§ También denominado computador

numérico controlado (CNC);

Fabricación asistida por computadora
(CAM) sin diseño asistido por
computadora (CAD) mediante el
escaneo directo de un objeto
https://www.zirkonzahn.com/es/zirconia-prettau
Enrico Steger (* 20-05-1959) es el inventor del
Zirkograph, sistema de fresado manual, para elaborar
prótesis de zirconia.

En 1981 funda su propio laboratorio tras cinco años de

formación como protésico dental en Bolzano (Sudtirol) y
diversos empleos como técnico dental en varios
laboratorios de Europa. Desarrolla además productos
odontotécnicos como ceras, fresas, y cerámicas en
colaboración con empresas industriales y realiza estudios
de color y análisis de formas.
https://www.zirkonzahn.com/es/zirconia-prettau
 Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi Baba, DDS, PhD
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords Abstract
Dental implants; fixed dental prostheses;
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
§ El objetivo de este informe clínico es
laindescribir eltosistema de zirconia
fabricació n de(PAZ)
nuevo
CAD/CAM; zirconia framework; porcelain
crown. crowns adhered a CAD/CAM framework have been developed.
The aim of this report was to describe the clinical application of a newly developed
desarrollo sobre implantes FDP, que
Correspondence utiliza PAZ,FDP
implant-supported y evaluar elsystem,
fabrication resultado clínPAZ,
which uses ico and to evaluate the out-
después de un período de aplicaciópatients
n máxwith
imaedentulous
de 36 meses.
come after a maximum application period of 36 months. Implants were placed in three
Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku, areas in either the maxilla or mandible. After the implant
Tokyo 145-8515, Japan. E-mail: fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
mtakaba@dent.showa-u.ac.jp abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
The authors deny any conflict of interest.
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
Accepted October 20, 2012 zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
doi: 10.1111/jopr.12001 improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

Dental implants are now widely recognized as a viable treat-
ment option for prosthetic replacement of missing teeth. After
implant fixtures are successfully placed and abutments are con-
nected, implant-supported fixed dental prostheses (FDPs) are
fabricated on the abutments. Porcelain is the material of choice
for most FDPs, and metal ceramic restorations are widely used
for FDPs because of their clinically acceptable biological sta-
bility, esthetics, and mechanical properties. Previous reports
1,2
In recent years, FDPs using a zirconia framework produced
by a new fabrication system combined with computer-assisted
fabrication (CAD/CAM) systems have attracted much attention
and emerged as a popular treatment modality.8,9 While zirco-
nia ceramic FDPs exhibited a survival rate similar to metal
ceramic FDPs after 3 years of function,10 it has been noted
that veneering porcelain on the zirconia framework by the con-
ventional manual laboratory technique resulted in significantly
7,11
 Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi
7 I SC radiografía panorámicaBaba, DDS,
tomada en PhD
el examen inicial (paciente 1).
Takaba CL CAD / CAM coronas de porcelana y Marco Zirconia
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
crown.
Correspondence
Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku,
Tokyo 145-8515, Japan. E-mail:
mtakaba@dent.showa-u.ac.jp
The authors deny any conflict of interest.
Accepted October 20, 2012
doi: 10.1111/jopr.12001
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
come after a maximum application period of 36 months. Implants were placed in three
patients with edentulous areas in either the maxilla or mandible. After the implant
fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

7 I SC radiografía panorámica tomada después la colocación del implante

7 I SC radiografía panorámica tomada en el examen inicial (paciente 1). I SC radiografía panorámica tomada en el examen inicial (paciente 2).
(Paciente 1).
Dental implants are now widely recognized as a viable treat- In recent years, FDPs using a zirconia framework produced
ment option for prosthetic replacement of missing teeth. After by a new fabrication system combined with computer-assisted
implant fixtures are successfully placed and abutments are con- fabrication (CAD/CAM) systems have attracted much attention
nected, implant-supported fixed dental prostheses (FDPs) are and emerged as a popular treatment modality.8,9 While zirco-

Caso I
fabricated on the abutments. Porcelain is the material of choice nia ceramic FDPs exhibited a survival rate similar to metal
for most FDPs, and metal ceramic restorations are widely used ceramic FDPs after 3 years of function,10 it has been noted
for FDPs because of their clinically acceptable biological sta- that veneering porcelain on the zirconia framework by the con-
bility, esthetics, and mechanical properties. Previousse producen
reports fracturas de porcelana,
ventional manualque se esperatechnique
laboratory para reducir los daños
resulted in asociados
significantly
1,2 7,11
Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework CAD / CAM coronas de porcelana y Marco Zirconia
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi Baba, DDS, PhD
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
crown.
Correspondence
Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku,
Tokyo 145-8515, Japan. E-mail:
mtakaba@dent.showa-u.ac.jp
The authors deny any conflict of interest.
Accepted October 20, 2012
doi: 10.1111/jopr.12001
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
come after a maximum application period of 36 months. Implants were placed in three
patients with edentulous areas in either the maxilla or mandible. After the implant
fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

Dental implants are now widely recognized as a viable treat- In recent years, FDPs using a zirconia framework produced
ment option for prosthetic replacement of missing teeth. After by a new fabrication system combined with computer-assisted
implant fixtures are successfully placed and abutments are con- fabrication (CAD/CAM) systems have attracted much attention
nected, implant-supported fixed dental prostheses (FDPs) are and emerged as a popular treatment modality.8,9 While zirco-
fabricated on the abutments. Porcelain is the material of choice nia ceramic FDPs exhibited a survival rate similar to metal
for most FDPs, and metal ceramic restorations are widely used ceramic FDPs after 3 years of function,10 it has been noted
7 I SC of
for FDPs because - their
De prótesis definitivo
clinically en elbiological
acceptable paciente sta-
1 (vista frontal).
that veneering porcelain on the zirconia framework by the con-
bility, esthetics, and mechanical properties. Previous reports ventional manual laboratory technique resulted in significantly
1,2 7,11
 Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
CADMasayuki
ografía panorámica tomada en elcoronas
/ CAM examenTakaba,
inicial
de Shinpei
(paciente
porcelana Tanaka, Yuichi Ishiura,
1). Zirconia
y Marco & Kazuyoshi
I SC radiografía Baba,
panorámica tomadaDDS, PhD inicial (paciente 2).
en el examen
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords Abstract
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
crown. lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
Correspondence implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
Masayuki Takaba, Showa University, come after a maximum application period of 36 months. Implants were placed in three
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku, patients with edentulous areas in either the maxilla or mandible. After the implant
Tokyo 145-8515, Japan. E-mail: fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
mtakaba@dent.showa-u.ac.jp abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
The authors deny any conflict of interest.
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
Accepted October 20, 2012 zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
doi: 10.1111/jopr.12001 improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

7 I SC - radiografía panorámica tomada después la colocación del implante

ografía
I SC panorámica
radiografía tomada después
panorámica la colocación del implante
tomada en el examen inicial (paciente 2).
(Paciente 2).
Dental implants are now widely recognized as a viable treat- In recent years, FDPs using a zirconia framework produced
ment option for prosthetic replacement of missing teeth. After by a new fabrication system combined with computer-assisted
implant fixtures are successfully placed and abutments are con- fabrication (CAD/CAM) systems have attracted much attention
nected, implant-supported fixed dental prostheses (FDPs) are and emerged as a popular treatment modality.8,9 While zirco-
fabricated on the abutments. Porcelain is the material of choice nia ceramic FDPs exhibited a survival rate similar to metal
for most FDPs, and metal ceramic restorations are widely used
Caso II
6L PCE sta-
for FDPs because of their clinically acceptable biological
ceramic FDPs after 3 years of function,10 it has been noted
that veneering porcelain on the zirconia framework by the con-
bility, esthetics, and mechanical properties. Previous reports ventional manual laboratory technique resulted in significantly
Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
7 I SCShinpei
Masayuki Takaba, - De prótesis definitivoYuichi
Tanaka, en el paciente 1 (vista&frontal).
Ishiura, Kazuyoshi Baba, DDS, PhD
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
crown.
Correspondence
Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku,
Tokyo 145-8515, Japan. E-mail:
mtakaba@dent.showa-u.ac.jp
The authors deny any conflict of interest.
Accepted October 20, 2012
doi: 10.1111/jopr.12001
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
come after a maximum application period of 36 months. Implants were placed in three
patients with edentulous areas in either the maxilla or mandible. After the implant
fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

Dental implants are now widely recognized as a viable treat- In recent years, FDPs using a zirconia framework produced
ment option for prosthetic replacement of missing teeth. After by a new fabrication system combined with computer-assisted
implant fixtures are successfully placed and abutments are con- fabrication (CAD/CAM) systems have attracted much attention
nected, implant-supported fixed dental prostheses (FDPs) are and emerged as a popular treatment modality.8,9 While zirco-
fabricated on the abutments. Porcelain is the material of choice nia ceramic FDPs exhibited a survival rate similar to metal
for most FDPs, and metal ceramic restorations are widely used ceramic FDPs after 3 years of function,10 it has been noted
for FDPs because of their clinically acceptable biological sta- that veneering porcelain on the zirconia framework by the con-
7 I SC
bility, esthetics, and . De prótesis
mechanical definitivo enPrevious
properties. el pacientereports
2 (vista frontal).
ventional manual laboratory technique resulted in significantly
1,2 7,11
 Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi Baba, DDS, PhD
CAD / CAM coronas de porcelana y Marco Zirconia Takaba CL
Department of Prosthodontics, Showa University School of 7 I SC . radiografía
Dentistry, panorámica tomada en el examen inicial (paciente 3).
Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
crown.
Correspondence
Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku,
Tokyo 145-8515, Japan. E-mail:
mtakaba@dent.showa-u.ac.jp
The authors deny any conflict of interest.
Accepted October 20, 2012
doi: 10.1111/jopr.12001
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
come after a maximum application period of 36 months. Implants were placed in three
patients with edentulous areas in either the maxilla or mandible. After the implant
fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

7 I SC . radiografía panorámica tomada en el examen inicial (paciente 3). 7 I SC / radiografía panorámica tomada después la colocación del implante

(Paciente 3).
Dental implants are now widely recognized as a viable treat-
ment option for prosthetic replacement of missing teeth. After
implant fixtures are successfully placed and abutments are con-
nected, implant-supported fixed dental prostheses (FDPs) are
fabricated on the abutments. Porcelain is the material of choice
Caso III
for most FDPs, and metal ceramic restorations are widely used
7 I SC 1 Pilares personalizados hechos de óxido de circonio.
for FDPs because of their clinically acceptable biological sta-
bility, esthetics, and mechanical properties. Previous reports
1,2
In recent years, FDPs using a zirconia framework produced
by a new fabrication system combined with computer-assisted
fabrication (CAD/CAM) systems have attracted much attention
and emerged as a popular treatment modality.8,9 While zirco-
nia ceramic FDPs exhibited a survival rate similar to metal
ceramic FDPs after 3 years of function,10 it has been noted
that veneering porcelain on the zirconia framework by the con-
ventional manual laboratory technique resulted in significantly
7,11
Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi Baba, DDS, PhD
7 I SC . De prótesis definitivo en el paciente 2 (vista frontal).
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
crown.
Correspondence
Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku,
Tokyo 145-8515, Japan. E-mail:
mtakaba@dent.showa-u.ac.jp
The authors deny any conflict of interest.
Accepted October 20, 2012
doi: 10.1111/jopr.12001
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
come after a maximum application period of 36 months. Implants were placed in three
patients with edentulous areas in either the maxilla or mandible. After the implant
fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

Dental implants are now widely recognized as a viable treat- In recent years, FDPs using a zirconia framework produced
ment option for prosthetic replacement of missing teeth. After by a new fabrication system combined with computer-assisted
implant fixtures are successfully placed and abutments are con- fabrication (CAD/CAM) systems have attracted much attention
nected, implant-supported fixed dental prostheses (FDPs) are and emerged as a popular treatment modality.8,9 While zirco-
fabricated on the abutments. Porcelain is the material of choice nia ceramic FDPs exhibited a survival rate similar to metal
for most FDPs, and metal ceramic restorations are widely used ceramic FDPs after 3 years of function,10 it has been noted
for FDPs because 7 of
I SC / De
their prótesis definitivo
clinically acceptableen elbiological
paciente 3 (vista
sta- frontal).
that veneering porcelain on the zirconia framework by the con-
bility, esthetics, and mechanical properties. Previous reports ventional manual laboratory technique resulted in significantly
1,2 7,11
 Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi Baba, DDS, PhD
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
crown.
Discusion
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
The aim of this report was to describe the clinical application of a newly developed
Correspondence implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-
Masayuki Takaba, Showa University, come after a maximum application period of 36 months. Implants were placed in three
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku, patients with edentulous areas in either the maxilla or mandible. After the implant

§ El pronóstico de 5 años
basado en un meta-análisis reveló que la frecuencia
Tokyo 145-8515, Japan. E-mail: fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
mtakaba@dent.showa-u.ac.jp abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
de fractura fue significativamente mayor en la cerámica de recubrimiento
The authors deny any conflict of interest.
CAD/CAM system. Next, wax-up was performed on working models for porcelain
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM

(8,8% vs. 2,9%)

Accepted October 20, 2012 zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
doi: 10.1111/jopr.12001 improved the esthetics and masticatory efficiency in all patients. No undesirable out-

§ El mecanismo de amortiguación del ligamento periodontal , y losreceptores

comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
mecánicos asociados tambien hacen falta, lo que resulta en una menor
complicated repair procedures in implant-supported FDPs.

capacidad de ajustar la fuerza de mordida.

§ Por lo tanto, la
fractura de la cerámica de recubrimiento en las PDF sobre
Dental implants are now widely recognized as a viable treat-
ment option for prosthetic replacement of missing teeth. After
implant fixtures are successfully placed and abutments are con-
implantes podría ser una complicación inevitable
nected, implant-supported fixed dental prostheses (FDPs) are
fabricated on the abutments. Porcelain is the material of choice
for most FDPs, and metal ceramic restorations are widely used
for FDPs because of their clinically acceptable biological sta-
bility, esthetics, and mechanical properties. Previous reports
1,2
In recent years, FDPs using a zirconia framework produced
by a new fabrication system combined with computer-assisted
fabrication (CAD/CAM) systems have attracted much attention
and emerged as a popular treatment modality.8,9 While zirco-
nia ceramic FDPs exhibited a survival rate similar to metal
ceramic FDPs after 3 years of function,10 it has been noted
that veneering porcelain on the zirconia framework by the con-
ventional manual laboratory technique resulted in significantly
7,11
 Implant-Supported Fixed Dental Prostheses with
CAD/CAM-Fabricated Porcelain Crown and Zirconia-Based
Framework
Masayuki Takaba, Shinpei Tanaka, Yuichi Ishiura, & Kazuyoshi Baba, DDS, PhD
Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan

Keywords
Dental implants; fixed dental prostheses;
CAD/CAM; zirconia framework; porcelain
§Discusion
Abstract
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porce-
lain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed.
§ Unasuperestructura de implante que permite la reparación fácil y rápida
crown.
The aim of this report was to describe the clinical application of a newly developed
Correspondence implant-supported FDP fabrication system, which uses PAZ, and to evaluate the out-

cuando se producen este tipo de complicaciones, con nuestro sistema, lo que

Masayuki Takaba, Showa University,
Prosthodontics, 2-1-1 Kitasenzoku Ohta-ku,
come after a maximum application period of 36 months. Implants were placed in three
patients with edentulous areas in either the maxilla or mandible. After the implant

permite un fácil re-fabricación del CAD / CAM de porcelana

Tokyo 145-8515, Japan. E-mail: fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom
mtakaba@dent.showa-u.ac.jp abutments were first fabricated. Zirconia framework wax-up was performed on the
custom abutments, and the CAD/CAM zirconia framework was prepared using the
The authors deny any conflict of interest.
CAD/CAM system. Next, wax-up was performed on working models for porcelain
§ Porel contrario, el mecanizado de bloques de porcelana utilizando el sistema
Accepted October 20, 2012
crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM
zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive

de CAD / CAM puede crear coronas que mantienen un alto nivel de fuerza sin
doi: 10.1111/jopr.12001
resin cement, and the PAZ was cemented. Cementation of the implant superstructure
improved the esthetics and masticatory efficiency in all patients. No undesirable out-
comes, such as superstructure chipping, stomatognathic dysfunction, or periimplant
defectos internos bone resorption, were observed in any of the patients. PAZ may be a potential solution
for ceramic-related clinical problems such as chipping and fracture and associated
complicated repair procedures in implant-supported FDPs.

§ Por último, este estudio describe la aplicación clínica del sistema PAZ e
informó manejo exitoso de tres pacientes que utilizan este sistema de 2 a 3
Dental implants are now widely recognized as a viable treat-
años. ment option for prosthetic replacement of missing teeth. After
implant fixtures are successfully placed and abutments are con-
nected, implant-supported fixed dental prostheses (FDPs) are
fabricated on the abutments. Porcelain is the material of choice
for most FDPs, and metal ceramic restorations are widely used
for FDPs because of their clinically acceptable biological sta-
bility, esthetics, and mechanical properties. Previous reports
1,2
In recent years, FDPs using a zirconia framework produced
by a new fabrication system combined with computer-assisted
fabrication (CAD/CAM) systems have attracted much attention
and emerged as a popular treatment modality.8,9 While zirco-
nia ceramic FDPs exhibited a survival rate similar to metal
ceramic FDPs after 3 years of function,10 it has been noted
that veneering porcelain on the zirconia framework by the con-
ventional manual laboratory technique resulted in significantly
7,11
 Retrievable Metal Ceramic Implant-Supported Fixed
Prostheses with Milled Titanium Frameworks and All-Ceramic
Crowns: Retrospective Clinical Study with up to 10 Years of
Follow-Up
Paulo Maló, DDS,1 Miguel de Araújo Nobre, RDH,2 João Borges, DDS,3 & Ricardo Almeida, DDS3
1
Department of Oral Surgery, Malo Clinic, Lisbon, Portugal
2
Department of R&D, Malo Clinic, Lisbon, Portugal
3
Department of Prosthodontics, Malo Clinic, Lisbon, Portugal

Keywords
Implant-supported prosthesis; metal
framework; Procera copings; zirconia;
retrievable.
Correspondence
§ Propósito: El propósito de este estudio fue para informar sobre el resultado de
Miguel de Araújo Nobre, Malo Clinic–R&D,
Avenida dos Combatentes, 43, 8 Edificiio
Abstract
Purpose: The purpose of this study was to report on the outcome of metal ceramic
implant-supported fixed prostheses with milled titanium frameworks and all-ceramic
crowns.
Materials and Methods: The clinical study included 108 patients (67 women, 41 men),
mean age of 58.6 years (range: 34–82), followed between 9 months and 10 years (post
occlusal loading). The mean follow-up time for all patients in the study was 5 years.

metales fi prótesis jos sobre implantes de cerámica con estructuras de titanio

Green Park, Lisboa 1600-043, Portugal. A total of 125 prostheses were fabricated. The data were divided into 2 groups. De-
E-mail: mnobre@maloclinics.com velopment group (DG): 52 patients with 66 prostheses (28 maxillary, 38 mandibular)

molido y coronas de cerámica.

Accepted August 13, 2011
doi: 10.1111/j.1532-849X.2011.00824.x
fabricated with individual Procera crowns (Alumina copings, Nobel Biocare AB) and
Allceram ceramics (Ducera Dental GmbH) cemented onto a CAD/CAM fabricated
Ti framework (Nobel Biocare AB) with pink ceramic (Duceram, Ducera Dental
GmbH) that replicated the missing gingival tissues. Routine group (RG): 56 patients
with 59 prostheses (49 maxillary, 10 mandibular) fabricated with individual Procera
crowns (Zirconia copings and Nobel Rondo Zirconia Ceramic; Nobel Biocare AB)
cemented onto a CAD/CAM fabricated Ti framework (Nobel Biocare AB) with pink
acrylic resin (PallaXpress Ultra, Heraeus Kulzer GmbH) that replicated the missing
gingival tissues. Primary outcome measures were prosthetic survival and mechanical
complications. Secondary outcome measures were biological complications testing
the retrievability characteristic of the prosthesis. Survival estimates were calculated
on the patient level with the Kaplan-Meier product limit estimator (95% confidence
intervals [CI]). Data were analyzed with descriptive and inferential analyses.
Results: The cumulative survival rates for the implant-supported fixed prostheses were
92.4% for the DG at 10 years and 100% for the RG at 5 years (overall 96%) (Kaplan-
Meier). Mechanical complications occurred in 44 patients (DG: 29 patients, 36 prosthe-
ses; RG: 15 patients, 16 prostheses); the large majority were crown fractures, occurring
in 48 patients (DG: 33 patients, 36 prostheses; RG: 15 patients, 16 prostheses). In the
DG, univariate analysis of logistic regression disclosed the presence of a metal ceramic
implant-supported fixed prosthesis opposing dentition as a risk factor for crown frac-
 Retrievable Metal Ceramic Implant-Supported Fixed
Prostheses with Milled Titanium Frameworks and All-Ceramic
Crowns: Retrospective Clinical Study with up to 10 Years of
Follow-Up
Paulo Maló, DDS,1 Miguel de Araújo Nobre, RDH,2 João Borges, DDS,3 & Ricardo Almeida, DDS3
1
Department of Oral Surgery, Malo Clinic, Lisbon, Portugal
Mal ' o M :F 2
Department of R&D, Malo Clinic, Lisbon, Portugal Metal recuperable soportadas por implantes de cerámica Prótesis Fija
3
Department of Prosthodontics, Malo Clinic, Lisbon, Portugal

M: F: Población y métodos (grupos de rutina y el desarrollo)

Población y métodos
Número de pacientes
distribución por sexo
edad (intervalo) Media
Número de prótesis (distribución por
Tipo de marco de titanio
Tecnología
Tipo de cofias
Tipo de cerámica utilizado para fabricar las coronas
Tipo de material de la replicación de los tejidos gingivales
haber diferencias en los resultados de supervivencia y de complicaciones de los implant-supported
Keywords
Implant-supported prosthesis; metal
framework; Procera copings; zirconia;
retrievable.
Correspondence
52
Miguel de Araújo Nobre, Malo Clinic–R&D,
Avenida dos Combatentes, 43, 8 Edificiio
23 mujeres, 29
Green Park, Lisboa 1600-043, Portugal.
E-mail: mnobre@maloclinics.com
arco) August 13, 2011
Accepted
doi: 10.1111/j.1532-849X.2011.00824.x
Abstract
Purpose: The purpose of this study was to report on the outcome of metal ceramic
grupo de desarrollo grupo rutina
implant-supported fixed prostheses with milled titanium frameworks and all-ceramic
crowns.
Materials and Methods: The clinical study included 108 patients (67 women, 41 men),
mean age of 58.6 years (range: 5634–82), followed between 9 months and 10 years (post
occlusal loading). The mean follow-up time for all patients in the study was 5 years.
hombresA total of 125 prostheses were 35 mujeres, 21 hombres
fabricated. The data were divided into 2 groups. De-
velopment group (DG): 52 patients with 66 prostheses (28 maxillary, 38 mandibular)
59,5 años (38-81) fabricated with individual Procera 57,6 años (34-82)(Alumina copings, Nobel Biocare AB) and
crowns
Allceram ceramics (Ducera Dental GmbH) cemented onto a CAD/CAM fabricated
66 (28 maxilar, 38 mandibular) 59 (49 maxilar, 10 mandibular)
Ti framework (Nobel Biocare AB) with pink ceramic (Duceram, Ducera Dental
GmbH) that replicated the missing gingival tissues. Routine group (RG): 56 patients
withprocera marco de titanio
59 prostheses (49(Nobel Biocare AB)
maxillary, 10 mandibular) fabricated with individual Procera
crowns (Zirconia copings and Nobel Rondo Zirconia Ceramic; Nobel Biocare AB)
cemented onto a CAD/CAM CAD / CAMfabricated Ti framework (Nobel Biocare AB) with pink
acrylic resin (PallaXpress Ultra, Heraeus Kulzer GmbH) that replicated the missing
cofias de alúmina (Nobel Biocaretissues.
gingival AB) Primary outcome cofias demeasures
óxido de circonio (Nobel prosthetic
were Biocare AB) survival and mechanical
complications. Secondary outcome measures were biological complications testing
Allceram (Ducera Dental)
the retrievability characteristic Nobel
of Rondo cerámica del Zirconia
the prosthesis. Survival(Nobel Biocare AB)were calculated
estimates
on the patient level with the Kaplan-Meier product limit estimator (95% confidence
Duceram (Ducera Dental)
intervals [CI]). Data were analyzed PalaXpress withUltra (Heraeus Kulzer
descriptive andGmbH)
inferential analyses.
Results: The cumulative survival rates for the implant-supported fixed prostheses were
92.4% for the DG at 10 years and 100% for the RG at 5 years (overall 96%) (Kaplan-
Meier). Mechanical complications occurred in 44 patients (DG: 29 patients, 36 prosthe-
ses; RG: 15 patients, 16 prostheses); the large majority were crown fractures, occurring
in 48 patients (DG: 33 patients, 36 prostheses; RG: 15 patients, 16 prostheses). In the
fabricado, con un prosthesis
seguimiento medio dedentition
46 meses as(rango:
DG, univariate analysis of logistic regression disclosed the presence of a metal ceramic
fixed opposing 12 meses
a risk factor a 67 frac-
for crown
 Retrievable Metal Ceramic Implant-Supported Fixed
Prostheses with Milled Titanium Frameworks and All-Ceramic
Crowns: Retrospective Clinical Study with up to 10 Years of
Follow-Up
5D : Producción del marco de titanio. duplicado acrílico preparado para ser escaneada.
Paulo Maló, DDS,1 Miguel de Araújo Nobre, RDH,2 João Borges,5DDDS, 3
& Ricardo
: Las coronas Almeida,
fueron cementadas DDS
con el marco fuera
3
de la boca.

1
Department
Metal recuperable soportadas por implantes de cerámica of
Prótesis Fija Oral Surgery, Malo Clinic, Lisbon, Portugal Mal ' o M :F
2 5D Lisbon,
Department of R&D, Malo Clinic, : ( TitanioPortugal
marco terminado y pulido.
5D : Vista oclusal de la prótesis.
3
Department of Prosthodontics, Malo Clinic, Lisbon, Portugal

Keywords Abstract
Implant-supported prosthesis; metal
framework; Procera copings; zirconia; Purpose: The purpose of this study was to report on the outcome of metal ceramic
retrievable. implant-supported fixed prostheses with milled titanium frameworks and all-ceramic
crowns.
Correspondence Materials and Methods: The clinical study included 108 patients (67 women, 41 men),
Miguel de Araújo Nobre, Malo Clinic–R&D, mean age of 58.6 years (range: 34–82), followed between 9 months and 10 years (post
Avenida dos Combatentes, 43, 8 Edificiio occlusal loading). The mean follow-up time for all patients in the study was 5 years.
Green Park, Lisboa 1600-043, Portugal. A total of 125 prostheses were fabricated. The data were divided into 2 groups. De-
E-mail: mnobre@maloclinics.com velopment group (DG): 52 patients with 66 prostheses (28 maxillary, 38 mandibular)
fabricated with individual Procera crowns (Alumina copings, Nobel Biocare AB) and
5D : Producción del marco de titanio. duplicado acrílico preparado para ser escaneada.
5D : ( Titanio marco terminado y pulido.Allceram ceramics (Ducera Dental
Metal recuperable soportadas por implantes de cerámica Prótesis Fija
Accepted August 13, 2011 D : coronas
5D Procera
: Lasfueron
coronasfabricados
fueron de acuerdo concon
cementadas la prótesis
el marco Malde
provisional
fuera :F5D GmbH)
' yo laM boca. cemented
: Vista oclusal onto a CAD/CAM fabricated
de la prótesis.
Ti
especificaciones de prostodoncista.
framework (Nobel Biocare AB) with pink
5D
ceramic (Duceram, Ducera Dental
: Vista intraoral de la prótesis maxilar en la oclusión.
doi: 10.1111/j.1532-849X.2011.00824.x GmbH) that replicated the missing gingival tissues. Routine group (RG): 56 patients
with 59 prostheses (49 maxillary, 10 mandibular) fabricated with individual Procera
crowns (Zirconia copings and Nobel Rondo Zirconia Ceramic; Nobel Biocare AB)
pilares, Nobel Biocare AB) para lograr una
cemented abertura
onto de acceso del tornillo
a CAD/CAM El laboratorio(Nobel
no visible. Ti framework
fabricated dental utiliza la disposición
Biocare AB) de with
dientespink
en las pró
acrylic resin (PallaXpress Ultra, Heraeus Kulzer implantesGmbH)provisionales that
como replicated
punto de partidatheparamissing
la fabricación
Todas las impresiones gingival
de fi nitiva se tissues.
lograron en dos Primary
pasos. El outcome
primer paso fue measuresdewere fi nitivo.prosthetic
En primer lugar, survival
un patrón and mechanical
atornillada resina acrílica d
complications. Secondary outcome
entablillar juntos cofias de unidades múltiples impresión (Nobel Biocare AB) o cofias
measures were biological complications
prótesis fija implantosoportada se hizo sobre el modelo testing
maestro p
the retrievability characteristic of the prosthesis. Survival estimates were calculated
fi-nivel xture impresión (Nobel Biocare AB) con barras de acero inoxidable y una resina futuro marco Ti. Este patrón de resina acrílica se fabricó con prep
on the patient level with the Kaplan-Meier product limit estimator (95% confidence
acrílica de bajo autopolimerizable contracción (GC Pattern Resin, GC Co, Alsip, coronas individuales (12 a 14) para acomodar las correspondient
intervals [CI]). Data were analyzed with descriptive and inferential analyses.
ILLINOIS). De fi nitivos impresiones se hicieron con la costumbre,
Results: The cumulative survival rates for the bandejas abiertas y cerámica individuales (Nobel Biocare
implant-supported fixed AB; Fig 1). Después
prostheses were de com
92.4% for the DG at 10 years and 100% for the RG at 5 years (overall 96%) (Kaplan- P
reacción de adición de material de impresión de silicona (Cuerpo de Luz y masilla el patrón estaba listo para ser escaneado y leído por el software
blanda, de fraguado rápido; Meier).
Zhermack Mechanical
Co, Rovigo, Italia). complications occurred in 44 patients (DG: 29 patients, 36 prosthe-
Biocare
ses; RG: 15 patients, 16 prostheses); the large majority were crown fractures, occurring
in 48 patients (DG: 33 patients, 36 prostheses; RG: 15 patients, 16 prostheses). In the
5D : Producción del marco de titanio. duplicado acrílico preparado para ser escaneada. DG, univariate analysis of logistic regression disclosed the presence of a metal ceramic
5D : ( Titanio marco terminado y pulido. 5D implant-supported
: Las coronas fueron cementadas con el marco fuera de la fixed
boca. prosthesis opposing dentition as a risk factor for crown frac-
 Retrievable Metal Ceramic Implant-Supported Fixed
Prostheses with Milled Titanium Frameworks and All-Ceramic
Crowns: Retrospective Clinical Study with up to 10 Years of
Follow-Up
Paulo Maló, DDS,1 Miguel de Araújo Nobre, RDH,2 João Borges, DDS,3 & Ricardo Almeida, DDS3
1
Department of Oral Surgery, Malo Clinic, Lisbon, Portugal
2
Department of R&D, Malo Clinic, Lisbon, Portugal
3
Department of Prosthodontics, Malo Clinic, Lisbon, Portugal

Keywords § RESULTADOS
Implant-supported prosthesis; metal
Abstract
framework; Procera copings; zirconia; Purpose: The purpose of this study was to report on the outcome of metal ceramic
§ 11 pacientes desertaron se perdio el rastro
retrievable. implant-supported fixed prostheses with milled titanium frameworks and all-ceramic
crowns.
Correspondence Materials and Methods: The clinical study included 108 patients (67 women, 41 men),
§ fracturas de las
Miguel coronas,
de Ara posterior
újo Nobre, Malo Clinic–R&D,
Avenida dos Combatentes, 43, 8 Edificiio
repacion
mean age ofdel
58.6od. Despues
years (range: 34–82),del provisional
followed between 9 months and 10 years (post
occlusal loading). The mean follow-up time for all patients in the study was 5 years.
Green Park, Lisboa 1600-043, Portugal. A total of 125 prostheses were fabricated. The data were divided into 2 groups. De-
§ Recementacion de las coronas en los velopment
2 grupos
E-mail: mnobre@maloclinics.com group (DG): 52 patients with 66 prostheses (28 maxillary, 38 mandibular)
fabricated with individual Procera crowns (Alumina copings, Nobel Biocare AB) and
Allceram ceramics (Ducera Dental GmbH) cemented onto a CAD/CAM fabricated
§ fractura de la estructura rosada, arreglada con resina rosada
Accepted August 13, 2011
Ti framework (Nobel Biocare AB) with pink ceramic (Duceram, Ducera Dental
doi: 10.1111/j.1532-849X.2011.00824.x GmbH) that replicated the missing gingival tissues. Routine group (RG): 56 patients

§ El grupo rutina rindió una tasa de supervivencia del 100% a los 5 años de
with 59 prostheses (49 maxillary, 10 mandibular) fabricated with individual Procera
crowns (Zirconia copings and Nobel Rondo Zirconia Ceramic; Nobel Biocare AB)
seguimiento cemented onto a CAD/CAM fabricated Ti framework (Nobel Biocare AB) with pink
acrylic resin (PallaXpress Ultra, Heraeus Kulzer GmbH) that replicated the missing
gingival tissues. Primary outcome measures were prosthetic survival and mechanical
§ la incidencia de complicaciones biológicas registradas en el grupo de desarrollo
complications. Secondary outcome measures were biological complications testing
the retrievability characteristic of the prosthesis. Survival estimates were calculated
se produjo en 18 pacientes, incluyendo la patología periimplantaria (nueve
on the patient level with the Kaplan-Meier product limit estimator (95% confidence
intervals [CI]). Data were analyzed with descriptive and inferential analyses.
pacientes), tejidos blandos inflamación (siete pacientes), y la pérdida del implante
Results: The cumulative survival rates for the implant-supported fixed prostheses were
(dos pacientes 92.4% for the DG at 10 years and 100% for the RG at 5 years (overall 96%) (Kaplan-
Meier). Mechanical complications occurred in 44 patients (DG: 29 patients, 36 prosthe-
ses; RG: 15 patients, 16 prostheses); the large majority were crown fractures, occurring
in 48 patients (DG: 33 patients, 36 prostheses; RG: 15 patients, 16 prostheses). In the
DG, univariate analysis of logistic regression disclosed the presence of a metal ceramic
implant-supported fixed prosthesis opposing dentition as a risk factor for crown frac-
 Retrievable Metal Ceramic Implant-Supported Fixed
Prostheses with Milled Titanium Frameworks and All-Ceramic
Crowns: Retrospective Clinical Study with up to 10 Years of
Follow-Up
Paulo Maló, DDS,1 Miguel de Araújo Nobre, RDH,2 João Borges, DDS,3 & Ricardo Almeida, DDS3
1
Department of Oral Surgery, Malo Clinic, Lisbon, Portugal
2
Department of R&D, Malo Clinic, Lisbon, Portugal
3
Department of Prosthodontics, Malo Clinic, Lisbon, Portugal

Keywords
§ DISCUSION
Abstract
Implant-supported prosthesis; metal
§ La tasa de supervivencia más baja alcanzada enThe
Purpose: el grupo
framework; Procera copings; zirconia; purpose ofdethisdesarrollo se relaciona
study was to report on the outcome of metal ceramic

con la incidencia de complicaciones mecá

retrievable.
nicas (la mayoría de ellos fracturas de
implant-supported fixed prostheses with milled titanium frameworks and all-ceramic
crowns.
coronas) Correspondence Materials and Methods: The clinical study included 108 patients (67 women, 41 men),
mean age of 58.6 years (range: 34–82), followed between 9 months and 10 years (post
Miguel de Araújo Nobre, Malo Clinic–R&D,

§ La precisión exacta de estas rehabilitaciones

A totalde Ti.prostheses
estabawere relacionada con
data el marco
divided Ti
occlusal loading). The mean follow-up time for all patients in the study was 5 years.
Avenida dos Combatentes, 43, 8 Edificiio
Green Park, Lisboa 1600-043, Portugal.
of 125 fabricated. The were into 2 groups. De-
soldada utilizado en este concepto, que se
E-mail: mnobre@maloclinics.com
describe
velopment group en la
(DG): 52literatura
patients withcomo el
66 prostheseslogro de
(28 maxillary, 38 mandibular)
resultados superiores en comparación con
Accepted August 13, 2011
los marcos hechos conGmbH)
aleació n deonto a CAD/CAM fabricated
fabricated with individual Procera crowns (Alumina copings, Nobel Biocare AB) and
Allceram ceramics (Ducera Dental cemented
fundición de oro. Ti framework (Nobel Biocare AB) with pink ceramic (Duceram, Ducera Dental
GmbH) that replicated the missing gingival tissues. Routine group (RG): 56 patients
doi: 10.1111/j.1532-849X.2011.00824.x

§ 36 coronas de cerámica sin metal con laminados Procera

alto resultado estético
copingsdieron
and NobelcomoRondo resultado un Nobel Biocare AB)
with 59 prostheses (49 maxillary, 10 mandibular) fabricated with individual Procera
crowns (Zirconia Zirconia Ceramic;
cemented onto a CAD/CAM fabricated Ti framework (Nobel Biocare AB) with pink
acrylic resin (PallaXpress Ultra, Heraeus Kulzer GmbH) that replicated the missing

§ Las razones para las fracturas de la corona (fallos deSecondary

cerámoutcome
ica) pueden
measures estar
gingival tissues. Primary outcome measures were prosthetic survival and mechanical
complications. were biological complications testing
relacionados con un fallo técnico en el proceso de fabricació
the retrievability characteristicnof
, insuficiencia oclusió
the prosthesis. Survival n were calculated
estimates
en el control de la oclusión siguiendo lasintervals
directrices presentadas
[CI]). Data were analyzed withanteriormente, o analyses.
on the patient level with the Kaplan-Meier product limit estimator (95% confidence
descriptive and inferential
parafuncional Results: The cumulative survival rates for the implant-supported fixed prostheses were
92.4% for the DG at 10 years and 100% for the RG at 5 years (overall 96%) (Kaplan-
Meier). Mechanical complications occurred in 44 patients (DG: 29 patients, 36 prosthe-
ses; RG: 15 patients, 16 prostheses); the large majority were crown fractures, occurring
in 48 patients (DG: 33 patients, 36 prostheses; RG: 15 patients, 16 prostheses). In the
DG, univariate analysis of logistic regression disclosed the presence of a metal ceramic
implant-supported fixed prosthesis opposing dentition as a risk factor for crown frac-
 Retrievable Metal Ceramic Implant-Supported Fixed
Prostheses with Milled Titanium Frameworks and All-Ceramic
Crowns: Retrospective Clinical Study with up to 10 Years of
Follow-Up
Paulo Maló, DDS,1 Miguel de Araújo Nobre, RDH,2 João Borges, DDS,3 & Ricardo Almeida, DDS3
1
Department of Oral Surgery, Malo Clinic, Lisbon, Portugal
2
Department of R&D, Malo Clinic, Lisbon, Portugal
3
Department of Prosthodontics, Malo Clinic, Lisbon, Portugal

§ DISCUSION
Keywords Abstract
Implant-supported prosthesis; metal
framework; Procera copings; zirconia; Purpose: The purpose of this study was to report on the outcome of metal ceramic
retrievable. implant-supported fixed prostheses with milled titanium frameworks and all-ceramic
crowns.
§ hubo un aumento de dos veces en la probabilidad de fractura de la corona cuando el
Correspondence Materials and Methods: The clinical study included 108 patients (67 women, 41 men),
dentición antagonista era una FPD de cerámica de metal implantosoportada, una
Miguel de Araújo Nobre, Malo Clinic–R&D,
Avenida dos Combatentes, 43, 8 Edificiio
mean age of 58.6 years (range: 34–82), followed between 9 months and 10 years (post
occlusal loading). The mean follow-up time for all patients in the study was 5 years.
situación que se reconoció en informes anteriores, lo que podría implicar una falta de
Green Park, Lisboa 1600-043, Portugal.
E-mail: mnobre@maloclinics.com
A total of 125 prostheses were fabricated. The data were divided into 2 groups. De-
velopment group (DG): 52 patients with 66 prostheses (28 maxillary, 38 mandibular)
propiocepción por el paciente y / o la falta de capacidad de absorción de choques por
fabricated with individual Procera crowns (Alumina copings, Nobel Biocare AB) and
la prótesis.
Accepted August 13, 2011 Allceram ceramics (Ducera Dental GmbH) cemented onto a CAD/CAM fabricated
Ti framework (Nobel Biocare AB) with pink ceramic (Duceram, Ducera Dental
doi: 10.1111/j.1532-849X.2011.00824.x GmbH) that replicated the missing gingival tissues. Routine group (RG): 56 patients
§ Las complicaciones biológicas registrados en este estudio fueron muy probablemente
with 59 prostheses (49 maxillary, 10 mandibular) fabricated with individual Procera
crowns (Zirconia copings and Nobel Rondo Zirconia Ceramic; Nobel Biocare AB)
relacionados con bajos niveles de higiene oral. Además de los altos niveles necesarios
cemented onto a CAD/CAM fabricated Ti framework (Nobel Biocare AB) with pink
de higiene auto-cuidado bucal del paciente que influyen en el resultado
acrylic resin (PallaXpress Ultra, Heraeus Kulzer GmbH) that replicated the missing
gingival tissues. Primary outcome measures were prosthetic survival and mechanical
complications. Secondary outcome measures were biological complications testing
§ la necesidad de eliminar las prótesis en estas situaciones expresa además la necesidad
the retrievability characteristic of the prosthesis. Survival estimates were calculated
on the patient level with the Kaplan-Meier product limit estimator (95% confidence
de fácil recuperabilidad de estas estructuras, lo que facilita el acceso a los implantes
intervals [CI]). Data were analyzed with descriptive and inferential analyses.
para el diagnóstico exacto o intervenciones terapéuticas. Results: The cumulative survival rates for the implant-supported fixed prostheses were
92.4% for the DG at 10 years and 100% for the RG at 5 years (overall 96%) (Kaplan-
Meier). Mechanical complications occurred in 44 patients (DG: 29 patients, 36 prosthe-
ses; RG: 15 patients, 16 prostheses); the large majority were crown fractures, occurring
in 48 patients (DG: 33 patients, 36 prostheses; RG: 15 patients, 16 prostheses). In the
DG, univariate analysis of logistic regression disclosed the presence of a metal ceramic
implant-supported fixed prosthesis opposing dentition as a risk factor for crown frac-
 Evaluation of Zirconium-Oxide-Based Ceramic Single-Unit
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
CAD/CAM Systems Compared to Porcelain-Fused-to-Metal
Single-Unit Posterior FDPs: A 5-Year Clinical Prospective
Study
Paolo Vigolo, DMD, MScD1 & Sabrina Mutinelli, DMD2
1
Department of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, Padova, Italy
2
Private Practice, Trento, Italy

Keywords Abstract
Metal–ceramic FDPs; zirconia–ceramic FDPs;
success rate. Purpose: The purpose of this prospective clinical study was to determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
Correspondence generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM)
Paolo Vigolo, Via Vecchia Ferriera, 13 Vicenza single-unit posterior FDPs after 5 years of function.

§ Propósito: este estudio clínico prospectivo fue determinar la tasa de éxito de

36100, Italy. E-mail: paolovigolo@virgilio.it Materials and Methods: From 2005 to 2006, 60 patients who needed a single-unit
FDP on a first molar in the mandibular jaw (left or right) in a private office setting were

prótesis fija posterior de una sola unidad (PDF) con cofias de zirconia generados
Accepted August 13, 2011
con dos sistemas CAD / CAM, en comparación con porcelana fundida a metal
doi: 10.1111/j.1532-849X.2011.00825.x
(PFM) y una unidad posterior después de 5 años de función.
included in this study. The 60 first mandibular molars were randomly divided into three
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the
other two groups CAD/CAM technology was used for the fabrication of the zirconium-
oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated
with the Procera system (group P, Nobel Biocare); 20 single-unit posterior FDPs with
zirconia copings were generated with the Lava system (group L, 3M ESPE). For the
ANOVA follow-up data, the clinical life table method was applied. The statistical
analysis was performed using two nonparametric tests, the log-rank test for k-groups
and the Fisher exact test.
Results: No statistically significant difference in the clinical outcome of
zirconia–ceramic FDPs of both groups (P and L) evaluated together and metal–ceramic
posterior single FDPs was found at 5 years of function; however, clinical data showed
that technical problems, such as extended fracture of the veneering ceramic, tended
to occur more frequently in the zirconia–ceramic FDP groups. The difference in the
frequency of failure was statistically significant only in the comparison of groups C
and P.
Conclusions: Even if no statistically significant difference in the clinical out-
come of zirconia–ceramic FDPs of both groups (P and L) considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
ical problems: for this reason all the clinical and technical variables related to the
use of zirconia–ceramic FDPs generated with CAD/CAM systems should be carefully
considered prior to all treatment procedures.

Vigolo y Mutinelli
CDLC criterios USPHS
Hacer frente a la fractura
fractura de chapado
El desgaste oclusal
adaptación marginal de captura sonda Sin
forma anatómica
cerámica Conia generado con el sistema Procera (P) y el sistema de la lava (L)
se toman juntos.
Evaluation of Zirconium-Oxide-Based Ceramic Single-Unit
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
CAD/CAM Systems Compared to Porcelain-Fused-to-Metal
Single-Unit Posterior FDPs: A 5-Year Clinical Prospective
Study
Paolo Vigolo, DMD, MScD1 & Sabrina Mutinelli, DMD2
1 Metal y circonio-óxido
Department of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, individual
Padova, Italy FDPs
2
Private Practice, Trento, Italy
Keywords Abstract
Metal–ceramic FDPs; zirconia–ceramic FDPs;
Alfa (A)
success rate.
Bravo (B) Purpose: The purposeCharlie of this(C)prospective clinical study was Delta to(D)determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
Correspondence generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM)
Sin fractura dePaolo
hacer frente
Vigolo, Via Vecchia Ferriera, 13 Vicenza single-unit posterior FDPs after 5 years of function. Fractura de hacer frente
36100, Italy. E-mail: paolovigolo@virgilio.it Materials and Methods: From 2005 to 2006, 60 patients who needed a single-unit
No se fractura Astillado, pero pulido Chipping hacer frente a la nueva reconstrucción es
FDP on a first molar in the mandibular jaw (left or right) in a private office setting were
Accepted August 13, 2011 posible included in this study. The 60 first mandibular molars were randomly divided into three
necesario
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the
No llevar endoi:oclusal Oclusal desgaste de
10.1111/j.1532-849X.2011.00825.x Oclusal
other two groups desgaste de technology was used
CAD/CAM Nueva reconstrucción
for the fabricationes of the zirconium-
oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated
reconstrucción o en los reconstrucción o en los dientes
with the Procera reconstrucción
system (group o en losP,dientes
Nobel Biocare);necesario
20 single-unit posterior FDPs with
zirconia copings were generated with the Lava system (group L, 3M ESPE). For the
dientes opuestos opuestos <2 mm opuestos> 2 mm
ANOVA follow-up data, the clinical life table method was applied. The statistical
analysis was Gap
captura sonda ligero, pero sin performed
con un pocousing two
de dentina o nonparametricNueva tests, the log-rank
reconstrucción es test for k-groups
and the Fisher exact test.
brecha Results: No exposición
statistically
al cementosignificant difference
necesarioin the clinical outcome of
zirconia–ceramic FDPs of both groups (P and L) evaluated together and metal–ceramic
forma anatómica ideal, Ligeramente sobre o Altamente
posterior single FDPs sobre-o Nueva reconstrucción
was found at 5 years of function; however, es clinical data showed
that technical problems, such as extended fracture of the veneering ceramic, tended
buen contacto proximal bajo-contorneada, el contacto bajo-contorneada,
to occur more frequently in el contacto
the zirconia–ceramic necesario
FDP groups. The difference in the
frequency of failure was statistically significant only in the comparison of groups C
proximal débil and P.
proximal abierto
Conclusions: Even if no statistically significant difference in the clinical out-
come of zirconia–ceramic FDPs of both groups (P and L) considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
ical problems: for this reason all the clinical and technical variables related to the
use of zirconia–ceramic FDPs generated with CAD/CAM systems should be carefully
considered prior to all treatment procedures.
y L y la prueba exacta de Fisher p no revelaron valores significativos durante los intervalos
en todos los grupos.
 Evaluation of Zirconium-Oxide-Based Ceramic Single-Unit
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
CAD/CAM Systems Compared to Porcelain-Fused-to-Metal
Single-Unit Posterior FDPs: A 5-Year Clinical Prospective
Study
Paolo Vigolo, DMD, MScD1 & Sabrina Mutinelli, DMD2

Metal and Zirconium-Oxide Department

Single FDPs Vigolo and Mutinelli
1
of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, Padova, Italy
2
Private Practice, Trento, Italy

Table 2 Life table of the groups of the metal ceramic (C), zirconia ceramic generated with Procera system (P), and zirconia ceramic generated with
Keywords Abstract
the Lava system (L). The failures are the number of crowns needing
Metal–ceramic FDPs; zirconia–ceramic FDPs;
success rate.
replacement (C +purpose
Purpose: The D) of this prospective clinical study was to determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
Correspondence generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM)
Probability
single-unit posterior
Paolo Vigolo, Via Vecchia Ferriera, 13 Vicenza FDPs ofafter
failure during
5 years of function.Cumulative probability of
36100, Italy. E-mail: paolovigolo@virgilio.itMaterials and Methods: From 2005 to 2006, 60 patients who needed a single-unit
Numbers entering interval Failures during interval
FDP on a first molar in the interval failure
mandibular jaw (left or right) in by end ofoffice
a private interval
setting were
Accepted August 13, 2011 included in this study. The 60 first mandibular molars were randomly divided into three
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the
Interval Group C Group P Group L Group C Group P
doi: 10.1111/j.1532-849X.2011.00825.x
Group L groups
other two GroupCAD/CAM
C Grouptechnology
P GroupwasL used
Group C fabrication
for the Group P of the
Group L
zirconium-
oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated
with the Procera system (group P, Nobel Biocare); 20 single-unit posterior FDPs with
6 months 20 20 20 0 0 0
zirconia copings 0 were generated
0 0 Lava system
with the 0 (group L, 0 3M ESPE). 0 For the
ANOVA follow-up data, the clinical life table method was applied. The statistical
1 year 19 19 20 0 0 0
analysis 0
was performed 0 two nonparametric
using 0 0
tests, 0
the log-rank test for0 k-groups
and the Fisher exact test.
2 years 19 19 20 0 2 1
Results: No 0statistically 0.11significant
0.05difference
0.00in the 0.11 0.05
clinical outcome of
zirconia–ceramic FDPs of both groups (P and L) evaluated together and metal–ceramic
3 years 19 17 19 0 1 1
posterior single0FDPs was0.06 0.05 of function;
found at 5 years 0.00 however, 0.16clinical data
0.10showed
4 years 19 16 18 1 1 1 0.05 0.06 0.06 0.05 0.21
that technical problems, such as extended fracture of the veneering ceramic, tended
to occur more frequently in the zirconia–ceramic FDP groups. The difference in the
0.15
5 years 18 15 17 0 0 0
frequency
and P.
0
of failure 0
was statistically 0
significant 0.05 in the comparison
only 0.21 0.15
of groups C

Conclusions: Even if no statistically significant difference in the clinical out-

come of zirconia–ceramic FDPs of both groups (P and L) considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
La tabla de vida (Tabla 2) muestra que la probabilidad acumulativa de supervivencia para el final del intervalo de 5 años fue del 95%
Table 3 Life table of groups of the metal ceramic (C), zirconia ceramic ical generated withfor
problems: thethis
Procera
reason system
all the (P), and zirconia
clinical ceramic
and technical generated
variables withto the
related
en el grupo C, 79% en el grupo P, y 85% en el grupo L. 21,24 - 30 Otro
the Lava system (L). The failures are the addition of the number of crowns
use of zirconia–ceramic FDPs generated with CAD/CAM systems should be carefully
needing replacement,
considered together
prior to all treatment with crowns damaged by small but clinically
procedures.

acceptable defect (B + C + D)
 Probability of failure during Cumulative probability of
Numbers entering interval Failures during interval interval failure by end of interval

Interval Group C Group PEvaluation

Group L of Group
Group C Zirconium-Oxide-Based
P Group L Group C Group P Ceramic
Group L Group Single-Unit
C Group P Group L
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
6 months 20 20 20 0 0 0 0 0 0 0 0 0
1 year 19 19
CAD/CAM
20 0
Systems
0
Compared
0 0
to 0Porcelain-Fused-to-Metal
0 0 0 0
2 years 19 19
Single-Unit
20 0
Posterior
2
FDPs:0 A 5-Y
1
ear Clinical
0.11 0.05
Prospective
0.00 0.11 0.05
3 years 19 17 Study
19 0 1 1 0 0.06 0.05 0.00 0.16 0.10
4 years 19 16 Paolo18
Vigolo, DMD,
1 MScD1
1 & Sabrina
1 Mutinelli,
0.05DMD
2
0.06 0.06 0.05 0.21 0.15
5 years 18 15 1
2
17 0 0 0 0 0 0 0.05
Department of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, Padova, Italy 0.21 0.15
Private Practice, Trento, Italy

Table 3 Life table of groups of the metal ceramic (C), zirconia ceramic generated with the Procera system (P), and zirconia ceramic generated with
the Lava system (L). The failures are the addition of the number of crowns needing
Keywords replacement, together with crowns damaged by small but clinically
Abstract
Metal–ceramic FDPs; zirconia–ceramic FDPs;
acceptable defect (B + C + D) success rate. Purpose: The purpose of this prospective clinical study was to determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
Correspondence generated with two CAD/CAM
Probability of failuresystems,
during comparedCumulative
to porcelain-fused-to-metal
probability of (PFM)
single-unit posterior FDPs after 5 years of function.
Paolo Vigolo, Via Vecchia Ferriera, 13 Vicenza
Numbers entering interval Failures during intervalMaterials and Methods:
36100, Italy. E-mail: paolovigolo@virgilio.it interval
From 2005 to 2006, 60failure bywho
patients end needed
of interval
a single-unit
FDP on a first molar in the mandibular jaw (left or right) in a private office setting were
included in this study. The 60 first mandibular molars were randomly divided into three
Interval Group C Group PAccepted
Group L
August Group
13, 2011C Group P Group L Group C Group P Group L Group C Group P Group L
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the
doi: 10.1111/j.1532-849X.2011.00825.x other two groups CAD/CAM technology was used for the fabrication of the zirconium-
6 months 20 20 20 0 0 1
oxide copings:0 20 single-unit
0 0.05FDPs with
posterior 0 zirconia copings
0 were0.05
generated
with the Procera system (group P, Nobel Biocare); 20 single-unit posterior FDPs with
1 year 19 19 19 1 1 0
zirconia 0.05 were generated
copings 0.05 0.00
with 0.05 (group
the Lava system 0.05
L, 3M ESPE).0.05 For the
2 years 18 18 19 0 3 3
ANOV A 0
follow-up 0.17
data, the 0.16
clinical life table 0.05
method was 0.21
applied. The0.20
statistical
analysis was performed using two nonparametric tests, the log-rank test for k-groups
3 years 18 15 16 0 1 1 the Fisher
and 0 exact test.
0.07 0.06 0.05 0.26 0.25
4 years 18 14 15 2 3 1
Results: 0.11statistically
No 0.21 significant
0.07 difference
0.16 in the0.42 0.30
clinical outcome of
zirconia–ceramic FDPs of both groups (P and L) evaluated together and metal–ceramic
5 years 16 11 14 0 0 0
posterior 0 FDPs was
single 0.00 0.00
found at 5 0.16 however,
years of function; 0.42clinical data
0.30showed
that technical problems, such as extended fracture of the veneering ceramic, tended
to occur more frequently in the zirconia–ceramic FDP groups. The difference in the
frequency of failure was statistically significant only in the comparison of groups C
Table 4 Life table of the metal ceramic (C) group and the groups of the zirconiaand P.ceramic generated with Procera system (P) and with the Lava system
Conclusions: Even if no statistically significant difference in the clinical out-
(L) together. The failures are the addition of the number of crowns needing come replacement, together
of zirconia–ceramic with
FDPs of crowns damaged
both groups (P andbyL)small but clinically
considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
acceptable defects (B + C + D)
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
ical problems: for this reason all the clinical and technical variables related to the
Probability FDPs
use of zirconia–ceramic of failure duringwith CAD/CAM
generated Cumulative probability
systems should beofcarefully
considered prior to all treatment procedures.
Numbers entering interval Failures during interval interval failure by end of interval

Interval Group C Groups P and L Group C Groups P and L Group C Groups P and L Group C Groups P and L
 Numbers entering interval Failures during interval interval failure by end of interval

Interval Group C Group P Group L Group C Group P Group L Group C Group P Group L Group C Group P Group L
Evaluation of Zirconium-Oxide-Based Ceramic Single-Unit
6 months 20 20 20 0 0 1 0 0 0.05 0 0 0.05
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
1 year 19 19 19 1 1 0 0.05 0.05 0.00 0.05 0.05 0.05
CAD/CAM Systems Compared to Porcelain-Fused-to-Metal
2 years 18 18 19 0 3 3 0 0.17 0.16 0.05 0.21 0.20
Single-Unit Posterior FDPs: A 5-Year Clinical Prospective
3 years 18 15 16 0 1 1 0 0.07 0.06 0.05 0.26 0.25
Study
4 years 18 14 15 2 3
Paolo Vigolo, DMD, MScD1 & Sabrina Mutinelli, DMD2
1 0.11 0.21 0.07 0.16 0.42 0.30
5 years 16 11 1
14 0 0 0 0 0.00 0.00 0.16
Department of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, Padova, Italy
0.42 0.30
2
Private Practice, Trento, Italy

Table 4 Life table of the metal ceramic (C) group and the groups of the zirconia ceramic generated with Procera system (P) and with the Lava system
(L) together. The failures are theKeywords
addition of the number of crowns needing replacement, together with crowns damaged by small but clinically
Abstract
Metal–ceramic FDPs; zirconia–ceramic FDPs;
acceptable defects (B + C + D) success rate. Purpose: The purpose of this prospective clinical study was to determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
Correspondence generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM)
Probability
single-unit posterior
Paolo Vigolo, Via Vecchia Ferriera, 13 Vicenza FDPs of after
failure during
5 years of function.Cumulative probability of
36100, Italy. E-mail: paolovigolo@virgilio.itMaterials and Methods: From 2005 to 2006, 60 patients who needed a single-unit
Numbers entering interval Failures during interval interval
FDP on a first molar in the failure
mandibular jaw (left or right) in aby end of
private interval
office setting were
Accepted August 13, 2011 included in this study. The 60 first mandibular molars were randomly divided into three
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the
Interval Group C Groups P and L Group C Groups P and L Group C Groups P and L Group C Groups P and L
other two groups CAD/CAM technology was used for the fabrication of the zirconium-
doi: 10.1111/j.1532-849X.2011.00825.x
oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated
6 months 20 40 0 1 with the Procera 0 system (group P, 0.03
Nobel Biocare); 20 0 single-unit posterior
0.03 FDPs with
zirconia copings were generated with the Lava system (group L, 3M ESPE). For the
1 year 19 38 1 1 ANOVA follow-up 0.05 data, the clinical
0.03 life table method
0.05 was applied.0.05 The statistical
analysis was performed using two nonparametric tests, the log-rank test for k-groups
2 years 18 37 0 6 and the Fisher exact
0 test. 0.16 0.05 0.20
Results: No statistically significant difference in the clinical outcome of
3 years 18 31 0 2 zirconia–ceramic 0 FDPs of both groups
0.06 (P and L) evaluated
0.05 together and0.26 metal–ceramic
4 years 18 29 2 4 posterior single0.11
FDPs was found0.14 0.16 however, clinical
at 5 years of function; 0.36 data showed
that technical problems, such as extended fracture of the veneering ceramic, tended
5 years 16 25 0 0 to occur more 0 0
frequently in the zirconia–ceramic 0.16 groups. The difference
FDP 0.36 in the
frequency of failure was statistically significant only in the comparison of groups C
and P.
Conclusions: Even if no statistically significant difference in the clinical out-
come of zirconia–ceramic FDPs of both groups (P and L) considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
ical problems: for this reason all the clinical and technical variables related to the
clinical factor to consider with regard to risk of chipping of the tation were observed in the present study; however, further clin-
use of zirconia–ceramic FDPs generated with CAD/CAM systems should be carefully
considered prior to all treatment procedures.
veneering ceramic is the design of the framework, which ideally ical research should be conducted on the effect of cementation
provides space for an even thickness of the veneering ceramic. on zirconia FDPs.
 Evaluation of Zirconium-Oxide-Based Ceramic Single-Unit
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
CAD/CAM Systems Compared to Porcelain-Fused-to-Metal
Single-Unit Posterior FDPs: A 5-Year Clinical Prospective
Study
Paolo Vigolo, DMD, MScD1 & Sabrina Mutinelli, DMD2
1
Department of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, Padova, Italy
2
Private Practice, Trento, Italy

Keywords
§ DISCUSIÓ
Metal–ceramic FDPs; zirconia–ceramic FDPs;
success rate.
Correspondence
Paolo Vigolo, Via Vecchia Ferriera, 13 Vicenza
36100, Italy. E-mail: paolovigolo@virgilio.it
Abstract
Purpose:N
The purpose of this prospective clinical study was to determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM)
single-unit posterior FDPs after 5 years of function.
Materials and Methods: From 2005 to 2006, 60 patients who needed a single-unit
FDP on a first molar in the mandibular jaw (left or right) in a private office setting were

§ Dentro de las limitaciones de este estudio in vivo, debido al pequeño número de

Accepted August 13, 2011 included in this study. The 60 first mandibular molars were randomly divided into three
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the

muestras analizadas, se concluyó que los tres sistemas demostraron un

doi: 10.1111/j.1532-849X.2011.00825.x other two groups CAD/CAM technology was used for the fabrication of the zirconium-
oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated
with the Procera system (group P, Nobel Biocare); 20 single-unit posterior FDPs with
zirconia copings were generated with the Lava system (group L, 3M ESPE). For the
§ Sólo cuando la comparación de la frecuencia de fallos clasificados como B + C + se
ANOVA follow-up data, the clinical life table method was applied. The statistical
analysis was performed using two nonparametric tests, the log-rank test for k-groups
llevó a cabo D entre los tres grupos, se percibió que el riesgo de fracaso fue
and the Fisher exact test.
Results: No statistically significant difference in the clinical outcome of

significativamente mayor, en astillados fractruras ceramica de recubrimiento

zirconia–ceramic FDPs of both groups (P and L) evaluated together and metal–ceramic
posterior single FDPs was found at 5 years of function; however, clinical data showed
that technical problems, such as extended fracture of the veneering ceramic, tended
to occur more frequently in the zirconia–ceramic FDP groups. The difference in the
frequency of failure was statistically significant only in the comparison of groups C
and P.
Conclusions: Even if no statistically significant difference in the clinical out-
come of zirconia–ceramic FDPs of both groups (P and L) considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
ical problems: for this reason all the clinical and technical variables related to the
use of zirconia–ceramic FDPs generated with CAD/CAM systems should be carefully
considered prior to all treatment procedures.
 Evaluation of Zirconium-Oxide-Based Ceramic Single-Unit
Posterior Fixed Dental Prostheses (FDPs) Generated with Two
CAD/CAM Systems Compared to Porcelain-Fused-to-Metal
Single-Unit Posterior FDPs: A 5-Year Clinical Prospective
Study
Paolo Vigolo, DMD, MScD1 & Sabrina Mutinelli, DMD2
1
Department of Clinical Odontostomatology, University of Padova, Institute of Clinical Dentistry, Padova, Italy
2
Private Practice, Trento, Italy

§ CONCLUSIÓN
Keywords Abstract
Metal–ceramic FDPs; zirconia–ceramic FDPs;
success rate. Purpose: The purpose of this prospective clinical study was to determine the success
rate of single-unit posterior fixed dental prostheses (FDPs) with zirconia copings
generated with two CAD/CAM systems, compared to porcelain-fused-to-metal (PFM)
§ el resultado clínico de la cerámica de circonio y metal posterior de cerámica sola
Correspondence
Paolo Vigolo, Via Vecchia Ferriera, 13 Vicenza single-unit posterior FDPs after 5 years of function.
36100, Italy. E-mail: paolovigolo@virgilio.it Materials and Methods: From 2005 to 2006, 60 patients who needed a single-unit
FDPs se encontró a los 5 años de la función, a partir de los datos clínicos, la
Accepted August 13, 2011
FDP on a first molar in the mandibular jaw (left or right) in a private office setting were
included in this study. The 60 first mandibular molars were randomly divided into three
zirconia grupos FDP cerámica tendían a tener problemas técnicos más frecuentes,
doi: 10.1111/j.1532-849X.2011.00825.x
groups (n = 20): in the control group (group C), 20 PFM FDPs were included. In the
other two groups CAD/CAM technology was used for the fabrication of the zirconium-

tales como fractura extendida de la cerámica de recubrimiento
oxide copings: 20 single-unit posterior FDPs with zirconia copings were generated
with the Procera system (group P, Nobel Biocare); 20 single-unit posterior FDPs with
zirconia copings were generated with the Lava system (group L, 3M ESPE). For the
ANOVA follow-up data, the clinical life table method was applied. The statistical
analysis was performed using two nonparametric tests, the log-rank test for k-groups
and the Fisher exact test.
Results: No statistically significant difference in the clinical outcome of
zirconia–ceramic FDPs of both groups (P and L) evaluated together and metal–ceramic
posterior single FDPs was found at 5 years of function; however, clinical data showed
that technical problems, such as extended fracture of the veneering ceramic, tended
to occur more frequently in the zirconia–ceramic FDP groups. The difference in the
frequency of failure was statistically significant only in the comparison of groups C
and P.
Conclusions: Even if no statistically significant difference in the clinical out-
come of zirconia–ceramic FDPs of both groups (P and L) considered together and
metal–ceramic posterior single FDPs was found at 5 years of function, clinical data
showed that the two zirconia–ceramic FDP groups tended to have more frequent clin-
ical problems: for this reason all the clinical and technical variables related to the
use of zirconia–ceramic FDPs generated with CAD/CAM systems should be carefully
considered prior to all treatment procedures.
 The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
Ariel J. Raigrodski, DMD, MSb
School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce the likelihood of
porcelain chipping. (J Prosthet Dent 2014;-:---)
§ CONCLUSION
Dental implants are considered to prostheses (FDP). Suggested causes abutment screw access that are bonded
be a predictable treatment for restor- include a lack of compatibility in terms onto a zirconia framework to restore
ing edentulous mandibular arches.1-3 of the coefficient of thermal expansion the edentulous mandible while de-
Computer-aided design/computer-aided between the zirconia core and the creasing the risk of veneering porcelain
§ Esta técnica combina la fabricación CAD / CAM de un marco zirconia para la
manufacturing (CAD/CAM) systems veneering porcelain,18-21 a framework fracture and facilitating retrievability.
have been used for restoring edentulous design that does not provide proper
precisión con coronas de disilicato de litio monolíticos presionado-calor
arches with implant-supported fixed para la
support for the veneering porcelain,22
CLINICAL REPORT
estética y la función. Este tipo de prótesis puede reducir la probabilidad
restorations4,5 because they facilitate
the fit between implants and super-
de Las
rapid cooling rates, and relatively low
A 49-year-old man presented to
fracture toughness and low flexural
fracturas de porcelana y permitir la facilidad de recuperabilidad.
structures better than conventional
metal alloy castings.6,7 Various meth-
strength of the veneering porcelain.23-25
the prosthodontic clinic of Gowoon
Guide Dental Hospital with generalized
To address these concerns, new layering
ods for fabricating these types of res- porcelains with an adequate coefficient advanced chronic periodontitis and
torations have been reported. Some of thermal expansion and adequate missing teeth in the right posterior
suggest acrylic resin and denture teeth mechanical properties have been de- mandible and multiple teeth missing in
processed onto a CAD/CAM milled veloped.26,27 However, the veneering the maxilla (Fig. 1). His chief complaint
titanium framework,8 and others re- porcelain may still chip, and the repair was difficulty in masticating. His med-
commend the use of a screw or cement- process may become complicated ical history was noncontributory, with
retained 1-piece zirconia framework and time consuming. In addition, por- the exception of controlled hyperten-
with veneering porcelain.9,10 celain chipping is the most frequently sion. A clinical evaluation revealed class
A zirconia framework is superior reported prosthesis-related technical II to class III mobility (according to
to a metal alloy or titanium framework complication of implant-supported the Miller classification) of the man-
in terms of esthetics and biocom- ceramic FDPs.28-30 To reduce the like- dibular teeth and gingival swelling with
11-14

1 fotografías preoperatorias: vista frontal.
The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
Ariel J. Raigrodski, DMD, MSb
School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;
Cuestión de volumen -
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce the likelihood of
porcelain chipping. (J Prosthet Dent 2014;-:---)
Dental implants are considered to prostheses (FDP). Suggested causes abutment screw access that are bonded
be a predictable treatment for restor- include a lack of compatibility in terms onto a zirconia framework to restore
ing edentulous mandibular arches.1-3 of the coefficient of thermal expansion the edentulous mandible while de-
Computer-aided design/computer-aided between the zirconia core and the creasing the risk of veneering porcelain
manufacturing (CAD/CAM) systems veneering porcelain,18-21 a framework fracture and facilitating retrievability.
have been used for restoring edentulous design that does not provide proper
arches with implant-supported fixed support for the veneering porcelain,22 CLINICAL REPORT
4,5
restorations because they facilitate rapid cooling rates, and relatively low
the fit between implants and super- fracture toughness and low flexural A 49-year-old man presented to
structures better than conventional strength of the veneering porcelain.23-25 the prosthodontic clinic of Gowoon
metal alloy castings.6,7 Various meth- To address these concerns, new layering Guide Dental Hospital with generalized
ods for fabricating these types of res- porcelains with an adequate coefficient advanced chronic periodontitis and
torations have been reported. Some of thermal expansion and adequate missing teeth in the right posterior
suggest acrylic resin and denture teeth mechanical properties have been de- mandible and multiple teeth missing in
processed onto a CAD/CAM milled veloped.26,27 However, the veneering the maxilla (Fig. 1). His chief complaint
titanium framework,8 and others re- porcelain may still chip, and the repair was difficulty in masticating. His med-
commend the use of a screw or cement- process may become complicated ical history was noncontributory, with
retained 1-piece zirconia framework and time consuming. In addition, por- the exception of controlled hyperten-
with veneering porcelain.9,10 2 radiografía panorámica
celain chipping is the preoperatoria.
most frequently sion. A clinical evaluation revealed class
A zirconia framework is superior reported prosthesis-related technical II to class III mobility (according to
to a metal alloy or titanium framework complication of implant-supported the Miller classification) of the man-
in terms of esthetics and biocom- ceramic FDPs.28-30 To reduce the like- dibular teeth and gingival swelling with
11-14
 The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
1 fotografías preoperatorias: vista frontal.
Ariel J. Raigrodski, DMD, MSb 2 radiografía panorámica preoperatoria.
School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework(Vertex lámpara de p
and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
Dental)
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce y cofias de
the likelihood of im
porcelain chipping. (J Prosthet Dent 2014;-:---)
(cofia de impresión de
Dental implants are considered to prostheses (FDP). Suggested causes abutment screw access that are bonded
be a predictable treatment for restor- include a lack of compatibility in terms
impresión se vertió co
onto a zirconia framework to restore
ing edentulous mandibular arches.1-3 of the coefficient of thermal expansion the edentulous mandible while de-
Computer-aided design/computer-aided between the zirconia core and the
(Fujirock EP; GC Ame
creasing the risk of veneering porcelain
manufacturing (CAD/CAM) systems veneering porcelain,18-21 a framework fracture and facilitating retrievability.
definitivo. Seis pilares
have been used for restoring edentulous design that does not provide proper
arches with implant-supported fixed support for the veneering porcelain,22 CLINICAL REPORT
directo (Dual tope de
restorations4,5 because they facilitate rapid cooling rates, and relatively low
the fit between implants and super- fracture toughness and low flexural A 49-year-old recubrimiento
man presenteddetonitru
structures better than conventional strength of the veneering porcelain.23-25 the prosthodontic clinic of Gowoon
metal alloy castings.6,7 Various meth- To address these concerns, new layering Guide Dental Hospitala laswith
réplicas de los im
generalized
ods for fabricating these types of res- porcelains with an adequate coefficient advanced chronic periodontitis and
torations have been reported. Some of thermal expansion and adequate missing teeth in definitivo.
the right Estos se m
posterior
suggest acrylic resin and denture teeth mechanical properties have been de- mandible and multiple teeth missing in
processed onto a CAD/CAM milled veloped.26,27 However, the veneering the maxilla (Fig. 1).2His
grados para la fabri
chief complaint
titanium framework,8 and others re- porcelain may still chip, and the repair was difficulty in masticating. His med-
commend the use of a screw or cement- process may become complicated zirconia de tipowith
ical history was noncontributory, ceme
retained 1-piece zirconia framework and time consuming. In addition, por- the exception of controlled hyperten-
with veneering porcelain.9,10 celain chipping is the most frequently pilaresrevealed
sion. A clinical evaluation se transfirieron
class
A zirconia framework is superior reported prosthesis-related technical II to class III mobility (according to
to a metal alloy or titanium framework complication of implant-supported posiciones
the Miller classification) of theeran
man-con-
3 Radiografía panorámica
in terms después
of esthetics anddebiocom-
conectar pilares intermedios
ceramic a los
FDPs.28-30 To reduce the like- dibular teeth and gingival swelling with
11-14
 The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
Ariel J. Raigrodski, DMD, MSb
- 2014
School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce the likelihood of
porcelain chipping. (J Prosthet Dent 2014;-:---)

Dental implants are considered to prostheses (FDP). Suggested causes abutment screw access that are bonded
be a predictable treatment for restor- include a lack of compatibility in terms onto a zirconia framework to restore
ing edentulous mandibular arches.1-3 of the coefficient of thermal expansion the edentulous mandible while de-
Computer-aided design/computer-aided between the zirconia core and the creasing the risk of veneering porcelain
manufacturing (CAD/CAM) systems veneering porcelain,18-21 a framework fracture and facilitating retrievability.
have been used for restoring edentulous design that does not provide proper
arches with implant-supported fixed support for the veneering porcelain,22 CLINICAL REPORT
4,5
restorations because they facilitate rapid cooling rates, and relatively low
the fit between implants and super- fracture toughness and low flexural A 49-year-old man presented to
structures better than conventional strength of the veneering porcelain.23-25 the prosthodontic clinic of Gowoon
metal alloy castings.6,7 Various meth- To address these concerns, new layering Guide Dental Hospital with generalized
ods for fabricating these types of res- porcelains with an adequate coefficient advanced chronic periodontitis and
torations have been reported. Some of thermal expansion and adequate missing teeth in the right posterior
suggest acrylic resin and denture teeth mechanical properties have been de- mandible and multiple teeth missing in
processed onto a CAD/CAM milled veloped.26,27 However, the veneering the maxilla (Fig. 1). His chief complaint
titanium framework,8 and others re- porcelain may still chip, and the repair was difficulty in masticating. His med-
commend the use of a screw or cement- process may become complicated ical history was noncontributory, with
retained 1-piece zirconia framework and time consuming. In addition, por- the exception of controlled hyperten-
with veneering porcelain.9,10 celain chipping is the most frequently sion. A clinical evaluation revealed class
A zirconia framework is superior reported prosthesis-related technical II to class III mobility (according to
4 dimensión vertical y la evaluación de soporte de los tejidos blandos. 5 Escaneado
to a metal alloy or titanium framework de armazón
complication of de resina acrílica.
implant-supported the Miller classification) of the man-
in terms of esthetics and biocom- ceramic FDPs.28-30 To reduce the like- dibular teeth and gingival swelling with
11-14

4 dimensión vertical y la evaluación de soporte de los tejidos blandos.
6 marco de óxido de circonio antes fi sinterización final.
The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
Ariel J. Raigrodski, DMD, MSb
5 Escaneado
School of Dentistry, de armazón
Kyung HeedeUniversity,
resina acrílica. Seoul, Republic of Korea;
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce the likelihood of
porcelain chipping. (J Prosthet Dent 2014;-:---)
Dental implants are considered to prostheses (FDP). Suggested causes abutment screw access that are bonded
be a predictable treatment for restor- include a lack of compatibility in terms onto a zirconia framework to restore
ing edentulous mandibular arches.1-3 of the coefficient of thermal expansion the edentulous mandible while de-
Computer-aided design/computer-aided between the zirconia core and the creasing the risk of veneering porcelain
manufacturing (CAD/CAM) systems veneering porcelain,18-21 a framework fracture and facilitating retrievability.
have been used for restoring edentulous design that does not provide proper
arches with implant-supported fixed support for the veneering porcelain,22 CLINICAL REPORT
4,5
restorations because they facilitate rapid cooling rates, and relatively low
the fit between implants and super- fracture toughness and low flexural A 49-year-old man presented to
structures better than conventional strength of the veneering porcelain.23-25 the prosthodontic clinic of Gowoon
metal alloy castings.6,7 Various meth- To address these concerns, new layering Guide Dental Hospital with generalized
ods for fabricating these types of res- porcelains with an adequate coefficient advanced chronic periodontitis and
torations have been reported. Some of thermal expansion and adequate missing teeth in the right posterior
suggest acrylic resin and denture teeth mechanical properties have been de- mandible and multiple teeth missing in
processed onto a CAD/CAM milled veloped.26,27 However, the veneering the maxilla (Fig. 1). His chief complaint
titanium framework,8 and others re- porcelain may still chip, and the repair was difficulty in masticating. His med-
commend the use of a screw or cement- process may become complicated ical history was noncontributory, with
retained 1-piece zirconia framework and time consuming. In addition, por- the exception of controlled hyperten-
with veneering porcelain.9,10 celain chipping is the most frequently sion. A clinical evaluation revealed class
A zirconia framework is superior reported prosthesis-related technical II to class III mobility (according to
to a metal alloy or titanium framework7 Nuevo registro de relación
complication céntrica.
of implant-supported the Miller classification) of the man-
in terms of esthetics and biocom- ceramic FDPs.28-30 To reduce the like- dibular teeth and gingival swelling with
11-14
 The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
Ariel J. Raigrodski, DMD, MSb
School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;
Cuestión de volumen -
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce the likelihood of
porcelain chipping. (J Prosthet Dent 2014;-:---)

Dental implants are considered to
be a predictable treatment for restor-
ing edentulous mandibular arches.1-3
Computer-aided design/computer-aided
manufacturing (CAD/CAM) systems
have been used for restoring edentulous
arches with implant-supported fixed
restorations4,5 because they facilitate
the fit between implants and super-
structures better than conventional
metal alloy castings.6,7 Various meth-
ods for fabricating these types of res-
torations have been reported. Some
suggest acrylic resin and denture teeth
processed onto a CAD/CAM milled
titanium framework,8 and others re-
commend the use of a screw or cement-
retained 1-piece zirconia framework
with veneering porcelain.9,10
A zirconia framework is superior
to a metal alloy or titanium framework
in terms
8 Completa depilación contorno y coronas of esthetics
de disilicato and
de litio biocom-
monolíticos.
11-14
prostheses (FDP). Suggested causes
include a lack of compatibility in terms
of the coefficient of thermal expansion
between the zirconia core and the
veneering porcelain,18-21 a framework
design that does not provide proper
support for the veneering porcelain,22
rapid cooling rates, and relatively low
fracture toughness and low flexural
strength of the veneering porcelain.23-25
To address these concerns, new layering
porcelains with an adequate coefficient
of thermal expansion and adequate
mechanical properties have been de-
veloped.26,27 However, the veneering
porcelain may still chip, and the repair
process may become complicated
and time consuming. In addition, por-
celain chipping is the most frequently
reported prosthesis-related technical
complication of implant-supported
ceramic FDPs.28-30 To reduce the like-
abutment screw access that are bonded
onto a zirconia framework to restore
the edentulous mandible while de-
creasing the risk of veneering porcelain
fracture and facilitating retrievability.
CLINICAL REPORT
A 49-year-old man presented to
the prosthodontic clinic of Gowoon
Guide Dental Hospital with generalized
advanced chronic periodontitis and
missing teeth in the right posterior
mandible and multiple teeth missing in
the maxilla (Fig. 1). His chief complaint
was difficulty in masticating. His med-
ical history was noncontributory, with
the exception of controlled hyperten-
sion. A clinical evaluation revealed class
II to class III mobility (according to
the Miller classification) of the man-
dibular teeth and gingival swelling with

8 Completa depilación contorno y coronas de disilicato
9 prótesis mandibular completa en proceso de unión de las coronas de
disilicato de litio individual.
The rehabilitation of an edentulous
mandible with a CAD/CAM zirconia
framework and heat-pressed lithium
disilicate ceramic crowns: A clinical
report
Youngwook Cho, DMD, MSD, PhDa and
ArieldeJ.litioRaigrodski,
monolíticos. DMD, MSb
School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;
School of Dentistry, University of Washington, Seattle, Wash
This clinical report describes a complete arch, implant-supported prosthesis with a zirconia framework and monolithic
lithium disilicate crowns. The design of the computer-aided design/computer-aided manufacturing zirconia framework with
cemented crowns with screw access is useful in facilitating retrievability and adequate fit, and may reduce the likelihood of
porcelain chipping. (J Prosthet Dent 2014;-:---)
Dental implants are considered to prostheses (FDP). Suggested causes abutment screw access that are bonded
be a predictable treatment for restor- include a lack of compatibility in terms onto a zirconia framework to restore
ing edentulous mandibular arches.1-3 of the coefficient of thermal expansion the edentulous mandible while de-
Computer-aided design/computer-aided between the zirconia core and the creasing the risk of veneering porcelain
manufacturing (CAD/CAM) systems veneering porcelain,18-21 a framework fracture and facilitating retrievability.
have been used for restoring edentulous design that does not provide proper
arches with implant-supported fixed support for the veneering porcelain,22 CLINICAL REPORT
4,5
restorations because they facilitate rapid cooling rates, and relatively low
the fit between implants and super- fracture toughness and low flexural A 49-year-old man presented to
structures better than conventional strength of the veneering porcelain.23-25 the prosthodontic clinic of Gowoon
metal alloy castings.6,7 Various meth- To address these concerns, new layering Guide Dental Hospital with generalized
ods for fabricating these types of res- porcelains with an adequate coefficient advanced chronic periodontitis and
torations have been reported. Some of thermal expansion and adequate missing teeth in the right posterior
suggest acrylic resin and denture teeth mechanical properties have been de- mandible and multiple teeth missing in
26,27
processed onto a CAD/CAM milled veloped. However, the veneering the maxilla (Fig. 1). His chief complaint
titanium framework,8 and others re- porcelain may still chip, and the repair was difficulty in masticating. His med-
commend the use of a screw or cement- process may become complicated ical history was noncontributory, with
10 intraoral vista oclusal de la prótesis completa.
retained 1-piece zirconia framework and time consuming. In addition, por- the exception of controlled hyperten-
with veneering porcelain.9,10 celain chipping is the most frequently sion. A clinical evaluation revealed class
A zirconia framework is superior reported prosthesis-related technical II to class III mobility (according to
to a metal alloy or titanium framework complication of implant-supported the Miller classification) of the man-
in terms of esthetics and biocom- ceramic FDPs.28-30 To reduce the like- dibular teeth and gingival swelling with
11-14