Faeghinejad Meisam, Proussaefs Periklis, AlHelal Abdulaziz, Lozada Jaime
Int J Periodontics Restorative Dent. 2019 Jan/Feb;39(1):39-47. doi: 10.11607/prd.3409.
The computer-assisted design/computer-assisted manufactured compound prosthesis involves designing and milling a cement-retained prosthesis over milled titanium bars. In the presented clinical case report, a diagnostic wax pattern was made to assess esthetics, contours, and occlusion. A total of eight maxillary root-form implants were restored by following the combined prosthesis design concept. The mandibular arch was restored with a screw-retained implant-supported zirconia fixed prosthesis. A milled polymethyl methacrylate (PMMA) maxillary interim prosthesis was fabricated to intraorally confirm the diagnostic wax pattern. The interim PMMA prosthesis was then scanned, and three screw-retained titanium milled bars were designed that provided the substructure of the definitive restoration. A cement-retained milled zirconia prosthesis was then designed and fabricated. The zirconia prosthesis provided the superstructure of the definitive complete-arch restoration. After confirming esthetics, phonetics, occlusion, and accessibility for oral hygiene, the superstructure was cemented with temporary cement to enable retrievability.
计算机辅助设计/计算机辅助制造的复合假体包括在铣削的钛棒上设计和铣削一个粘结固位的假体。在本临床病例报告中，制作了诊断性蜡型以评估美观、外形和咬合。按照联合假体设计理念，共植入8枚上颌根形种植体并进行修复。下颌弓采用螺丝固位的种植体支持式氧化锆固定假体修复。制作了一个铣削的聚甲基丙烯酸甲酯（PMMA）上颌临时假体，在口内确认诊断性蜡型。然后对临时PMMA假体进行扫描，并设计了三根螺丝固位的铣削钛棒，作为最终修复体的下部结构。接着设计并制作了一个粘结固位的铣削氧化锆假体。氧化锆假体构成了最终全牙弓修复体的上部结构。在确认美观、语音、咬合以及口腔卫生的可达性后，上部结构用临时粘结剂粘结，以便日后取出。
