Translucent monolithic zirconia titanium‐supported FP1 full‐arch prosthesis: A novel proof of concept to address esthetic, functional, and biologic challenges

Abstract

ObjectiveDespite the wide clinical use of translucent zirconia for full‐arch implant prostheses, reduced flexural strength and fracture toughness compared with high‐strength opaque zirconia needs to be addressed. A novel proof of concept for FP1 full‐arch prosthesis featured by translucent monolithic zirconia and titanium framework was presented.Clinical ConsiderationsComputer‐guided implant planning and surgery were executed and digitally designed FP1 temporary prosthesis prefabricated. Implant and prosthetic placement were achieved with a set of three‐dimensional (3D)‐printed templates. Implants were immediately loaded. After 4 months intraoral optical scan was taken to record implant coordinates, soft tissue anatomy, and temporary FP1 prosthesis. A novel digital workflow was used to design and mill overlaying translucent zirconia and anatomically shaped titanium framework with a scalloped soft‐tissue interface. Final FP1 prosthesis was assembled cementing zirconia jacket on titanium counterpart.ConclusionsTranslucent zirconia supported by titanium framework can address esthetic and mechanical requirements of FP1 full‐arch prosthesis, minimizing risk of fracture and providing a rigid and passive joint with supporting implants. The smooth and highly polished titanium surface with an anatomic design, tightly matching scalloped soft tissue interface, can limit food impaction, air and saliva leakage and contribute to overall biologic integration of FP1 full‐arch prosthesis.Clinical SignificanceTranslucent monolithic zirconia featured with anatomically shaped titanium framework with scalloped transmucosal part, combining a pleasant esthetic outcome with increased flexural strength and fracture toughness, may be indicated to increase the clinical performance of FP1 full‐arch prosthesis.

A Retrospective Evaluation of 5 Years of Clinical Results of Metal–Ceramic vs. Monolithic Zirconia Superstructures in Maxillary All-on-4TM Concept

“…The incidence of framework fractures was significantly higher for ceramic groups, and the incidence for ceramic fractures and loss of retention secondary to the loosening of the screw was significantly higher for zirconia prostheses compared to metal-ceramic ones. Pelekanos et al [24] described the combination of a monolithic zirconia with an anatomically shaped titanium framework to increase the flexural strength and fracture toughness and stated that this novel concept may be indicated to increase the clinical performance of full-arch prosthesis. Herklotz et al [25] highlighted the accuracy of planning an immediate loading of full-arch zirconia restorations to avoid both mechanical and biological complications.…”