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.
Background and Targets
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.
As a result, dentists began looking at other materials. With the advancement of CAD/CAM (computer-aided design and manufacturing) technology, an alternative restoration technique than the complete-arch implant prosthesis is now available.
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.
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).
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.
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.”
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:
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: Fixed dental prostheses may be taken into consideration in these situations, although long-term clinical performance has to be evaluated.
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