Introduction:

Complete arch fixed implant-supported prostheses (CAFIP) have been shown to be a successful treatment option for patients with terminal dentition or those already edentulous. Many prosthetic complications of this treatment option can be minimized with proper treatment planning incorporating adequate prosthetic space and proper fabrication of a passive final prosthesis. The brittleness of zirconia mandates that the design criteria provide adequate prosthesis thickness of at least 12 mm, adequate passive fit and the absence of long spans and cantilevers. 1

This case report describes a male patient who was successfully managed after suffering from a mandibular midline fracture of two monolithic zirconia prostheses supported by five dental implants from distinct manufacturers.

Case Report: 

The patient, a 52-year-old male, presented in September 2021 with the chief complaint “I yawned and heard the bottom bridge crack.” The patient had a history of severe bruxism and was not compliant with occlusal guard usage. At the time of patient presentation, the mandibular zirconia prosthesis was removed and a copy-milled PMMA prototype prosthesis was inserted eliminating implant #30. The prosthesis was also reinforced with metal pins and autopolymerizing resin.  Prior to placement, the prototype prosthesis was verified for passive fit. Patient also received a temporary occlusal guard to wear with prototype prosthesis. Final zirconia prosthesis was inserted after a few months and patient was educated on the importance of regular occlusal guard usage.