Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Esthetic Full Zirconia Fixed Detachable Implant-Retained Restorations Manufactured from Monolithic Zirconia : Clinical Report

Monolithic zirconia framework으로 제작된 fixed detachable prostheses를 이용한 심미적인 임플란트 전악 수복 증례

  • Hong, Jun-Tae (Department of Prosthodontics and Dental Research Institute, College of Dentistry, Dankook University) ;
  • Choi, Yu-Sung (Department of Prosthodontics and Dental Research Institute, College of Dentistry, Dankook University) ;
  • Han, Se-Jin (Oral & Maxillofacial surgery, College of Dentistry, Dankook University) ;
  • Cho, In-Ho (Department of Prosthodontics and Dental Research Institute, College of Dentistry, Dankook University)
  • 홍준태 (단국대학교 치과대학 치과 보철학교실 및 치의학 연구소) ;
  • 최유성 (단국대학교 치과대학 치과 보철학교실 및 치의학 연구소) ;
  • 한세진 (단국대학교 치과대학 구강악안면외과학 교실) ;
  • 조인호 (단국대학교 치과대학 치과 보철학교실 및 치의학 연구소)
  • Received : 2012.08.25
  • Accepted : 2012.09.25
  • Published : 2012.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Full-mouth reconstruction of a patient using dental implants is a challenge if there is vertical and horizontal bone resorption, since this includes the gingival area and restricts the position of the implants. however, hard- and soft-tissue grafting may allow the implants to be placed into the desired position. Although it is possible to regenerate lost tissues, an alternative is to use fixed detachable prostheses that restore the function and the esthetics of the gingiva and teeth. Various material combinations including metal/acrylic, metal/ceramic, and zirconia/ceramic have been used for constructing this type of restoration. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. With virtually unbreakable, chip-proof, life-like nature, monolithic zirconia frameworks can prospectively replace other framework materials. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with dental implants. The occluding surfaces were made of monolithic zirconia, to decrease the risk of chipping or fracture. The prostheses were esthetically pleasing, and no clinical complications have been reported after two years.

수직적, 수평적 골흡수가 심한 환자에서 임플란트를 이용한 전악수복의 경우 경조직과 연조직 이식을 통해서 임플란트를 원하는 위치에 식립할 수도 있지만, 치은과 치아의 기능과 심미를 회복할 수 있는 fixed detachable prostheses를 대체 술식으로 사용할 수도 있다. 이러한 증례에서 다양한 재료가 수복물의 제작에 사용 가능하지만, metal/acrylic 보철물에서는 레진치아의 파절 및 탈락이 일어날 수 있고, metal/ceramic 혹은 zirconia/ceramic 보철물에서는 도재의 chipping이나 파절과 같은 문제가 발생할 수 있다. 이에 최근에 심미적이면서도 기능적인 보철수복을 위해 zirconia에 도재를 축성하지 않고 임상적으로 적용가능한 monolithic zirconia framework이 출시되어 사용되고 있다. 본 임상 증례는 심미적인 요구도가 높은 완전 무치악 환자에서 임플란트를 식립하고 chipping이나 파절의 위험을 감소시키기 위해 monolithic zirconia framework을 이용해 만들어진 complete fixed detachable 보철물을 이용한 수복에 대해 보고하고자 한다. 이번 증례에서 보철물은 심미적, 기능적으로 만족스러웠으며, 2년 간의 정기검사에서 임상적인 합병증은 보고되지 않았다.

Keywords

References

  1. Sjogren G, Andersson M, Bergman M. Laser welding of titanium in dentistry. Acta Odontol Scand 1988;46:247-53.
  2. Ortorp A, Linden B, Jemt T. Clinical experiences of laser welded titanium frameworks supported by implants in the edentulous mandible. A 5-year follow-up study. Int J Prosthodont 1999;12:65-72.
  3. Bergendal, Palmqvist. Laser-welded titanium framework for implant-supported fixed prostheses: a 5-year report. Int J Oral Maxillofac Implants 1999;14:69-71.
  4. Ortorp A, Jemt T. Clinical experiences of computer numeric control-milled titanium frameworks supported by implants in the edentulous jaw: a 5-year prospective study. Clin Implant Dent Relat Res 2000;2:2-9.
  5. Duncan JP, Nazarova E, Vogiatzi T, et al. Prosthodontic complications in a prospective clinical trial of single-stage implants at 36 months. Int J Oral Maxillofac Implants 2003;18:561-65.
  6. Örtorp A, Jemt T. Early laser-welded titanium frameworks supported by implants in the edentulous mandible: a 15-year comparative follow-up study. Clin Implant Dent Relat Res 2009;11:311-22.
  7. Purcell BA, McGlumphy EA, Holloway JA, et al. Prosthetic complications in mandibular metal-resin implant-fixed complete dental prostheses: a 5-to 9-year analysis. Int J Oral Maxillofac Implants 2008;23:847-57.
  8. Bozini T, Petridis H, Garefis K. A meta-analysis of prosthodontics complication rates of implantsupported fixed dental prostheses in edentulous patients after an observation period of at least 5 years. Int J Oral Maxillofac Implants 2011;26:304-18.
  9. Larsson C, Vult von Steyern P, Nilner K. A prospective study of implant-supported full-arch yttria-stabilized tetragonal zirconia polycrystal mandibular fixed dental prostheses: three-year results. Int J Prosthodont 2010;23:364-69.
  10. Papaspyridakos P, Lal K. Complete arch implant rehabilitation using subtractive rapid prototyping and porcelain fused to zirconia prosthesis: a clinical report. J Prosthet Dent 2008;100:165-72.
  11. Hassel AJ, Shahin R, Kreuter A, et al. Rehabilitation of an edentulous mandible with an implant-supported fixed prosthesis using an all-ceramic framework: a case report. Quintessence Int 2008;39:421-26.
  12. Linkevicius T, Vladimirovas E, Grybauskas S, et al. Veneer fracture in implant-supported metal-ceramic restorations. Part I: Overall success rate and impact of occlusal guidance. Stomatologija 2008;10:133-39.
  13. Roberts DH. The failure of retainers in bridge prostheses. An analysis of 2,000 retainers. Br Dent J 1970;128:117-24.
  14. Jacobi R, Shillingburg HT Jr, Duncanson MG Jr. Effect of abutment mobility, site, and angle of impact on retention of fixed partial dentures. J Prosthet Dent 1985;54:178-83.
  15. Reuter JE, Brose MO. Failures in full crown retained dental bridges. Br Dent J 1984;157:61-3.
  16. Llobell A, Nicholls JI, Kois JC, et al. Fatigue life of porcelain repair systems. Int J Prosthodont 1992;5:205-13.
  17. Guess PC, Att W, Strub JR. Zirconia in fixed implant prosthodontics. Clin Implant Dent Relat Res 2010 Dec 22. Epub ahead of print.
  18. Swain MV. Unstable cracking (chipping) of veneering porcelain on all-ceramic dental crowns and fixed partial dentures. Acta Biomater 2009;5:1668-77.
  19. Larsson C, Vult von Steyern P, Nilner K. A prospective study of implant-supported full-arch yttria-stabilized tetragonal zirconia polycrystal mandibular fixed dental prostheses: three-year results. Int J Prosthodont 2010;23:364-9.
  20. Ohlmann B, Marienburg K, Gabbert O, et al. Fracture-load values of all-ceramic cantilevered FPDs with different framework designs. Int J Prosthodont 2009;22:49-52.
  21. Al-Amleh B, Lyons K, Swain M. Clinical trials in zirconia: a systematic review. J Oral Rehabil 2010;37:641-52.
  22. Zitzmann NU, Marinello CP. Treatment plan for restoring the edentulous maxilla with implantsupported restorations: removable overdenture versus fixed partial denture design. J Prosthet Dent 1999;82:188-96.
  23. Bidra AS, Agar JR. A classification system of patients for esthetic fixed implant-supported prostheses in the edentulous maxilla. Compend Contin Educ Dent 2010;31:366-74.
  24. Kelly JR, Denry I. Stabilized zirconia as a structural ceramic: an overview. Dent Mater 2008;24:289-98.
  25. Chevalier J, Gremillar L. Ceramics for medical applications: A picture for the next 20 years. J Eur Ceramic Soc 2009;29:1245-55.
  26. Denry I, Kelly JR. State of the art of zirconia for dental applications. Dent Mater 2008;24:299-307.
  27. Rimondini L, Cerroni L, Carrassi A, et al. Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants 2002;17:793-8.
  28. Scarano A, Piattelli M, Caputi S, et al. Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol 2004;75:292-6.
  29. Jung YS, Lee JW, Choi YJ, et al. A study on the invitro wear of the natural tooth structure by opposing zirconia or dental porcelain. J Adv Prosthodont 2010;0232:111-5.
  30. Lim JH, Lim HS, Lim JH, Cho IH. The effect of various graft materials on the stability of implant and peri-implant tissue response in rabbit tibia. J Korean Acad Oral Maxillofac Implantol 2001;5:41-64.
  31. Turrel AJ. Clinical assessment of vertical dimension. J Prosthet Dent 1972;28:238-46.
  32. Zarb GA, Carlsson GE, Bolender CL. Boucher's Prosthodontic Treatment for Edentulous Patients (ed 11). St. Louis, Mosby, 1997, pp.218-29.
  33. Henry PJ. An alternate method for the production of accurate cast and occlusal records in the osseointegrated implant rehabilitation. J Prosthet Dent 1987;58:694-7.
  34. Yanase RT, Binon PP, Jemt T, et al. Current issue form. How do you test a cast framework for a full arch fixed implant supported prosthesis? Int J Oral Maxillofac Implants 1994;9:471-4.
  35. Tan KB, Rubenstein JE, Nicholls JI, et al. Threedimensional analysis of the casting accuracy of one piece, osseointegrated implant retained prostheses. Int J Prosthodont 1993;6:346-63.
  36. Hollender L, Rockler B. Radiographic evaluation of osseointegrated implants of the jaws. Experimental study of the influence of radiographic techniques on the measurement of the relation between implant and bone. Dentomaxillofac Radiol 1980;9:91-5.
  37. Flemming GJ, Dickens M, Thomas LJ, et al. The in vitro failure of all ceramic crowns and the connector area of fixed partial dentures using bilayered ceramic specimens: the influence of core to dentin thickness ratio. Dent Mater 2006;22:771-7.
  38. Tsumita M, Kokubo Y, Vult von Steyern P, et al. Effect of framework shape on the fracture strength of implant-supported all-ceramic fixed partial dentures in the molar region. J Prosthodont 2008;17:274-85.
  39. Sailer I, Feher A, Filser F, et al. Five-year clinical results of zirconia frameworks for posterior fixed partial dentures. Int J Prosthodont 2007;20:383-8.
  40. Keough BE, Kay HB, Sager RD. A ten-unit allceramic anterior fixed partial denture using Y-TZP zirconia. Pract Proced Aesthet Dent 2006;18:37-43.
  41. Beuer F, Stimmelmayr M, Gueth JF, et al. In vitro performance of full-contour zirconia single crowns. Dent Mater 2012;28:449-56.
  42. Alghazzawi TF, Lemons J, Liu PR, et al. Influence of low-temperature environmental exposure on the mechanical properties and structural stability of dental zirconia. J Prosthodont 2012;21:363-9.
  43. Rojas-Vizcaya FJ. Full zirconia fixed detachable implant-retained restorations manufactured from monolithic zirconia: clinical report after two years in service. J Prosthodont 2011;20:570-76.