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Full Arch Implant Prostheses: Part II - Fabrication Procedures

Course Number: 618



An implant prosthesis is a prosthesis supported and retained in part or whole by dental implants.

The successful osseointegration of implants has had an enormous impact on the treatment of edentulous patients. Rehabilitation with implant prostheses has significantly improved prosthesis retention and stability and the masticatory ability, esthetics, expectations, and the overall quality of life of edentulous patients.1-3 In the early phase of implant dentistry, implants were used to retain full arch fixed, totally implant-supported prostheses.5-8 With the success of the fixed implant-supported prostheses, new prosthetic designs and types were developed. Initially, the bar-retained implant overdenture was introduced as an alternative to the fixed implant-supported prosthesis.9-12 The bar supported implant overdenture helped improve the prosthesis retention, patient’s masticatory ability and required a lesser number of implants compared to the fixed counterpart. It also aided in decreasing the financial burden of implant rehabilitation.12 Easy placement and removal of the implant overdenture made oral hygiene maintenance easier to achieve. The implant overdenture also helped improve esthetics by providing optimal lip and facial support.13,14 With the continuous improvement in the success rates of implant, stud attachments were developed to retain and support the implant restorations, further reducing the treatment cost.15-17

Recently, newer technologies and materials (such as monolithic zirconia, ceramic veneered zirconia, milled monolithic acrylic, as well as new ceramics, polymers, and hybrids) have been developed and used for fabricating implant prostheses.18-20 Zirconia has emerged as a material with excellent biomechanical properties and is highly recommended for fabricating implant supported fixed prostheses. However, the ceramic layer of the ceramic veneered zirconia has low flexural strength and is susceptible to chipping and fracture.

The use of digital dental technologies has improved the overall prosthetic outcome. CAD/CAM technology has helped fabricate simple and complex fixed and removable prostheses and frameworks.21 CAD/CAM frameworks are very accurate compared to the cast frameworks developed by the lost wax technique.21 CAD/CAM frameworks have a passive fit thereby decreasing the prosthesis movement and bacterial leakage.22 Titanium and Zirconia have been the preferred material for fabricating CAD-CAM frameworks. This course will describe in detail the fabrication steps for both removable and fixed implant prostheses along with a brief discussion on CAD-CAM frameworks.