Zirconia Removable Telescopic Dentures Retained on Teeth or Implants for Maxilla Rehabilitation. Three-Year Observation of Three Cases
This report addresses maxillary restoration with removable telescopic crown-retained palatal free dentures. One patient with 7 natural teeth (PERIO), a second patient with 6 dental implants (IMPL), and a third patient with 2 natural teeth and 4 dental implants (IMPL-PERIO) were treated. Zirconia copings for natural teeth and individual zirconia implant abutments were fabricated in CAD/CAM and used as primary crowns. Electroformed gold copings were used as secondary telescopes. All maxilla supraconstructions were fabricated with zirconia and CAD/CAM. Patients were monitored during a 3-year period; all teeth and implants survived, and no biological or mechanical complications occurred. The peri-implant and periodontal conditions were healthy. While recognizing the limitations of this report, results showed that fabricating removable zirconia structures by means of CAD/CAM can yield highly functional and esthetic results. Galvanoforming technology is the preferable means of fabricating secondary crowns. The combination of these techniques and materials results in a prosthetic reconstruction of high quality, good fit, and biocompatibility. Long-term studies of large populations are necessary to investigate the clinical properties of the material utilized in this type of construction.Abstract

(a) Creation of implant abutments using C-silicon matrix as orientation. (b) Wax-up of an implant abutment before scanning. (c) Zirconia implant abutments were fixed on the synOcta titan parts. (d) Zirconia implant abutment was ground, polished, and sintered. (e) Finished zirconia implant abutment. (f) Fit-in of the zirconia implant abutments. IMPL patient: region number 2 and 15 natural teeth with primary telescopes of the “old” restoration.

(a) Zirconia copings were CAD/CAM created. (b) Finished zirconia coping. (c and d) Fit-in of the zirconia copings. (e) New working model fabricated after fit-in of the copings.

(a) Fabrication of electroformed gold copings. (b) IMPL patient, zirconia implant abutments as primary telescopes with secondary gold copings as secondary telescopes; natural teeth number 2 and 15 with primary telescopes from the old restoration. (c) Supraconstruction was created in CAD/CAM. (d) IMPL patient mock-up. (e) PERIO patient mock-up.

(a) CAD/CAM fabricated zirconia supraconstruction. (b and c) Finished/veneered supraconstruction for PERIO patient. (d and e) Finished/veneered supraconstruction for IMPL patient. (f) Gold copings fixed in the supraconstruction.

(a and b) Attachment system with natural tooth abutments 1: zirconia copings, 2: gold copings, and 3: zirconia supraconstruction. (c and d) Attachment system with implant abutments 1: zirconia implant abutments, 2: gold copings, and 3: zirconia supraconstruction. (e) The screw opening of the zirconia implant abutment was filled with a resin.

IMPL patient. (a–c) Clinical view right – front – left. (d) Orthopantomograph. (e) Palatal view. (f) Anterior area close-up.

Three-year clinical view. (a) Zirconia copings. (b) Zirconia implant abutment.
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