
Zirconia Permanent Dentures Pitfalls
Zirconia has been utilized in clinical dentistry for roughly a decade, and numerous reports have documented the impressive clinical performance and survival rates of zirconia-based restorations.
Below, we’ll review the literature published between 2000 and 2010 concerning the clinical performance and failure causes of zirconia fixed partial dentures (FPDs). We’ll also discuss the process of replacing natural teeth with immediate Zirconia dentures.
Benefits of Zirconia Dental Implants
Since the 1960s, titanium implants have been the gold standard in implant dentistry, boasting a long-term success rate of around 95%. However, zirconia implants are gaining popularity as a viable alternative due to their excellent biocompatibility, favorable soft-tissue response, and superior aesthetics.
Zirconia implants are tooth-colored, preventing any dark discoloration from showing through the gums—a notable benefit for replacing front missing teeth. Despite their advantages, zirconia implants are less commonly placed, resulting in a niche market and significantly higher costs compared to traditional titanium implants.
Clinical Performance of Zirconia Fixed Partial Dentures
We are reporting on fourteen studies reviewing zirconia FPDs. Survival rates for anterior and posterior FPDs ranged from 73.9% to 100% after 2 to 5 years. Common failure causes included veneer fractures, ceramic core fractures, abutment tooth fractures, secondary caries, and dislodgement. Core fractures were reported in four studies, while veneer fractures, either minor or major, occurred in 11 studies with rates up to 25%.
High secondary caries rates were noted in studies using CAM-fabricated zirconia. Abutment fractures and endodontic problems were also observed. Overall, zirconia FPDs performed satisfactorily according to USPHS and CDA evaluations.
Core Fracture
Zirconia’s high fracture toughness (5.5 to 7.4 MPa·m1/2) makes core fractures infrequent. Fractures often result from trauma or parafunctional habits rather than material failure. Coping thickness and connector size (minimum 9 mm²) are crucial for success.
Long-term stress can lead to subcritical crack growth, increasing fracture risk.
Veneer Fracture
Veneer fractures, either of the veneer material or at the core-veneer interface, are common. Veneering ceramics have low fracture toughness (0.7 – 0.9 MPa·m1/2) compared to zirconia cores. Factors contributing to veneer fractures include material porosity, chewing stress, and thermal expansion mismatches.
Enhancements like leucite addition or heat treatment may improve fracture resistance, but challenges remain in balancing aesthetics with durability. Compatibility between core and veneer materials is crucial.
Marginal Discrepancy
Marginal fit is critical for restoration longevity. Gaps can lead to cement leakage, secondary caries, and complications. CAD-CAM systems generally provide better fit than CAM systems, though discrepancies persist. Post-sintered milling offers better accuracy for complex restorations but has drawbacks like extended milling time and tool wear.
The overall performance of zirconia FPDs was satisfactory based on USPHS criteria and CDA evaluations. Issues such as fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancies in zirconia-based restorations were identified as causes of failure.
Still, a Zirconia dental implant is much more durable and long lasting than traditional dental implants made of materials like ceramic.
Preparing for Immediate Dentures: What to Expect
Getting immediate Zirconia dentures involves more than just a single visit—it’s a process that requires preparation and patience.
In the initial days with immediate dentures, discomfort and adjustments are normal as your mouth adjusts to the new changes. Expect some oozing from extraction sites and increased saliva production due to the foreign object in your mouth.
As the numbness wears off, you might feel like there’s no space for your tongue and that speaking clearly is challenging. Rest assured, these issues are temporary as you adapt to wearing dentures.
Prepare for Post-Operative Care
Planning ahead is key. After getting immediate dentures, your diet will need to shift. Focus on soft foods that are easy to chew for the first two to three months. Gradually, you’ll be able to enjoy a wider range of foods as your mouth adjusts.
Recommended Soft Foods:
- Soft scrambled eggs
- Smoothies
- Warm soup or broth
- Yogurt
- Cooked cereal
- Ripe bananas
- Creamed potatoes
- Well-cooked vegetables
- Flaky baked fish
Let friends, family, and colleagues know about your situation. They can assist with meal preparations or help manage other responsibilities, making your journey to permanent teeth smoother.
Immediate Denture Process
- Teeth Removal: Your denturist or oral surgeon will ensure you’re comfortable before removing your teeth and performing any necessary oral surgery. This sets the stage for fitting your immediate permanent or removable dentures.
- Fitting Immediate Dentures: While still numb, your dentist will place and adjust your dentures to minimize discomfort. Sometimes, adjustments are needed to improve the fit and ensure proper contact with your gums, aiding in bleeding control and healing.
- Healing Stage: Healing varies by individual. Initial healing involves clot formation and tissue growth at extraction sites. Full recovery, including bone and gum remodeling, can take from three to twelve months. Your dentist will guide you through this process.
- Fitting Permanent Dentures: After your gums and bone have healed, new impressions of your mouth are taken to create permanent dentures. You’ll get to preview and adjust these trial dentures to ensure the final product meets your expectations before the final dentures are made and fitted.
Following these steps and preparing for the transition will help make the immediate denture process smoother and more comfortable.
Prep for Dental Zirconia Implants
Preparing for dental zirconia implants involves a series of important steps to ensure a successful outcome and optimal healing. The weeks leading up to your dental implant surgery may be frightening, but your experienced implant dentist will minimize the risk of implant failure and guide you through this process.
1. Consultation and Planning
Schedule a consultation with your dentist to assess your oral health and determine if zirconia implants are suitable for you. This may include X-rays, CT scans, or digital imaging to evaluate bone density and structure. Significant bone loss or poor bone tissue could mean that standard dental implants are not an option.
Discuss your treatment plan, including the number of implants needed and the timeline for the procedure. Some Zirconia dentures require more implants than others. Your dentist will explain the process and set expectations for recovery and results.
2. Oral Health Preparation
If you have any current dental problems, such as gum disease or cavities, these should be treated before implant placement to ensure a healthy foundation.
If your bone density is insufficient, you may need a bone grafting procedure to build up the bone where the implant will be placed.
3. Dietary Adjustments
In the days leading up to your procedure, eat a balanced diet to support healing. Avoid foods that could irritate your gums or teeth.
Plan for a soft-food diet immediately after the implant placement. This will help you avoid discomfort and ensure proper healing of the surrounding tissues.
4. Lifestyle Modifications
If you smoke, try to quit or reduce smoking before the procedure, as smoking can impair healing and increase the risk of complications.
Inform your dentist about any medications or supplements you’re taking. Some medications may need to be adjusted or temporarily stopped before the procedure.
5. Procedure Day Preparation
Adhere to any pre-procedure instructions provided by your dentist, such as fasting if sedation will be used. If sedation or general anesthesia is involved, arrange for someone to drive you home after the procedure.
6. Post-Procedure Care
Be prepared for some discomfort post-procedure. Your dentist will provide pain management options and instructions for care.
Follow your dentist’s guidelines for oral hygiene to prevent infection and ensure proper healing around the implants.
7. Follow-Up Appointments
Attend all scheduled follow-up appointments to monitor the healing process and ensure the implants are integrating properly with your bone. Eventually, your new dentures will feel and act like natural teeth.
Discover the Difference at European Denture Center
Ready to transform your smile with high-quality, customized dentures? Our expert team at European Denture Center is here to provide you with personalized care and exceptional results.
Book your consultation today and experience denture implants, immediate dentures, and more designed for your comfort and confidence.