Objectives To evaluate the performance of two types of zirconia frameworks. Material and Methods From 2014 to 2016, in a prospective clinical trial, 150 patients were rehabilitated with 83 and 110 implant‐supported, screw‐retained, full‐arch ceramic‐veneered zirconia (PVZ) rehabilitations and monolithic zirconia with porcelain veneering limited to buccal (MZ) rehabilitations, respectively. Patients were consecutively enlisted according to pre‐defined inclusion criteria and evaluated on 4 months intervals. A Kaplan–Meier estimator was adopted, and the log‐rank test and Wilcoxon test used to test differences in survival and successful function in the two different groups. Results The average follow‐up time (±SD) and implant success rate was 608.80 ± 172.52 days with 99.53% implant success for the PVZ group and 552.63 ± 197.57 days with 99.83% success for the MZ group. According to the Kaplan–Meier estimator, the mean cumulative survival rate at the 2‐year follow‐up for framework fracture, major chipping, minor chipping, or any of the former combined to occur was 0.99, 0.95, 0.93 and 0.85 for the PVZ group (n = 18) and 0.99, 0.95, 0.95 and 0.89 for the MZ group (n = 15). No significant differences were found between the two groups. Conclusions Results suggest zirconia as a suitable material for frameworks in full‐arch implant‐supported rehabilitations. Both groups presented a low incidence of technical complications. When comparing the two different designs, the MZ group presented a lower technical complication rate, thus presenting itself as a viable alternative for full‐arch implant‐supported rehabilitations. Further clinical studies with longer follow‐ups (5 years) should be performed to evaluate the long‐term stability of such rehabilitations.

The enlarged myectomy allowed the treatment of a larger area in the wrinkled region without increasing the complications and with excellent results.

Management of severe worn dentition in patients with bruxism is challenging as a result of the loss of tooth structure and occlusal vertical dimension, temporomandibular implications, tooth hypersensitivity, and masticatory or aesthetic impairment. This case describes the 4-year follow-up clinical evaluation of a full mouth tooth-supported rehabilitation made on a 66-year-old man with bruxism and tooth wear, with aesthetic complaints and compromised masticatory function. The prosthetic treatment was planned with a digital smile design and a mock-up technique for an aesthetic and minimally invasive approach using lithium disilicate pressed and layered veneers on anterior teeth, posterior CAD/CAM lithium disilicate overlays with facial coverage, and CAD/CAM monolithic zirconia crowns with facial feldspathic ceramic on maxillary and mandibular canines and first molars in order to ensure the occlusal stability at the increased occlusal vertical dimension. After 4 years of function, no complications were registered. The choice of an appropriate material for the rehabilitation of these patients is essential to improve treatment prognosis and should be guided by mechanical and aesthetical properties. The use of four-point occlusal stabilization with CAD/CAM high strength monolithic zirconia crowns combined with ceramic veneers and overlays appears to be a reliable treatment option that enhances aesthetics and minimizes the occurrence of ceramic fractures, ensuring the treatment prognosis and predictability.

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