Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT.
J Prosthodont. 2020 Aug;29(7):558-563. doi: 10.1111/jopr.13172. Epub 2020 Jun 24.
Complete arch fixed implant supported prosthesis made of monolithic zirconia is a popular treatment option with minimal complications, as documented in the literature over a 5-year period. One of the limitations of this material is its inability to be used when the span between adjacent implants is excessively long. A potential solution to mitigate this problem is to support the zirconia prosthesis with a metal substructure, which intrinsically has higher tensile strength. This clinical report describes the successful use of this prosthetic design in a male patient with bruxism and history of multiple implant failures in the maxilla. This resulted in a large anterior-posterior span between the anterior implants in the maxillary lateral incisor region and the distal implants in the pterygoid region. This article also describes the use of a split file digital workflow to scan the prototype prosthesis and then digitally design and mill the screw-retained cobalt chromium bar, as well as the overlaying of zirconia prosthesis which was retained by separate screws. This novel approach offers promise for management of the atrophic maxilla where implants with remote anchorage are used resulting in broader distribution of implants.
全颌固定种植体支持式整体氧化锆修复体是一种备受欢迎的治疗选择，具有最小的并发症，这在文献中有长达 5 年的记录。这种材料的局限性之一是当相邻种植体之间的跨度过长时，无法使用。减轻这个问题的一个潜在解决方案是使用金属子结构来支撑氧化锆修复体，金属子结构具有更高的拉伸强度。本临床报告描述了在一位磨牙症男性患者和上颌多颗种植体失败的历史中成功使用这种修复设计的情况。这导致上颌侧切牙区域的前部种植体和翼突区域的后部种植体之间存在较大的前后跨度。本文还描述了使用分体文件数字化工作流程扫描原型修复体，然后数字化设计和铣削螺丝固位钴铬杆，以及通过单独的螺丝保留覆盖氧化锆修复体。这种新颖的方法有望用于管理使用远程锚固种植体的萎缩上颌，从而更广泛地分布种植体。
