 months) you will return to CR. We will uncover the head of the implant and take an impression. The laboratory will make a custom-made metal bar. This bar is to support the acrylic restoration.  Acrylic restoration by itself would break the first bite of food so must have the metal for support.  Then the laboratory will fabricate acrylic pink gingiva and white teeth on the bar and cover it completely.  The complete unit is screwed to the implants as a permanent solution to missing teeth. 

Advantages:  

Less expensive, looks natural, can be repaired if teeth break

Disadvantages:  

The acrylic can stain easily.  For example, if you have a plastic sink in your garage and you rinse blueberries in the sink, the sink can stain.  You must be cautious and brush immediately after eating.  The acrylic teeth can chip and break but repaired with composite fillings.  My experience is the acrylic needs to be remade on the existing metal bar about every 5 years

Solid Zirconia or Porcelain Teeth Fused to Zirconia

To have the solid Zirconia on the upper, it is necessary to have the All on 6 implants. This is due to the weight of the Zirconia restoration and the need for the additional 2 implants.  On the lower, depending on the size of the jaw, it is normally acceptable to use the All on 4 but the All on 6 just offers additional support.  After the implants are placed and become solid in the bone (4-6 months) you will return to CR. We will uncover the head of the implant and take an impression.  The laboratory will make a solid one piece of Zirconia (pink gingiva/white teeth) or Porcelain teeth fused to Zirconia.  Either is an excellent choice. Then the one unit is screwed to the implants as a permanent solution to missing teeth.

Advantages:

The restoration is one piece of Zirconia.  Zirconia and porcelain do not stain with normal use.  Similar to the sink in your kitchen.  You can rinse as many blueberries as you desire, and the sink does not stain if you rinse sink and normally last a lifetime.  The same with your Zirconia (porcelain) restoration….. it is meant to last a lifetime.  In my many years, I have never had a Zirconia restoration chip or break.  

Disadvantage:

More expensive  Both are excellent choices.  The main differences are the Acrylic will stain and need to be replaced.  The Zirconia is meant to be a lifetime with normal use and care.  Once you arrive to the clinic, our team will take a 3D imaging CT scan. They will then be able to determine the best options for you whether it is the All on 4 or All on 6.

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