Private Practice, Vancouver, British Columbia, Canada.
Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT, USA.
J Prosthodont. 2021 Jul;30(6):465-472. doi: 10.1111/jopr.13348. Epub 2021 Mar 4.
Recently, monolithic zirconia complete-arch fixed implant-supported prosthesis (CAFIP) has been shown to be an effective means of managing patients with edentulism or terminal dentition. Prosthetic complications have been reported to be rare, as long as there is proper treatment planning, prosthetic space and careful attention during fabrication of the prosthesis. Few reports exist in the literature that have described the management of patients with fractured zirconia CAFIP. This case report describes the successful management of a female patient with a midline fracture of a monolithic zirconia CAFIP supported by 6 dental implants in the mandibular arch. The fractured prosthesis had adequate prosthesis thickness with no distal cantilever, and opposed a similar prosthesis in the maxilla. However, upon careful analysis, diverse implant components were identified as the primary contributory factor to prosthetic misfit, and subsequent fracture. This is a new factor that requires attention by clinicians and dental laboratory technicians due to the increased prevalence of patients with preexisting dental implants. This article describes the considerations related to diverse implant components and connections from different implant manufacturers, choice of favorable implant-abutment design, technique for mitigation, and importance of passive fit for zirconia CAFIP.
最近，整体氧化锆全弓固定种植体支持修复体（CAFIP）已被证明是一种有效的方法，用于管理无牙颌或终末牙列的患者。只要有适当的治疗计划、修复空间和在制作修复体时仔细注意，就很少有报道称会出现修复体并发症。文献中很少有描述处理氧化锆 CAFIP 断裂的患者的报告。本病例报告描述了一位女性患者的成功管理，该患者下颌弓中 6 个种植体支持的整体氧化锆 CAFIP 发生了中线断裂。断裂的修复体具有足够的修复体厚度，没有远端悬臂，与上颌中类似的修复体相对。然而，经过仔细分析，不同的种植体部件被确定为导致修复体不匹配和随后断裂的主要因素。由于患有先前存在的种植牙的患者越来越多，这是临床医生和牙科实验室技术人员需要注意的一个新因素。本文描述了与不同种植体制造商的不同种植体部件和连接、有利的种植体-基台设计选择、缓解技术以及氧化锆 CAFIP 的被动适合性的相关考虑因素。
