FABRICATION OF A WEAR-RESISTANT CONVENTIONAL HYBRID PROSTHESIS INTEGRATING DIGITAL WORKFLOW

To discuss the workflow to fabricate a wear resistance acrylic-titanium  implant-supported fixed complete denture (ISFCD) through a digital workflow and using splinted CAD-CAM crowns.

A 78-year-old male presented to the Graduate Prosthodontics Clinic at the University of Alabama at Birmingham School of Dentistry, reporting significant wear and diminished masticatory efficiency of the maxillary implant-supported fixed complete denture (ISFCD) inserted in 2018. Clinical examination revealed extensive wear of the prosthesis and compromised occlusal function with opposing arch treated having implant-tooth supported all-ceramic crowns and non-restorable teeth requiring replacement with implants. Patient refused to replace the maxillary prosthesis with zirconia hybrid. The patient agreed on fabrication of a acrylic-titanium hybrid with having splinted zirconia crown on the posterior teeth to limit the wear and the loss of occlusal vertical dimension.

Wear and fracture of denture teeth is a common complication associated with an acrylic-titanium ISFCD which alters the occlusal scheme and vertical dimension of occlusion (VDO) specifically when the opposing arch has natural dentition or restored with a wear resistance prosthesis. Zirconia is a wear resistance material presenting a wear similar to enamel. The use of a splinted zirconia crowns on the acrylic-titanium ISFCD may provide a cost-effective and wear resistance prosthesis for patients. However, long-term follow up is needed to assess the treatment effectiveness considering the lack of studies on bonding of zirconia crowns on the PMMA base prosthesis. However, this clinical report used multiple retentive features and splinted the crowns to maximize the retention and resistance form of crowns.