What is Zirconia Prosthetics? Zirconia prosthetic is a durable and aesthetically pleasing material that can be used to provide patients with a well-fitting prosthesis. It is also a particularly desirable choice for edentulous patients wishing to replace a complete arch of teeth.
What is Zirconia Prosthetics?
Complete-arch implant-supported restorations have a proven success rate of more than 90% and are often used as a treatment option for patients who are completely dentiless. A number of material combinations, including metal alloy-acrylic, metal alloy-composite, and metal alloy-ceramic, have been used for these types of restorations.
Over short and long time periods, the following prosthesis-related difficulties are commonly observed: fracture of the acrylic resin veneer, loosening/fracture of prosthetic screws, wear and fracture of resin denture teeth, fracture of prosthesis framework, and poor gingival aesthetics and architecture.
Significant advancements regarding manufacturing technologies for zirconia-based ceramics are also currently in progress. Methodologies and conditions for uniaxial and isostatic pressing of zirconia powder are reviewed, as are the benefits of emerging CAD/CAM technologies.Several knowledge gaps were identified based on this review, primarily that different sintering conditions and methodologies, such as two-step sintering, should be investigated experimentally.
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Due to its biocompatibility, aesthetics, and structural strength, zirconia technology has had a considerable influence on dentistry during the past ten years.
The monolithic nature prevents any different interfaces from forming, reducing cracks and/or chipping situations, producing a larger bulk of material to improve the structural characteristics of each individual prosthesis, and making CAD/CAM manufacturing effective for fabrication and care provision.
Considering the increasing use of Monolithic Zirconia in full-mouth rehabilitations The case study that follows shows the clinical and laboratory techniques for producing a full arch prosthesis out of zirconia.
The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and materials used. Zirconia is a material widely used in fixed prosthodontics, whether on natural teeth or on implants, with excellent results over time.
A full-arch implant-supported zirconia prosthesis must be created utilising specialised techniques and must follow the clinical protocols outlined in this case study. The practitioner should carefully choose the patient and do substantial preparation to ensure a successful and anticipated outcome (placement and quantity of implants, framework design, suitable occlusal scheme).
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Since CAD/CAM technology and zirconia are being continuously innovated to achieve better results and performances over time, a narrative review of the literature seems necessary to focus research efforts towards effective and durable solutions for implant-supported, full-arch rehabilitations. The objective of the present narrative review was to search the literature for studies regarding the clinical performance of zirconia-based ISFCDPs
A typical case and the treatment procedure using Zirconia Prosthetics
A female patient, age 41, experiences a thorough treatment plan at our prosthodontic office. I have very sensitive teeth, and I have bad breath, were her main concerns. “My dentist informed me I had a lot of cavities, and my mouth always gets dry.”
She claims she wants to reconstruct her mouth and replace her missing teeth so she can eat, feel more confident, and appear better. The patient had occasional dental operations throughout the previous ten years. She said that the teeth fell out due to persistent decay and gum disease, which created abscesses and prompted extractions.
Medical history: The patient’s life is under threat. Following a working accident, she endured many surgeries, including neck and back procedures, and she was long-term incapacitated. She had a gastric bypass as well, but it was not performed properly, leading her to vomit often. Her teeth were all impacted and extremely sensitive as a result of this.
Problem list:
- Temporomandibular disorder.
- Mandible and maxilla with partial dentition.
- Numerous decaying previous repairs that are faulty.
- Widespread cervical tooth deterioration and generalized tooth erosion.
- Angular-cheilitis.
- Moderate plaque and calculus with inadequate and poor dental hygiene.
- Traumatic occlusal occlusion with insufficient occlusal vertical dimension and plane.
Treatment Plan:
After collecting all clinical data from the clinical extraoral and intraoral examinations, articulated diagnostic castings using an earbow and Gothic arch tracings, and radiographs, we presented the patient the following treatment plan:
“The key aspects of our recent conversation regarding the care we wish to provide you will be reaffirmed. Because you wanted a more dependable therapy with a long-term impact and you have some cost constraints, the following therapies were discussed with you.
- To reconstruct your mouth in a predictable manner, it is essential to extract any teeth that pose a risk of bad outcome due to your advanced oral condition, excessively high levels of sensitivity, and extensive decay.
- I have given you a variety of alternatives for replacing your missing teeth, and we have spoken about the advantages of each one. The following option has been chosen:
In the upper and lower jaws, there are 8 implants and fixed bridges supported by implants.
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Treatment Sequence:
- After all problematic teeth have been extracted, upper and lower urgent prostheses must be constructed and fitted. These prostheses were made prior to the loss of your teeth for enhanced healing and aesthetic reasons.
- The position of the final denture teeth will dictate where the implants are put to get the greatest potential cosmetic and functional benefits. As a consequence, a radiographic template is employed to generate a 3D bone investigation CBCT radiograph.
- Then, in a clinical setting, our oral and maxillofacial surgeon instals 16 Zimmer TSV® implants.
- Once the implant has merged and the healing process is completed, the final fixed prostheses are made. Fabricating temporary bridges that will be used for a short period of time is critical for getting a predictable outcome with the final repairs. These temporary bridges will be altered until an acceptable aesthetic and functional result is obtained. These will be the plans for the final fixed prosthesis.
- Periodic checkups.
This course of therapy is one that we hope will work well and enable us to attain both good function and a smile we like.
We think this project might be finished in 18 months. The length of time will mainly rely on how pleasant and aesthetically pleasing your dental restorations turn out.”
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Summary for Zirconia Prosthetics
This surgery resulted in both good function and a lovely smile. While discussing a complex, all-encompassing treatment plan, it is vital to clarify the following to the patient:
According to the results of this review, the use of zirconia for ISFCDPs showed good clinical outcomes, with high survival rates ranging from 88% to 100% and prosthetic complications that were restorable by the clinicians in most cases.
Everyone has constraints that influence the outcome. The fact that maxillary implants have a success record of 90% to 95%, as well as the likelihood of adverse reactions and the necessity for surgical or restorative changes, must all be considered. It goes without saying that guarantees concerning the human body cannot be given.
We (the dental clinic) will, however, be accountable for any treatment we have provided for a period of 12 months and will make any required repairs or modifications for these teeth at no additional cost. Experience has shown us that this allows any underlying difficulties to emerge.
It is critical that you return for follow-up appointments following our treatment to ensure that your mouth remains healthy. Excellent oral hygiene is essential, and the original payment does not include these follow-up sessions.
Conclusion: According to this narrative review of the literature, the use of zirconia for ISFCDPs showed good clinical results with high survival rates (88–100%). The major complication (superficial chipping) was, in most cases, easily restorable directly by the clinicians, with no necessity for laboratory repair.
It is worth nothing, however, that the authors found no randomized clinical trials comparing the clinical performances of different types of ISFCDPs made of zirconia or comparing zirconia to different materials.
Most of the studies included in the review, however, have a small number of cases; thus, the evidence in this review might be influenced by biases found in the selected studies and should be accepted with caution. To design an adequate randomized clinical trial, a repeatable and clear procedure for the rehabilitation project, implant placement, and prosthetic design should be introduced.
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