Implant Prosthetics: Planning for Success

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An implant supported prostheses requires careful planning and execution to ensure that it will give many years of service. From an engineering standpoint, nothing is more complicated in dentistry than implant prosthodontics. Material choice is paramount to the successful replacement of missing teeth.  Since we don’t have a singular material that can satisfy the both the esthetic and functional demands, we must blend  two or three different materials into a homogenous structure utilizing the best qualities of each to great advantage. In this case the decision was made not to place an implant in the bicuspid location for a traditional 3 unit bridge because of the lack of available bone and the proximity of the mental nerve.  And so, a cantilever was created in the zirconia substructure with a tall but cleansable connector. Zirconia was chosen for the supporting structure because of its high strength (900-1200 mPa)  as well as its biocompatibility.  The base of the prosthesis in contact with the tissue is polished to a mirror-like finish with diamond paste. Unfortunately zirconia in it’s monolithic state exhibits poor esthetic properties.  Rather than veneering the substructure with a low strength ceramic (90 mPa), the superstructure was pressed from a high translucency lithium disilicate ingot into a monolithic form. Managing the properties of light through the choice of ceramic materials gave this reconstruction lifelike properties with great strength for a long lasting prosthetic replacement for missing teeth….

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