less staining, better translucency) and better load-bearing characteristics than acrylic to maintain the vertical dimension of occlusion.ĭisadvantages: There is an increased risk for fracture with this type of restoration as porcelain can chip, develop craze lines and crack which are then associated with higher costs of repair and complexity. It is important to note at the outset that the use of porcelain has markedly better esthetics (e.g. 8-11).Īdvantages: The individually cemented crowns give this restoration a more natural look without requiring the implants to be in precise tooth positions. As a result, the final restoration is delivered to the patient as a single unit (Figs. Individual crowns are then fabricated and cemented onto the framework by the laboratory. This treatment option utilizes a metal framework as a base, which includes individual crown preparations as part of the framework. Metal Framework with Individual Porcelain Crowns However, this will increase the cost of the final restoration and the use of metal may potentially decrease the esthetic quality of the prosthesis.Ģ. Strategies to mitigate some of the issues outlined above include using porcelain denture teeth instead of acrylic denture teeth and/or the incorporation of metal islands and metal occlusal rests in the posterior regions to maintain cusp/fossa relationships. Ultimately, the patient’s vertical dimension of occlusion will decrease if left untreated over a period of time. This will greatly reduce chewing efficiency and compromise esthetics. As a result, if the prosthesis opposes natural dentition or porcelain restoration, the prosthesis will wear faster leading to flattening of the incisal edges and cusps of teeth. Additionally, acrylic wears at a faster rate than porcelain or natural teeth. If there is less than adequate space, the restoration is at risk of fracturing during function. To optimize the strength of acrylic, a minimum of 12-15 mm of restorative space from the bone to the occlusal plane is required. Hence, the patient is not impacted without the prosthesis for any length of time as the denture is not sent to the laboratory for repair.ĭisadvantages: There are also distinct disadvantages when using this prosthetic option. Additionally, the cost of repair is minimal as repairs are easily accomplished with repair resin which is added to the defects or areas of concern chairside. 1-7).Īdvantages: This is a popular option due to the low cost associated with fabrication of the prosthesis. A metal framework is fabricated, pink acrylic and denture teeth are processed to this framework (Figs. George Zarb and has been used for many years. ![]() In this article, the author focuses on the types of final fixed prosthetic options that are available to clinicians and the advantages and disadvantages of each.Ī fixed complete denture (also known as a traditional “hybrid” prosthesis) is a screw-retained treatment option that was introduced by Dr. The final prosthesis that is selected for a particular patient’s case can impact a patient in terms of cost and convenience. Previous articles by the author have outlined in detail the surgical and prosthetic procedures. When discussing a full arch fixed implant solution with patients, clinicians spend a considerable amount of time and attention on planning the surgical aspects of the case, the transitional prosthesis and the final full arch restoration.
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