Restoring Full Arch Max/Mand Fixed (Molar to Molar)

[mstanley614]

What Crown Material (i.e. Zirconia, Metal framework w/ porcelain/ Abutments (custom or not i.e. Brands) would you use to restore this case?

(Biohorizon implants in sites: 3-5-7-10-12-14 and 19-21-23-26-28-30) placed with Anatomage surgical guide with minimal lingual placement except on lower anteriors. Adequate clearance to occlusal plane (~14mm/arch).

Which teeth would you Cantilever? or Would you do a single unit fixed with custom abutments?

Questions to clarify are welcome. Its my first full arch Max/Mand case I've done.

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[briansle]

What Crown Material (i.e. Zirconia, Metal framework w/ porcelain/ Abutments (custom or not i.e. Brands) would you use to restore this case?

(Biohorizon implants in sites: 3-5-7-10-12-14 and 19-21-23-26-28-30) placed with Anatomage surgical guide with minimal lingual placement except on lower anteriors. Adequate clearance to occlusal plane (~14mm/arch).

Which teeth would you Cantilever? or Would you do a single unit fixed with custom abutments?

Questions to clarify are welcome. Its my first full arch Max/Mand case I've done.

Good job. I've never done one of these, so take my post with a grain of salt. Hope I get the chance to do one of these.

Based off the number and area that you placed the implants in, I'd go with single unit fixed. Would not cantilever, esp in maxillary.

I'd also probably go with metal framework w.porcelain. Zirconia sounds cool, but I personally felt it was pretty heavy. not sure why patients would want something so bulky and heavy in their head. But that said, with advent of 3-D printing, I feel these single-unit custom milled zirconia arches will be done in-office pretty soon. And prob be the primary option.

So: single unit fixed/metal porcelain - let us know how it goes!

edit: wait on second thought, you could cantilever the canines for both arches. Wind up doing 3 fpd's on each arch. You'll probably make the call. Afterall you know the bone quality and how you placed them.

edit: yea cantilever the canines for the maxillary. and do a single unit for the mand. I think this is best since the single unit undergoes alot of flexion which will probably lead to breakage. If you do 3 fpds on top this will adequately distribute the stress. Also zirconia is great at compression but weak on flexion so go with metal porc.

 

[iwantcandy]

Interesting