Full Zirconia for use on the final All-on-4® dental implant hybrid is all the rage now in our industry. The question we have to ask as a removable lab is how do we manage a complication down the road? We’ve learned through years of experience that almost every restoration eventually has some sort of complication, a chip or fractured tooth etc. Is it repairable? The answer to that question is often no.
When a full zirconia hybrid fractures, it must be remade. If a tooth chips or if a space under the prosthesis develops, porcelain must be added and it must be refired. The refiring of porcelain that has been in the mouth for a long period of time is a very high-risk procedure that is rarely successful. It will most likely combust under the pressure of refiring. We are always thinking long-term and to begin with the end in mind. Things like fractures will come. We have to be thinking ahead about what is going to best for the patient both durability and investment wise for the duration of their life. An alternative solution without sacrificing aesthetics is a CAD | CAM Titanium Bar with Zirconia teeth.
In most cases, a titanium bar lasts a lifetime. Should it fracture, it can easily be repaired through laser welding. Should a tooth chip or fracture, a single unit can easily be replaced. Additionally, a titanium bar is not as rigid as Zirconia and allows for flexure of the mandible. This would be our recommendation over full Zirconia so complications down the road do not require a complete redo on the investment your patient already made in their mouth.