Zirconia ceramic fixed dental prosthesis with all-on-4 concept implants for irradiated maxilla: A case report

For a patient with single edentulous arch opposed by a natural or restored dentition, complete denture or implant assisted overdenture might not be considered as the standard therapy any more due to varying support. Prosthodontic replacement in irradiated edentulous maxilla needs meticulous treatment planning due to low bone remodeling capacity, radiation caries, periodontal infection and reduced salivary secretions. Implant placement in patients with reduced bone volume in the posterior region can be treated using all-on-4 concept implantation avoiding bone grafting procedures. The advantages of all-on-4 concept implantation are reduced number of implants needed, capability of longer implant placement, and decreased cantilever length of prosthesis. Zirconia ceramic complete-arch implant-supported fixed dental prosthesis has been encouraged by high biocompatibility, low bacterial surface adhesion, high flexural strength and improved esthetic properties. The metal-resin hybrid prosthesis has shown complications such as fracture of resin teeth or resin base, loosening or fracture of prosthetic or abutment screws, and fracture of implant abutments. Since zirconia based, implant-supported fixed dental prosthesis showed high survival rate up to 100%, it could be a good substitute for metal-resin prosthesis. The purpose of this case report was to document a treatment procedure of maxillary edentulous patient with all-on-4 concept implantation using customized titanium abutments and cement-retained zirconia ceramic completearch fixed dental prostheses. Treatment goals were to improve mastication and esthetics. CASE REPORT