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Monolithic Zirconia: Moving Beyond the Traditional Hybrid Denture

Monolithic Zirconia - Dental CE Course
Launch Course

Course Objectives (2 CE Credits)

Jack A. Hahn, DDS; B. Patrick Schaefer, DDS; and Timothy F. Kosinski, DDS, MAGD

By substantially improving prosthetic stability and function, implant-supported dentures enhance the quality of life for edentulous patients. While both fixed and removable full-arch implant prostheses offer improved comfort, oral health, esthetics, and speech and chewing capabilities, the acrylic hybrid denture offers maximum stability by attaching to implants through a titanium substructure. The only drawback to fixed hybrid dentures is their susceptibility to wear and fracture over the long term, which can require ongoing maintenance, repairs or outright replacement. Advancements in CAD/CAM technology and material science allow for the fabrication of full-arch implant restorations from monolithic zirconia, providing clinicians with a more durable alternative. Drs. Jack Hahn, B. Patrick Schaefer and Timothy Kosinski outline the advantages of this new restorative option for edentulous patients. Topics include:

  • Clinical benefits of implant-supported full-arch prostheses
  • Fixed full-arch restorations vs. removable implant overdentures
  • Clinical protocol for restoring an edentulous arch with a monolithic zirconia implant prosthesis
  • Advantages and disadvantages of acrylic hybrid dentures
  • Physical characteristics of monolithic zirconia
  • All-on-4 and the use of multi-unit abutments in full-arch implant restorations
  • Confirming the restorative design with a provisional implant prosthesis
  • Achieving a passive fit with an implant verification jig
  • CAD/CAM technology’s role in fabricating full-arch implant prostheses
  • Construction and durability of acrylic hybrid dentures vs. monolithic zirconia full-arch implant restorations
  • The impact of implant therapy on the edentulous patient’s quality of life
  • Esthetic advantages of monolithic zirconia in full-arch indications

Summary

Full-arch implant restorations fabricated from monolithic zirconia offer a new standard in prosthetic durability and all the benefits of a fixed hybrid denture. Their singular construction from solid zirconia minimizes the odds that patients will ever have to go without their prosthesis. The workflow for restoring an edentulous arch with a monolithic zirconia implant prosthesis is straightforward and nearly identical to the clinical steps involved in producing a traditional hybrid denture. Although the traditional hybrid denture has been the optimal solution for edentulism for many years, clinicians now have the option of providing their patients with a fixed restoration that offers excellent esthetics and maximum resistance to the occlusal forces full-arch restorations are subject to over time.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


References

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  2. Rossein KD. Alternative treatment plans: implant-supported mandibular dentures. Inside Dentistry. 2006;2(6):42-3.
  3. Harris D, Höfer S, O'Boyle CA, Sheridan S, Marley J, Benington IC, Clifford T, Houston F, O'Connell B. A comparison of implant-retained mandibular overdentures and conventional dentures on quality of life in edentulous patients: a randomized, prospective, within-subject controlled clinical trial. Clin Oral Implants Res. 2013 Jan;24(1):96-103.
  4. Covani U, Cornelini R, Calvo JL, Tonelli P, Barone A. Bone remodeling around implants placed in fresh extraction sockets. Int J Periodontics Restorative Dent. 2010 Dec;30(6):601-7.
  5. Preciado A, Del Río J, Lynch CD, Castillo-Oyagüe R. Impact of various screwed implant prostheses on oral health-related quality of life as measured with the QoLIP-10 and OHIP-14 scales: a cross-sectional study. J Dent. 2013 Dec;41(12):1196-207.
  6. Brennan M, Houston F, O'Sullivan M, O'Connell B. Patient satisfaction and oral health-related quality of life outcomes of implant overdentures and fixed complete dentures. Int J Oral Maxillofac Implants. 2010 Jul-Aug;25(4):791-800.
  7. Gallucci GO, Doughtie CB, Hwang JW, Fiorellini JP, Weber HP. Five-year results of fixed implant-supported rehabilitations with distal cantilevers for the edentulous mandible. Clin Oral Implants Res. 2009 Jun;20(6):601-7.
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