Anterosuperior rehabilitation with metal-free fixed prosthesis based on zirconia

ABSTRACT

The loss of upper front dental elements causes functional and psychosocial problems to the affected individuals. In this case report, the treatment planning considered hard and soft tissue loss for a complex fixed partial denture (FPD) rehabilitation. The six-element, all-ceramic FPD was manufactured using a computer-aided design/computer-aided manufacturing system with zirconia framework, veneered with leucite-reinforced ceramic. Ceramic artificial gum was also produced to guarantee tooth-facial proportions as well as lip support, promoting both esthetics and phonetics. The material's mechanical properties allowed for the coupling of the esthetic and mechanical requirements, proving an alternative to the well-established metal-ceramic technology, optimizing biomimetic. One of the endodontic-treated abutment teeth required a radicular retainer with cast metal post, but because of the opacity of zirconia, the esthetics of the prosthesis was not compromised. The low silica content of high resistance ceramics such as zirconia hampers the adhesive cementation, with numerous studies advocating for different cementation protocols, with no clear scientific consensus so far. In the present case, the internal surface of the FPD was initially blasted with aluminum oxide, followed by the application of a universal adhesive system containing 10-methacryloyloxydecyl dihydrogen phosphate. Finally, cementation to the dental structure was conducted with dual-cure self-adhesive resin cement.

Key words:

Computer-aided design - dental - denture - esthetics - fixed - partial

• REFERENCES

• 1 Komine F, Blatz MB, Matsumura H. Current status of zirconia-based fixed restorations. J Oral Sci 2010; 52: 531-9
• 2 Solá-Ruíz MF, Agustin-Panadero R, Fons-Font A, Labaig-Rueda C. A prospective evaluation of zirconia anterior partial fixed dental prostheses: Clinical results after seven years. J Prosthet Dent 2015; 113: 578-84
• 3 Rashid H. The effect of surface roughness on ceramics used in dentistry: A review of literature. Eur J Dent 2014; 8: 571-9
• 4 Rashid H, Sheikh Z, Misbahuddin S, Kazmi MR, Qureshi S, Uddin MZ. Advancements in all-ceramics for dental restorations and their effect on the wear of opposing dentition. Eur J Dent 2016; 10: 583-8
• 5 Arias DM, Trushkowsky RD, Brea LM, David SB. Treatment of the patient with Gummy smile in conjunction with digital smile approach. Dent Clin North Am 2015; 59: 703-16
• 6 Barzilay I, Irene T. Gingival prostheses – A review. J Can Dent Assoc 2003; 69: 74-8
• 7 Faria AC, Rodrigues RC, de Almeida Antunes RP, de Mattos Mda G, Ribeiro RF. Endodontically treated teeth: Characteristics and considerations to restore them. J Prosthodont Res 2011; 55: 69-74
• 8 Seabra B, Arantes-Oliveira S, Portugal J. Influence of multimode universal adhesives and zirconia primer application techniques on zirconia repair. J Prosthet Dent 2014; 112: 182-7
• 9 Bramanti E, Cervino G, Lauritano F, Fiorillo L, D'Amico C, Sambataro S. et al. FEM and Von Mises analysis on prosthetic crowns structural elements: Evaluation of different applied materials. ScientificWorldJournal 2017; 2017-1029574
• 10 Lauritano F, Runci M, Cervino G, Fiorillo L, Bramanti E, Cicciù M. Three-dimensional evaluation of different prosthesis retention systems using finite element analysis and the Von Mises stress test. Minerva Stomatol 2016; 65: 353-67
• 11 Schmitter M, Mussotter K, Rammelsberg P, Gabbert O, Ohlmann B. Clinical performance of long-span zirconia frameworks for fixed dental prostheses: 5-year results. J Oral Rehabil 2012; 39: 552-7
• 12 Goodacre CJ, Campagni WV, Aquilino SA. Tooth preparations for complete crowns: An art form based on scientific principles. J Prosthet Dent 2001; 85: 363-76
• 13 Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of crown and bridge restorations. Aust Dent J 2011; 56 (Suppl. 01) 97-106
• 14 Karl M, Graef F, Wichmann M, Krafft T. Passivity of fit of CAD/CAM and copy-milled frameworks, veneered frameworks, and anatomically contoured, zirconia ceramic, implant-supported fixed prostheses. J Prosthet Dent 2012; 107: 232-8
• 15 Mahmoodi N, Hooshmand T, Heidari S, Khoshro K. Effect of sandblasting, silica coating, and laser treatment on the microtensile bond strength of a dental zirconia ceramic to resin cements. Lasers Med Sci 2016; 31: 205-11
• 16 Hattar S, Hatamleh M, Khraisat A, Al-Rabab'ah M. Shear bond strength of self-adhesive resin cements to base metal alloy. J Prosthet Dent 2014; 111: 411-5