Fixed All-on-4® Implant Restoration
Acrylic attached to a titanium framework:
Traditional way of restoring the edentulous arch. + least expensive option - most prone to fracture and wear Should be used in the mandible only and when opposed by a complete denture. Requires ridge reduction to have 15mm of interarch space.
Zirconia, either monolithic or layered:
Much stronger material to withstand heavy occlusal loads + monolithic rarely fractures -layered zirconia can chip -very heavy -more expensive and technique sensitive -no resilience or shock absorption Primarily used in the maxilla opposing natural dentition or an implant retained restoration. Requires 15-17mm of interarch space
Crystal Ultra (heavily quartz infused resin copolymer)
Stronger than acrylic, similar compressive strength to e.max + high compressive strength + resilient and has a shock absorption quality + translucent, more esthetic than zirconia + repairable intraorally with composite + lighter than acrylic to titanium -more expensive than zirconia Ideal for maxilla or mandible Requires 15 or more mm of interarch space.
Porcelain fused to metal or zirconia
Strongest and least bulky way to restore an edentulous arch + does not require ridge reduction, works best with good ridge form + least bulk on palatal -most expensive -most technique sensitive -most technically difficult to fabricate -requires excellent planning and communication between restorative dentist, lab and surgeon Requires usually 8 implants to fabricate 4, three unit bridges.
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