J Korean Acad Prosthodont.  2017 Apr;55(2):218-224. 10.4047/jkap.2017.55.2.218.

Zirconia ceramic fixed dental prosthesis with all-on-4 concept implants for irradiated maxilla: A case report

• Choi EJ
• Cho HW

• KMID: 2377192
• DOI: http://doi.org/10.4047/jkap.2017.55.2.218

Abstract

The implant-supported fixed dental prosthesis in irradiated maxilla needs meticulous treatment planning due to low bone healing capacity. All-on-4 concept implantation can reduce the number of implants to be placed avoiding bone grafting procedure. Conventionally, prefabricated angled abutments for tilted implants have been used. However, in this case, it was replaced with computer-aided design and computer-aided manufacturing (CAD/CAM) abutment. This case report described all-on-4 concept implantation and fabrication of CAD/CAM zirconia fixed dental prostheses using CAD/CAM titanium abutments.

Keyword

Tilted implant; All-on-4 implant; Maxillary edentulous patient; Zirconia fixed prosthesis

MeSH Terms

Bone Transplantation
Ceramics*
Computer-Aided Design
Dental Prosthesis*
Maxilla*
Titanium
Titanium

Figure

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  Fig. 1. Preoperative diagnostic panoramic radiograph.

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  Fig. 2. Computerized tomographic view of planned implant positions for all-on-4 concept.

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  Fig. 3. Placement of implants. (A) Intraoral surgery images of implants placed in the maxilla. (B) Panoramic radiograph after all-on-4 implant placement surgery.

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  Fig. 4. Impression and provisional prosthesis. (A) Splinted impression copings connected to implants, (B) Definitive implant-level cast, (C) Delivery of provisional restorations with temporary abutments.

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  Fig. 5. Digital design of customized titanium CAD/CAM abutments. (A) frontal view, (B) sagittal view.

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  Fig. 6. CAD/CAM abutments. (A) Connected customized abutments to implants, (B) Provisional restoration on the CAD/CAM abutments.

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  Fig. 7. Fabrication of zirconia ceramic prostheses. (A) Digitally designed zirconia framework, (B) Fabricated porcelain veneered zirconia fixed dental prostheses.

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  Fig. 8. Definitive zirconia prostheses. (A) Delivery of definitive zirconia ceramic prostheses, (B) Panoramic view of definitive prostheses in the patient.

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