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    Technique: Fabricating full arch implant prosthesis

    A look at how a zirconia CAD/CAM-milled restoration is a great treatment material option for full arch implant supported fixed prosthesis.

    Full-arch implant-supported restorations have been documented to have high success rates. Many combinations of materials have been used for this type of restoration, such as metal alloy-acrylic, metal alloy-composite and metal alloy-ceramic. 

    However, complications including fractured or debonded acrylic resin teeth, wear of opposing surfaces, ceramic chipping, difficulty in shade matching of acrylic and pink ceramic, lack of passive fit and extensive work for repair after framework breakage have encouraged dentists to look for other material options. The following case study will present the clinical and laboratory protocol to fabricate a zirconia full arch prosthesis. 

    Related article: Creating monolithic zirconia splinted crowns

    Case study

    A 70-year-old patient presented with fractured teeth and multiple failing restorations (Fig. 1-2). It was determined that the mandibular teeth were not restorable. The treatment plan was for a mandibular fixed detachable prosthesis with five implants. Due to patient’s finances, the maxillary arch will be restored after the mandibular arch is finished.

    Preop FrontalFig. 1Preop Occlusal viewFig. 2






    A full thickness flap was performed, as well as extraction of remaining mandibular teeth with alveoloplasty to create restorative space and achieve an even ridge. A clear duplicate surgical guide was used for implant position and distribution. Five BioHorizons Tapered Internal implants were placed using a second stage approach (Fig. 3). 

    After an uneventful healing period, uncovery of the implants was performed and multi-unit abutments were placed and torqued to 30NCM (Fig. 4).

    Implant placement surgery (Surgery by Dr. Kalee Claussen)Fig. 3Multi-unit abutments in placeFig. 4






    Up next: The fabrication and final results 

    Celin Arce, DDS, MS, FACP
    Celin Arce is an Assistant Professor at the University of Alabama at Birmingham School of Dentistry, Restorative Sciences, Division of ...
    Matt Winstead, CDT
    Matt Winstead is the Vice-President of Oral Arts Dental Laboratories in Huntsville, Alabama.


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