Management of Fractured Zirconia Complete Arch Fixed Implant-Supported Prosthesis Caused by Misfit Due to Diverse Implant Components: A Case Report.

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.